Thromboembolieprophylaxe mit unfraktioniertem Heparin (UFH), niedermolekularen Heparinen (NMH) und Pentasaccharid

Zusammenfassung

Zusammenfassend kann gesagt werden, dass die bisher in Vergleichsstudien individuell getesteten niedermolekularen Heparine (NMH) bezüglich ihrer antithrombotischen Wirksamkeit bei einmaliger Applikation pro Tag einer mehrfach täglichen Gabe von unfraktionierten Heparinen (UFH) zumindest ebenbürtig, zum Teil sogar überlegen sind. Nach dem derzeitigen Kenntnisstand kann somit eine Prophylaxe mit NMH für die Allgemeinchirurgie, Orthopädie und Unfallchirurgie und für nichtchirurgische Patienten, wie z. B. in der Inneren Medizin und während der Schwangerschaft empfohlen werden. Die größte Reduktion des relativen thromboembolischen Risikos gelingt offenbar bei besonders gefährdeten Patienten, d.h. bei Patienten, die trotz LDH(low-dose-heparin)-Prophylaxe immer noch eine hohe Rate thromboembolischer Komplikationen aufweisen.

Summary

In summary it can be said that the once-daily doses of low-molecular-weight heparins (LMWH) tested separately in comparative studies to date are at least equal, or in part even superior, to multiple daily doses of unfractionated heparins (UFH) in terms of antithrombotic efficacy. Thus, in view of current knowledge, prophylaxis with LMWH can be recommended for general surgery, orthopaedic and accident surgery, as well as for non-surgical patients, for instance in internal medicine and during pregnancy. The sharpest reduction of the relative thromboembolic risk is clearly achieved in patients at particularly high risk, i. e. patients who exhibit a high rate of thromboembolic complications despite LDH (low-dose heparin) prophylaxis.

Schlüsselwörter

Niedermolekulares Heparin - unfraktioniertes Heparin - Pentasaccharid - Thromboembolieprophylaxe - chirurgische Patienten - nichtchirurgische Patienten - Schwangerschaft

Keywords

Low-molecular-weight heparin - unfractionated heparin - pentasaccharide - prevention of thromboembolism - surgical patients - non-surgical patients - pregnancy

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