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Dicumarol has been given to 1,000 patients for the purpose of preventing postoperative venous thrombosis, pulmonary embolism, and thrombophlebitis. We have found it effective in preventing these complications in cases in which there has been nonfatal pulmonary embolism, thrombophlebitis or a history of previous thrombosis or embolism, and when the drug has been given prophylactically when no thrombosis or embolism has occurred. There is a small risk of bleeding. This can be further minimized by proper administration of the drug and rapid control of excessive prothrombin deficiency. Dicumarol should not be given unless daily and consistently comparable Quick prothrombin time tests are done. Consistently comparable prothrombin time tests depend on the use of thromboplastins of constant potency or on the checking of each new batch of thromboplastin with various dilutions of normal plasma. During the administration of dicumarol the prothrombin should be kept between 10 and 30 per cent of normal. Excessive prothrombin deficiency produced by dicumarol can almost always be controlled by the intravenous administration of large doses (60 to 64 mg.) of menadione bisulfite (synthetic vitamin K). If bleeding occurs as the result of excessive prothrombin deficiency, it can be controlled by transfusions of freshly drawn citrated blood and intravenous administration of large doses of menadione bisulfite.
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Received: October 4, 1944
© 1945 Published by Elsevier Inc.