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

The authors have carried out phlebograms on 50 patients with recent pulmonary emboli. In the majority of cases (44 out of 50) they found thrombosis in the veins of the lower limbs: in 35 cases, these were situated proximally, ending in the femoro-ilio-caval segment; in 9 cases they were confined to the suropopliteal veins. These facts have led us to modify our treatment plan for pulmonary embolism. Thrombolytic treatment seems to be justified in cases where the prebitis is high up, even if the pulmonary embolus is benign. Heparin is reserved for those cases of benign pulmonary emboli which are secondary to suro-popliteal phlebitis. The question of interrupting the inferior vena cava must bed ecided in the light of the phlebograms.
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PMID:[Venous signs at the acute stage of pulmonary embolism]. 82 66

The morbidity and incidence of thromboembolic complications can be reduced by patient awareness, nursing staff concern, and physician responsibility using mechanical measures and drugs. Preoperative exercise instrutions, early ambulation, calf exercise, antiembolism hose, postoperative circle-bed turning and use of the Trendelenburg position, the use of intravenous dextran postoperatively and, in selected cases, low doses of sodium warfarin (Coumadin) form the foundation of our approach to the prophylaxis of thromboembolic phenomena. In the presence of thrombophlebitis, phenylbutazone (Butazolidin) is used. Dextran is used with caution in the presence of diminished biliary function. Heparin is avoided except in proven pulmonary embolism. No complications have resulted from this regimen.
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PMID:A multifaceted approach to prevention of thromboembolism: a report of 529 cases. 87 Sep 79

During a period of 28 months 983 gynaecological patients had major abdominal or vaginal operations under Heparin prophylaxis. In no case thrombosis or pulmonary embolism occurred. 5 hemorrhages required surgical revision and temporary reduction of Heparin dose. Global tests for preoperative diagnosis of hemostasis and for postoperative control of Heparin effect are discussed. Possible reactive fibrinolysis under Heparin administration, its complications and control are mentioned. Peri- and postoperative prophylaxis of thrombo-embolism with Heparin in daily dosages up to 20,00 I.U. seems well suitable.
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PMID:[Prevention of thromboembolism with heparin in gynecological and obstetric surgery]. 91

Twenty-one patients with acute traumatic spinal cord lesions who were admitted to our Spinal Unit during 1974 have been treated with Calcium Heparin, using a dosage of 5000-7500 i.u. at 12-hourly intervals from the first days after the lesion until the use of a wheelchair, as a prophylactic measure in order to prevent venous thromboembolism. Of these 21 patients 18 received this treatment continuously, with a resulting 0 per cent of venous thrombosis and 0 per cent of pulmonary embolisms. In the three remaining cases, treatment had to be temporarily interrupted and in one case clinical thrombo-phlebitis was clearly evident. No case of pulmonary embolism was registered. We consider this technique to be very useful in the prophylaxis of thrombo-embolic complications in this type of patient. The use of this type of prophylactic therapy, results and conclusions are discussed.
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PMID:Prophylaxis of venous thrombosis and pulmonary embolism in patients with acute traumatic spinal cord lesions. 99 15

The standard low dose of heparin for the prevention of deep venous thrombosis in patients who are operated upon is 5,000 units administered subcutaneously two hours before operation and at eight or 12 hourly intervals for the next seven days. Heparin in low doses can at present be recommended as an effective agent in the prevention of deep venous thrombosis in patients over the age of 40 years who are undergoing a major abdominothoracic or gynecologic operation. There is reasonable evidence that heparin in low doses also offers a satisfactory protection against fatal pulmonary embolism for patients at high risk after general abdominothoracic operations. The evidence of the effectiveness of low doses of heparin in the prevention of deep venous thrombosis is less well established in other patients and particularly those at high risk, as after urologic and hip operations. This important distinction is to be made in terms of the population at risk and the efficacy of heparin in low doses. Considering the evidence so far available, it appears that the postoperative state in which dextran has been shown to reduce the incidence of phlebographically confirmed deep venous thrombosis most convincingly is after orthopedic operations. Major orthopedic operations are precisely the type in which the superiority of heparin in low doses is controversial. Unless proved otherwise, dextran 70 in an infusion of 500 to 1,000 milliliters of a 6 per cent solution started before operation and 500 milliliters the following and next three alternate days may be the agent of choice in preventing deep venous thrombosis in major orthopedic operations. Using this scheme, the prophylaxis of postoperative deep venous thrombosis appears equally effective with dextran 70 as with oral anticoagulants. Whether the protection offered by dextran 70 will also prevent fatal and nonfatal pulmonary embolism is still an open question. Low doses of heparin and dextran do not expose patients to serious risks of bleeding after operation, and with the recommended doses of the latter drug, other untoward effects are rare. At the doses recommended, neither of these two drugs requires laboratory monitoring.
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PMID:The prevention of postoperative deep vein thrombosis and pulmonary embolism with low dose subcutaneous heparin and dextran. 99 22

