Dr. Tom Colletti
Introduction: The purpose of this article is to review the literature regarding venous thromboembolic prophylaxis in cardiac surgery patients. Specifically, to compare the safety and efficacy of two widely used anticoagulants, unfractionated heparin and the low molecular weight heparin, enoxaparin.
Method: A PubMed literature search was conducted using the termscardiac surgery, unfractionated heparin, enoxaparin, venous thromboembolism, and prophylaxis.
Discussion: There are sparse results of a head-to-head comparison between enoxaparin and unfractionated heparin. Of the literature where this has been looked at, enoxaparin appears to show statistically significant reduction in venous thromboembolism (VTE) with a reduction in major bleeding over unfractionated heparin.
Conclusion: While the literature spanning inpatient medical patients and surgical patients (other than cardiac) shows enoxaparin to be more efficacious and safer than unfractionated heparin, there is limited data regarding this topic as it relates to cardiac surgical patients. Further research is needed in this population in order to reach an informed decision on the best method of pharmacologic VTE prophylaxis.
Farnsworth TC. Safety and Efficacy of Enoxaparin Versus Unfractionated Heparin in The Prevention of Venous Thromboembolic Events After Cardiac Surgery. Lynchburg Journal of Medical Science. 2021; 3(1).
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