Perioperativ heparin-bridging er sjaeldent indiceret
Sammanfattning
Meta-analyses of cohort studies and a recent randomized, placebo-controlled study have shown that perioperative bridging of warfarin therapy with therapeutic doses of heparin results in a multi-fold increase in major bleeding but no reduction in the
incidence of thromboembolism. It is time to reconsider heparin bridging: When is heparin bridging superfluous? When is prophylactic dosage indicated? And when is it safe to use therapeutic dosing?