Prospective Study on the Value of a Single Infusion of Dextran 70 During Surgical Operation in the Prevention of Fatal Postoperative Pulmonary Embolism (PE)

At Danderyd’s Hospital a controlled clinical trial of dextran 70 using phlebography in all patients demonstrated a significant reduction in postoperative deep venous thrombosis (DVT) from 52% in the untreated control group to 4% in the dextran group. Johnson et al. 1968. As a consequence, routine prophylaxis of postoperative DVT with dextran 70 was instituted for all patients over 50 years of age undergoing abdominal, orthopedic or urological surgery. A retrospective investigation of. the result of this two-year period of routine prevention with dextran 70, which was preceded and superceded by 2 two-year periods when no dextran was given, revealed the following sequence of fatal PE verified at autopsy over the six-year period:15 (no prophylaxis), 6 (dextran) and 15 (no prophylaxis), Ljungström, 1975.

At this stage a prospective study for a new two-year period was started. Infusion of 100 ml of dextran 70 was started during operation in all patients filling one of the following criteria: 1. All patients over 50 years of age undergoing abdominal, orthopedic or urological surgery. 2. All patients undergoing re-operation regardless of age. 3. All patients undergoing major surgery with a history of previous thromboembolic disease regardless of age.

During this last two-year period only 3 patients died of fatal postoperative PE. The difference between 15 fatal PE in the non-dextran and 3 in the dextran group was significant, P 0.05. A comparable number of surgical operations were performed during each year of the eight-year period.