Chemoprophylaxis Use and Risk of Venous Thromboembolism and Death in Adult Patients following Orthotopic Liver Transplantation.

Background: Coagulation abnormalities in end-stage liver disease may preclude patients from receiving venous thromboembolism (VTE) prophylaxis immediately following orthotopic liver transplantation.

Methods: To identify risk factors for VTE and death following liver transplantation, a retrospective chart review was conducted in adult liver transplant recipients from January 1, 2001, to October 1, 2011.

Results: In 716 transplantations in 701 patients, the overall incidence of VTE was 2.

Clinically significant venous thromboembolic complications in burn patients receiving unfractionated heparin or enoxaparin as prophylaxis.

The aim of the study is to examine the comparative effectiveness of unfractionated heparin 5000 units given subcutaneously two or three times daily and enoxaparin given 30 mg subcutaneously twice daily or 40 mg daily for the prevention of venous thromboembolism in burn patients. This is a retrospective cohort study conducted in adult burn patients admitted between January 1, 1998, and September 30, 2008, who received only one agent for prophylaxis against venous thromboembolism during their admission. The primary outcome was a symptomatic venous thromboembolism, defined as any lower extremity deep venous thrombosis or pulmonary embolism.

The use of anti-Xa assay to monitor intravenous unfractionated heparin therapy.

Continuous infusion unfractionated heparin (UH) has traditionally been monitored using the activated partial thromboplastin time (aPTT). The use of this test to monitor heparin therapy is not based on randomized controlled clinical trials, and the test is associated with significant intra- and inter-patient variability that is not related to circulating blood heparin activity. Due to these and other limitations, the use of aPTT alone to monitor UF has been questioned.

Review of a large clinical series: once- versus twice-daily enoxaparin for venous thromboembolism prophylaxis in high-risk trauma patients.

Background: Consensus guidelines support the use of low-molecular-weight heparin for venous thromboembolism (VTE) prophylaxis in high-risk trauma patients but do not recommend a specific regimen. The current study compared the effectiveness and safety of enoxaparin 40 mg once-daily versus enoxaparin 30 mg twice-daily for VTE prophylaxis in high-risk trauma patients.

Methods: A retrospective chart review was conducted of all trauma patients older than 18 years of age admitted to Shands at the University of Florida between July 1, 2005 and June 30, 2007, who received either dosing regimen.

Current practice of thromboprophylaxis in the burn population: a survey study of 84 US burn centers.

While there is limited prospective data on the incidence of venous thromboembolism (VTE) in the burn population, there are no prospective studies on the efficacy and safety of VTE prophylaxis in these patients. Despite lack of such data, we hypothesized that most burn centers practice some form of prophylaxis. Eighty-four US burn centers were contacted regarding their modality of VTE prophylaxis, if any.

Methemoglobinemia secondary to topical benzocaine use in a lung transplant patient.

Objective: To report a case of methemoglobinemia secondary to the administration of topical benzocaine spray in an anemic patient who had previously undergone a lung transplant.

Case Summary: A 40-year-old white man with a past medical history significant for lung transplant acutely decompensated following oropharyngeal administration of topical benzocaine spray. Subsequent blood analysis revealed a methemoglobin concentration of 51.

Rash associated with piperacillin/tazobactam administration in infectious mononucleosis.

Objective: To report a case of piperacillin/tazobactam-induced rash in a patient with infectious mononucleosis.

Case Summary: A 25-year-old white man developed a rash while receiving piperacillin/tazobactam 3.375 g intravenously every 6 hours and gentamicin for osteomyelitis complicating a left femur fracture secondary to a motorcycle accident.