Thromb Haemost 2008; 99(03): 502-510
DOI: 10.1160/TH07-08-0500
Review Article
Schattauer GmbH

Treatment of pulmonary embolism: The use of low-molecularweight heparin in the inpatient and outpatient settings

Russell D. Hull
Financial support: The author received editorial (writing) support in the preparation of this manuscript, funded by sanofi-aventis, NJ, USA. The author is fully responsible for content and editorial decisions for this manuscript.
Further Information

Publication History

Received: 09 August 2007

Accepted after major revision: 21 January 2008

Publication Date:
07 December 2017 (online)

Summary

Pulmonary embolism (PE) remains a major clinical problem associated with considerable mortality and morbidity. In patients with PE, appropriate anticoagulant therapy has been shown to significantly reduce both recurrence and mortality. Low-molecular- weight heparin (LMWH) is at least as effective as unfractionated heparin (UFH) in the treatment of PE,with a similar risk of bleeding. Furthermore, LMWH offers more predictable pharmacokinetics and anticoagulant effects. As a result, current guidelines from both the American College of Chest Physicians and the joint American College of Physicians/American Academy of Family Physicians recommend the use of LMWH over UFH (in patients with submassive PE). Outpatient treatment with LMWH has been shown to be feasible in many patients,and offers the potential for cost-savings and improvements in healthrelated quality of life. Further data are needed to support an evidence- based recommendation for the use of LMWH in the outpatient treatment of PE.

 
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