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Query: UMLS:C0034065 (pulmonary embolism)
 14,979 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Using the radiofibrinogen test and perfusion lung scanning (2-phase pharmacoscintigraphy), the incidence of postoperative thrombosis and pulmonary embolism was determined in a group of 362 operated patients. Low-dose heparin administration (twice 5000 IU daily) was given to 162, combined heparin and dihydroergotamine administration (5000 IU heparin and 0.5 mg dihydroergotamine daily) to 150, while 50 patients received no prophylactic treatment. There was a significant decrease in thrombo-embolism in the heparin/DHE group (8.7% deep-vein thrombosis; 2.7% pulmonary embolism) compared with the heparin group (19.8% and 5.5%, respectively) and the control group (30% and 14%, respectively).
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PMID:[Prevention of postoperative thrombo-embolism by heparin/dihydroergotamine (author's transl]. 33

In a prospective, randomized, assessor-blind multicentre study two antithrombotic subcutaneous regimens were compared in patients undergoing total hip replacement. Group 1 (154 patients) received 750 anti-Xa units of a new low molecular weight heparinoid (Lomoparan) subcutaneously twice a day and group 2 (155 patients) received 5000 units heparin and 0.5 mg dihydroergotamine (heparin-DHE 5000) twice a day. The incidence of deep vein thrombosis, assessed by routine bilateral venography on day 10 (+/- 1), was 17 and 32 per cent in groups 1 and 2 respectively (risk reduction 47 per cent; P = 0.007). One patient in each group developed a symptomatic pulmonary embolism confirmed by lung scanning. Major bleeding complications occurred in one patient in each group and no significant difference was observed between the two groups with respect to minor bleeding complications. Subcutaneous Lomoparan appears to be as safe as heparin-DHE 5000 at the above doses with regard to bleeding complications, and is more efficacious with respect to venous thrombosis.
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PMID:Thromboembolic prophylaxis in total hip replacement: a comparison between the low molecular weight heparinoid Lomoparan and heparin-dihydroergotamine. 142 54

Operative or postoperative deep vein thrombosis (DVT) occurs in about 10-30% of the patients undergoing gynecologic surgery, depending on the kind of operation and the presence of predisposing risk factors. Fatal pulmonary embolism is the direct and most severe complication of DVT in 8% of all patients in the postoperative period. DVT commonly results in circulatory insufficiency and ulcers of the lower extremities. The goal of effective prevention of DVT is achieved only by the use of drugs like coumarin, dextran, low dose heparin or low dose heparin-DHE. The therapeutic value of these medicaments and their side effects will be presented and new developments shortly discussed.
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PMID:[Perioperative prevention of thromboembolism in gynecology]. 243 41

The phlebothrombosis and pulmonary embolism are severe postoperative complications. Urological patients are particularly at risk with thrombosis. Therefore it becomes necessary for urology to perform a consequent prophylaxis of thromboembolism which, when an increased risk is present, must contain medicamentous measures. As it is confirmed by evident studies, the low-dose heparin prophylaxis proved as optimum method. A still more effective thrombosis protection can be achieved by the combination of small heparin doses with dihydroergotamine. Retrospectively, 2 comparable groups of urological risk patients with and without heparin prophylaxis were examined. In the adenomectomies under heparin prophylaxis a trend to the reduction of the events of postoperative thromboembolism is revealed. The heparin prophylaxis does not lead to an increase of complications of haemorrhages which need therapy. The prophylaxis of thromboembolism with heparin and a heparin-DHE-combination, respectively, is recommended for the application in urological risk patients.
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PMID:[Significance of drug prevention of thromboembolism in urologic risk patients]. 243 32

The antithromboembolic efficacy of once a day low molecular weight heparin in fixed combination with dihydroergotamine (LMWH-DHE) was compared with conventional heparin-DHE in combination with Acenocoumarol (heparin-DHE/A) in 191 patients undergoing gynaecological surgery. LMWH-DHE proved equally effective in preventing thromboembolic complications, with a similar incidence of postoperative bleeding and side effects. Deep vein thrombosis occurred once in each group and one non-fatal pulmonary embolism occurred in the LMWH-DHE group. The main advantage of LMWH-DHE was significantly better patient acceptance of the single daily subcutaneous injection as compared with the two injections of conventional heparin-DHE (P = 0.02). On the other hand, LMWH-DHE was associated with significantly increased incidence of intraoperative bleeding (P less than 0.02). The bleeding did not, however, cause any clinical problems. Discontinuation of therapy due to bleeding or pain at the site of injection occurred three times in each group. We consider the use of LMWH-DHE to be an attractive, economic and safe method of thromboembolic prophylaxis.
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PMID:A prospective randomized trial of low molecular weight heparin-DHE and conventional heparin-DHE (with acenocoumarol) in patients undergoing gynaecological surgery. 254 52

