Effects of low-molecular-weight heparin and unfractionated heparin on traumatic disseminated intravascular coagulation
Purpose: To explore the effects of unfractionated heparin (UFH) and low-molecular-weight heparin (LMWH) on traumatic disseminated intravascular coagulation (DIC).
Methods: A total of 77 cases of severe trauma (APACHE II score: 5 – 10) with DIC were collected and randomly assigned to one of three groups: LMWH treatment - 26 cases were subcutaneously injected with LMWH (75–150 units/kg/d); UFH treatment - 25 cases were subcutaneously injected with UFH (100 – 250 units/kg/d); control - 26 cases supplemented with blood coagulation factor only. Daily mortality in the intensive care unit (ICU), hospitalization time, bleeding rate, thrombin time, prothrombin time, activated partial thromboplastin time, and levels of fibrinogen, antithrombin III (ATIII), and D-dimer were recorded and analyzed.
Results: In ICU, LMWH and UFH treatments resulted in lower mortality than in the control group. In addition, hospitalization time was longer in patients treated with LMWH and UFH than in control patients. No significant differences were found between LMWH-treated and control patients in terms of bleeding rate, but UFH-treated patients had lower bleeding rates than control patients. Multifactor analysis indicate a strong relationship between ATIII levels and bleeding rate.
Conclusion: The results indicate that low-dose UFH and LMWH are effective options for the treatment of DIC.
Keywords: Trauma, Disseminated intravascular coagulation, Unfractionated heparin, Low-molecularweight heparin, Fibrinogen, Antithrombin