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Journal of Thrombosis and Thrombolysis
Published in: Journal of Thrombosis and Thrombolysis 1/2016

Open Access 01-01-2016

Guidance for the practical management of the heparin anticoagulants in the treatment of venous thromboembolism

Authors: Maureen A. Smythe, Jennifer Priziola, Paul P. Dobesh, Diane Wirth, Adam Cuker, Ann K. Wittkowsky

Published in: Journal of Thrombosis and Thrombolysis | Issue 1/2016

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Abstract

Venous thromboembolism (VTE) is a serious and often fatal medical condition with an increasing incidence. Despite the changing landscape of VTE treatment with the introduction of the new direct oral anticoagulants many uncertainties remain regarding the optimal use of traditional parenteral agents. This manuscript, initiated by the Anticoagulation Forum, provides clinical guidance based on existing guidelines and consensus expert opinion where guidelines are lacking. This specific chapter addresses the practical management of heparins including low molecular weight heparins and fondaparinux. For each anticoagulant a list of the most common practice related questions were created. Each question was addressed using a brief focused literature review followed by a multidisciplinary consensus guidance recommendation. Issues addressed included initial anticoagulant dosing recommendations, recommended baseline laboratory monitoring, managing dose adjustments, evidence to support a relationship between laboratory tests and meaningful clinical outcomes, special patient populations including extremes of weight and renal impairment, duration of necessary parenteral therapy during the transition to oral therapy, candidates for outpatient treatment where appropriate and management of over-anticoagulation and adverse effects including bleeding and heparin induced thrombocytopenia. This article concludes with a concise table of clinical management questions and guidance recommendations to provide a quick reference for the practical management of heparin, low molecular weight heparin and fondaparinux.
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Metadata
Title
Guidance for the practical management of the heparin anticoagulants in the treatment of venous thromboembolism
Authors
Maureen A. Smythe
Jennifer Priziola
Paul P. Dobesh
Diane Wirth
Adam Cuker
Ann K. Wittkowsky
Publication date
01-01-2016
Publisher
Springer US
Published in
Journal of Thrombosis and Thrombolysis / Issue 1/2016
Print ISSN: 0929-5305
Electronic ISSN: 1573-742X
DOI
https://doi.org/10.1007/s11239-015-1315-2

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New intervention for STEMI-related cardiogenic shock

10-04-2024 Myocardial Infarction News

» View more highlights on the ACC 2024 congress hub page

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