Advertisement
Surgery
Advanced searchSave search
Original communication| Volume 17, ISSUE 2, P207-217, February 1945

The use of dicumarol in the prevention of postoperative thrombosis and embolism with special reference to dosage and safe administration

DOI:https://doi.org/10.5555/uri:pii:0039606045901802
The use of dicumarol in the prevention of postoperative thrombosis and embolism with special reference to dosage and safe administration
Previous ArticlePostoperative pulmonary embolism
Next ArticleSurgery of deep venous thrombosis of the lower extremity
      This paper is only available as a PDF. To read, Please Download here.

      Abstract

      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.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Surgery
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Register: Create an account
      Institutional Access: Sign in to ScienceDirect

      References

        • Campbell H.A.
        • Link K.P.
        Studies on the Hemorrhagic Sweet Clover Disease; IV. The Isolation and Crystallization of the Hemorrhagic Agent.
        J. Biol. Chem. 1941; 138: 21-33
        • Stahmann M.A.
        • Huebner C.F.
        • Link K.P.
        Studies on the Hemorrhagic Sweet Clover Disease; V. Identification and Synthesis of the Hemorrhagic Agent.
        J. Biol. Chem. 1941; 138: 513-527
        • Butt H.R.
        • Allen E.V.
        • Bollman J.L.
        A Preparation From Spoiled Sweet Clover [3,3′-Methylene-Bis-(4-Hydroxycoumarin)] Which Prolongs Coagulation and Prothrombin Time of the Blood: Preliminary Report of Experimental and Clinical Studies.
        in: Proc. Staff Meet., Mayo Clin. 16. 1941: 388-395
        • Bingham J.B.
        • Meyer O.O.
        • Pohle F.J.
        Studies on the Hemorrhagic Agent 3,3′-Methylenebis-(4-Hydroxycoumarin); I. Its Effect on the Prothrombin and Coagulation Time of the Blood of Dogs and Humans.
        Am. J. M. Sc. 1941; 202: 563-578
        • Allen E.V.
        • Barker N.W.
        • Waugh J.M.
        A Preparation From Spoiled Sweet Clover [3,3′-Methylene-Bis-(4-Hydroxycoumarin)] Which Prolongs Coagulation and Prothrombin Time of the Blood; a Clinical Study.
        J. A. M. A. 1942; 120: 1009-1015
        • Barker N.W.
        The Use of Dicumarol in Surgery.
        Minnesota Med. 1944; 27: 102-106
        • Barker N.W.
        • Nygaard K.K.
        • Walters Waltman
        • Priestley J.T.
        A Statistical Study of Postoperative Venous Thrombosis and Pulmonary Embolism; III. Time of Occurrence During the Postoperative Period.
        in: Proc. Staff Meet., Mayo Clin. 16. 1941: 17-21
        • Barker N.W.
        • Nygaard K.K.
        • Walters Waltman
        • Priestley J.T.
        A Statistical Study of Postoperative Venous Thrombosis and Pulmonary Embolism; I. Incidence in Various Types of Operations.
        in: Proc. Staff Meet., Mayo Clin. 15. 1940: 769-773
        • Quick A.J.
        • Stanley-Brown Margaret
        • Bancroft F.W.
        A Study of the Coagulation Defect in Hemophilia and in Jaundice.
        Am. J. M. Sc. 1935; 190: 501-511
        • Magath T.B.
        Technic of the Prothrombin Time Determination.
        Am. J. Clin. Path. (Tech. Suppl.). 1939; 3: 187-189
        • Quick A.J.
        The Nature of the Bleeding in Jaundice.
        J. A. M. A. 1938; 110: 1658-1662
        • Overman R.S.
        • Stahmann M.A.
        • Link K.P.
        Studies on the Hemorrhagic Sweet Clover Disease; VIII. The Effect of 2-Methyl-1, 4-Naphthoquinone and 1-Absorbic Acid Upon the Action of 3,3′-Methylenebis(4-Hydroxycoumarin) on the Prothrombin Time of Rabbits.
        J. Biol. Chem. 1942; 145: 155-162
        • Shapiro Shepard
        • Redish M.H.
        • Campbell H.A.
        Prothrombin Studies; III. Effect of Vitamin K Upon Hypoprothrombinemia Induced by Dicumarol in Man.
        in: Proc. Soc. Exper. Biol. & Med. 52. 1943: 12-15
        • Davidson C.S.
        • MacDonald Harriet
        The Effect of Vitamin K1 Oxide on Hypoprothrombinemia Induced by Dicoumarol.
        New England J. Med. 1943; 229: 353-355
        • Lehmann Jörgen
        Thrombosis; Treatment and Prevention With Methylene-Bis-(Hydroxycoumarin).
        Lancet. 1943; 1: 611-613
        • Cromer Jr., H.E.
        • Barker N.W.
        The Effect of Large Doses of Menadione Bisulfite (Synthetic Vitamin K) on Excessive Hypoprothrombinemia Induced by Dicumarol.
        in: Proc. Staff Meet., Mayo Clin. 19. 1944: 217-223

      Article info

      Publication history

      Received: October 4, 1944

      Identification

      DOI: https://doi.org/10.5555/uri:pii:0039606045901802

      Copyright

      © 1945 Published by Elsevier Inc.

      ScienceDirect

      Access this article on ScienceDirect
      We use cookies to help provide and enhance our service and tailor content. To update your cookie settings, please visit the for this site.
      Copyright © 2023 Elsevier Inc. except certain content provided by third parties. The content on this site is intended for healthcare professionals.


      RELX