Pulmonary embolism is one of the common complications of aortocoronary artery graft surgery. During one year period, 22 patients had documented evidence of pulmonary embolism out of 231 patients who were operated. There were four deaths and all confirmed by autopsy. Clinical signs of phlebitis were absent in many cases of pulmonary embolism. Elastic stockings were not effective to prevent phlebitis. Heparin did not prevent deaths in all four patients. Heparin therapy and aggressive caval interruption by Modin-Uddin umbrella has eliminated deaths in the last 450 cases.
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PMID:Incidence and prevention of pulmonary embolism after coronary artery surgery. 107 2

The mechanism and significance of elevated levels of serum fibrin degradation products (FDP) in pulmonary embolism were investigated experimentally. Dogs were embolized with autologous blood clot-incorporating canine 125I-fibrin and were infused with either saline, heparin, or streptokinase. Serial measurements were made of total FDP by hemagglutination inhibition assay and of radioactive FDP. After saline, the peak level of total FDP was 323 mug/ml, but radioactive FDP was only 8 mug/ml. After heparin, these values were 44 and 11 mug/ml, respectively, and after streptokinase, 415 and 20 mug/ml. The results suggest that under these experimental conditions the elevated levels of FDP in pulmonary embolism are derived mainly from lysis of fibrin deposited after embolization rather than from lysis of the original embolus. Heparin inhibits both fibrin deposition and elevation of FDP levels after embolism.
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PMID:Mechanisms for elevated fibrin/fibrinogen degradation products in acute experimental pulmonary embolism. 111 42

In a randomized series of patients who underwent gynaecological operations, the prophylactic effect on thrombophlebitis of low dose Heparin was compared to that of oral anti-coagulants. One group (n = 221) received Heparin (Liquemin Roche) subcutaneously in a dosage of 5000 units 2 hours pre-operatively and every 12 hours until the eighth post-operative day. The control group (n = 237) continued to receive the conventional prophylactic medication with Sintrom by mouth from the second post-operative day to complete ambulation keeping the quick test between 20 and 30%. The two groups were more or less identical regarding several risk factors and the following results were obtained: 1. The number of cases of deep thrombophlebitis diagnosed by the I-125-Fibrinogen test was significantly less in the group receiving Heparin than in the group receiving Sintrom. Clinical examination showed the same correlation but only detected 30% of all cases of deep thrombophlebitis. 2. The clinical suspicion of pulmonary embolism was more frequent in the group of patients receiving low dosage Heparin. Most of the symptoms were mild and none of the patients died. 3. During the anti-coagulant treatment the incidence of secondary bleeding was the same in both groups. The prevention of deep thrombophlebitis by low dosage Heparin is a very effective and simple method with few side effects and is superior to the post-operative prophylaxis with oral anti-coagulants.
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PMID:[A comparison of low dose heparin and oral anticoagulants in the prevention ot thrombo-phlebitis following gynaecological operations (author's transl)]. 118 92

The treatment of thrombophlebitis in pregnancy with streptokinase is reviewed. Four personal cases are reported. In 3 cases the streptokinase treatment of thrombosis was carried out in the first trimester of pregnancy. Two pregnancies ended in spontaneous term deliveries of well infants without malformations. In one case the pregnancy ended by a spontaneous abortion two weeks following the treatment of the thrombosis. It is suggested that the abortion was much more likely due to a severe state of shock with pulmonary embolism following laparotomy in early pregnancy. The authors are of the opinion that the thrombolytic therapy with streptokinase should also be carried out in the first trimester of pregnancy to prevent embolization of thrombotic material and to prevent a post-thrombotic syndrome. In each case, streptokinase treatment should be followed up with subcutaneous prophylactic treatment with Heparin until term to prevent recurrent thrombophlebitis in pregnancy. With the onset of labour Heparin medication should be interrupted and the thrombin time should be normal with the beginning of the second stage of labour or the Heparin effect should be neutralized by protamine chloride. At the earliest six hours postpartum, the subcutaneous Heparin prophylaxis can be resumed in order to prevent recurrent thrombo-embolism during the postpartum stay.
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PMID:[The treatment of thrombosis in pregnancy (author's transl)]. 121 58

The Heparin Study in Internal Medicine (HESIM) compares the efficacy and safety of an unfractionated (UF) heparin with a low molecular weight (LMW) heparin (CY 216 D) for prevention of proximal deep vein thrombosis (DVT) and pulmonary embolism (PE) in medical inpatients with a high risk for development of thromboembolism. Patients are randomized and receive three times daily 5000 IU UF heparin or once daily 3100 IU LMW heparin and two placebo injections subcutaneously for 10 days. All patients are screened for the presence of proximal DVT at day 1 and 10 by real-time B-mode compression sonography and for PE by repeated clinical examinations. Perfusion scintigraphy is used for confirmation of the clinical diagnosis of PE. The study protocol includes a stratified randomization of patients on admission to the hospital according to one of the following main diagnoses: malignant disease, cardiovascular disease, bronchopulmonary disease, neurologic disease, and other diseases. The present study may serve as a model for further clinical trials in medical inpatients using the biometric approach of statistical analysis for proving equivalence of drug efficacy, and to adopt less sensitive but noninvasive methods for the detection of primary endpoints.
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PMID:Heparin Study in Internal Medicine (HESIM): design and preliminary results. 133 5


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