201 patients aged over 40 years undergoing abdominal surgery were divided randomly into two groups. Each patient received two subcutaneous injections daily: the first group received a morning injection of 1500 aPTT U of low molecular weight heparin combined with 0.5 mg dihydroergotamine (LMH/DHE) and an evening injection of placebo; the second group received morning and evening injections of 2500 IU standard heparin combined with 0.5 mg dihydroergotamine(H/DHE). 25 patients were withdrawn during the course of the trial, 13 in the LMH/DHE group and 12 in the H/DHE group. There was no significant difference between the two groups with regard to age, sex, body weight or history of thromboembolism. 125I-labelled fibrinogen test was routinely used to detect deep vein thrombosis (DVT), which was confirmed by phlebography. Ventilation-perfusion scanning was performed in patients in whom pulmonary embolism was suspected on clinical grounds. DVT occurred in 6 patients in the LMH/DHE group (6.9%) and in 7 patients in the H/DHE group (7.9%). Pulmonary embolism occurred in one patient in each group. The only noteworthy haemorrhagic incident was a haematoma of the abdominal wall in one patient (LMH/DHE). It was concluded that a single daily injection of 1500 aPTT U low molecular weight heparin combined with DHE is as effective and as well tolerated as two injections daily of 2500 IU standard heparin combined with DHE.
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PMID:Prevention of postoperative deep vein thrombosis by one daily injection of low molecular weight heparin and dihydroergotamine. 254 54

In a prospective study the complications of Heparin-Dihydroergotamine (HDHE) [2,500 units Heparin + 0.5 mg DHE] s c. twice daily as thromboembolic prophylaxis have been studied in patients undergoing a lumbar disc operation. During a two year period 616 patients were operated, 47 patients had to be excluded, 107 patients did not receive HDHE desired by the surgeon; 462 patients received HDHE as described in the protocol. Because the distribution of age, sex, duration of hospitalisation of the 107 patients without HDHE is the same as in the HDHE group, this group can be used as control group. Increased intraoperative bleeding--written down in the operation report--66 patients (14.3%) in HDHE group and 6 patients (5.6%) in the control group. There is no statistic significance between the both groups in superficial and deep wound hematomas, deep vein thromboses or pulmonary embolism. In the HDHE group two death appears. Both patients [a 37 year old, asymptomatic woman and a 65 year old man with mild ischemic symptoms 11 months prior to operation] died because of an acute myocardial infarction. The clinical course and the missing of stenosis or occlusion at autopsy let us think at the possibility of coronary arterial spasm, presumably caused by DHE, as the cause of myocardial infarction. We suggest not to apply HDHE to patients with coronary artery heart disease or with atypical thoracic pain.
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PMID:[Complications of thromboembolic prophylaxis with heparin-dihydroergotamine]. 280 59

In a prospective trial 33,421 patients receiving a combination of low molecular weight heparin and dihydroergotamine (LMWH/DHE; Embolex NM) as a routine antithrombotic agent were observed. The patients were recruited from surgical, traumatological, orthopedic, gynecological and urological departments. During the observation period 17 patients suffered from myocardial infarction leading to death in 7 cases. In 63 patients pulmonary embolism occurred, causing death in 12 cases. No irreversible vasospastic reaction due to DHE was seen. In one case a reversible ischaemic reaction in a lower limb was described which might have possibly been due to DHE. The low rate of complications suggests that LMWH/DHE is a safe and highly effective combination with a low risk of vasospastic reactions.
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PMID:[Evaluation of the prevention of perioperative thromboembolism with low molecular weight heparin and dihydroergotamine. A study of the incidence of lethal pulmonary embolisms and undesired symptoms, especially the risk of vasospasm and myocardial infarction]. 319 93

The effect and the degree of safety of administering a fixed combination of 5000 IU of heparin + 0.5 mg dihydroergotamine (HDHE s.c. per every 12 hours) as opposed to 5000 IU of heparin (LDH s.c. every 8 hours) was assessed in a prospective randomized study on 86 patients having undergone major abdominal operation. Postoperatively a deep vein thrombosis was detected by the radiofibrinogen test in 10% of the 40 patients of the HDHE group and in 13% of 46 of the LDH group. Four patients died. At autopsy neither fatal nor a contributing pulmonary embolism was found. 'Non-lethal' pulmonary embolism diagnosed by lung perfusion scintigraphy and by chest X-rays, developed in 2 patients treated with LDH and in one treated with HDHE. Two-thirds of the dose of heparin were identically effective in prevention of venous thromboembolisms than the whole dose if heparin was combined with DHE. The decrease of the heparin dose significantly reduced the number of wound haematomas and of suffusion due to injection.
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PMID:Prevention of postoperative thromboembolisms in general surgery by the combination of heparin and dihydroergotamine. 352 72

Low-molecular heparin-dihydroergotamine had been applied once a day to 103 patients and heparin-dihydroergotamine twice a day to 97 patients as part of a double-blind, controlled, consecutive, and randomised clinical study, with 200 abdominal surgery patients being involved. High-risk patients above 40 years of age and potentially affected by thrombotically predisposing factors were almost equally represented in both groups. Evidence to postoperative thrombosis was phlebographically produced in either group. No fatal pulmonary embolism was found to be among ten deaths. No significant differences of clinical relevance were found to exist between both groups with regard to coagulative values, intra-operative and postoperative blood and drainage loss, and complications due to bleeding. No accumulated occurrence of major postoperative complications was recordable from either group. The vascular status of all patients was unchanged from beginning to end of the period of observation. The following conclusion was drawn as a result of the study: One single NMH/DHE injection daily is comparable with two HDHE applications per die for action and undesired side-effects.
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PMID:[Effectiveness and side effects of low-molecular weight heparin-dihydroergotamine in preventing thromboembolism in abdominal surgery]. 354 5


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