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December 17, 1973

High-Dosage Heparin Treatment of Large Burns

JAMA. 1973;226(12):1464. doi:10.1001/jama.1973.03230120046022

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To the Editor.—  The article of M. J. Saliba et al (225:261-269, 1973) and the editorial of Francis D. Moore (225:294-295, 1973) reported and commented upon the heparin treatment of large burns in humans. The excellent results proved the value of the authors' method. I should like to underline another important advantage of the high-dosage heparin treatment in burns: the successful prevention of disseminated intravascular coagulation (DIS)-related acute renal insufficiency.In our patients with severe coagulation disorders due to obstetrical complications, the DIC-related renal insufficiency could be prevented only if the Lee-White clotting time was maintained above 30 minutes. Insufficient heparinization in burns, as well as in other forms of DIC, does not eliminate the danger of bilateral renal cortical necrosis. In addition, we did not encounter occult or manifest bleeding, if adequate doses of heparin were given during the treatment of DIC or during hemodialysis.