Hemostatic effects of uniform, low-dose subcutaneous heparin in surgical patients

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Abstract
Two hours before surgery and every 12 h thereafter 5000 units of heparin sodium was administered s.c. to 100 general surgical patients. Hemostasis was evaluated by a template bleeding time and an activated partial thromboplastin time (PTT). The latter was sensitive to 0.05 units/ml of heparin and gave a straight-line response up to 0.2 units/ml. In the great majority of patients, only a modest elevation of PTT occurred 2 and 4 h after heparin therapy. In 10-15% the PTT was prolonged 2 .times. or more and in a similar number, PTT after surgery was shorter than baseline values despite heparin. No correlation between PTT prolongation and weight, ponderal index, age or sex was found. Significant bleeding occurred in 3 patients, 2 from the group of hyperresponders to heparin. Recent aspirin ingestion was implicated in 1 patient. Low-dose heparin may potentiate aspirin-induced prolongation of bleeding time in certain individuals. Local hematoma formation and discomfort from injections was not a problem.