Deep vein thrombosis: prophylaxis in acute spinal cord injured patients.

Abstract

The purpose of this prospective, randomized study was to evaluate the efficacy of low-dose heparin, alone or in combination with electric stimulation, in the prevention of deep vein thrombosis (DVT) in C2 to T11 motor complete and incomplete-preserved motor, nonfunctional spinal cord injured patients. The tibialis anterior and gastrocnemius-soleus muscle groups were stimulated bilaterally, using 50 microsecond pulses given at 10Hz with a four-second "on" and an eight-second "off" cycle for 23 hours daily over a 28-day period. Forty-eight patients, less than two weeks after injury, were randomly assigned to saline placebo (n = 17), low-dose heparin (5,000U, subcutaneous every eight hours) (n = 16), and low-dose heparin plus electric stimulation (n = 15). A normal 125-I fibrinogen scan and impedance plethysmography were required for entry into the study. Surveillance for DVT was evaluated by daily 125-I fibrinogen scanning. Venography was performed to confirm a positive impedance plethysmography and/or 125-I fibrinogen scanning tests for two consecutive days and at the completion of the study. The incidence of DVT was 8 of 17 in the placebo group, 8 of 16 in the low-dose heparin group, and 1 of 15 in the electric stimulation plus low-dose heparin group. The use of electric stimulation plus low-dose heparin significantly (p less than 0.05) decreased the incidence of DVT compared to the other treatments.

• Authors: G J Merli, G J Herbison, J F Ditunno, H H Weitz, J H Henzes, C H Park, M M Jaweed
• Journal: Archives of physical medicine and rehabilitation (Arch Phys Med Rehabil) Vol. 69 Issue 9 Pg. 661-4 (Sep 1988) ISSN: 0003-9993 [Print] United States
• PMID: 3262334 (Publication Type: Clinical Trial, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't, Research Support, U.S. Gov't, Non-P.H.S.)

Chemical References

• Heparin

Topics

• Electric Stimulation Therapy
• Heparin (administration & dosage, therapeutic use)
• Humans
• Prospective Studies
• Random Allocation
• Spinal Cord Injuries (complications, drug therapy)
• Thrombophlebitis (etiology, prevention & control)