Differentiating the Effects of Prophylactic Unfractionated Heparin Infusion by Rotational Thromboelastometry in Sepsis

Background and Aims Coagulation abnormalities are relatively common among septic patients. The standard of care for preventing thrombosis in critically ill patients is subcutaneous administration of unfractionated heparin 2 or 3 times a day, which fails in some cases. We studied the influence of continuous intravenous infusion of equivalent doses on coagulation profile using rotational thromboelastometry. Subjects and Methods Patients were randomly allocated to the subcutaneous group (n = 15) or infusion group (n = 15). The subcutaneous group received 5000 units 3 times a day, whereas the infusion group received heparin 500 units/hour intravenously. Results Clotting times were significantly lower in the infusion group compared with the subcutaneous group on days 2 and 7 (P < 0.05). Clot formation times were also significantly lower in the infusion group both on days 2 and 7 (P < 0.05). Conclusions Intravenous infusion of low-dose heparin might provide more efficient thromboprophylaxis in septic patients. This method could be used in those who are at higher risk of thrombosis.