retroperitoneal bleed

athomas91 · Jan 17, 2004

i assume this was post-op??

rn4cicu · Jan 17, 2004

no post op! pt was transferred from outlying facility with CP; pt started on Lovenox I guess in preparation for intervention that was going to be done here.

kc ccurn · Jan 17, 2004

gheez, how much Lovenox was he on? Usually if pt's are on a "maintenance" or preventative dose of lovenox it's only 1mg/kg sq bid. If they have a proven clot, like a DVT the dose is higher. What other meds was this guy on? any past history? I've seen plenty of retroperitoneal bleeds but not from Lovenox.

Dinith88 · Jan 17, 2004

I'm betting this retro-bleed would've happened regardless of what type of anticoagulation he/she was being given. The Lovenox surely made it worse, but it's not some side-effect unique to the drug.

(hey KC, that 1mg/kg bid is a big dose for prophylaxis. We usually give 40mg sq qd for prevention(maybe more if patient weighs alot). The 1mg/kg/bid is more for chest pain/dvt)

athomas91 · Jan 17, 2004

i agree w/ the previous post...i have seen a ton of RP bleeds, but they were usually post cath etc....i would guess that there was another pathology re: the bleed and that the lovonox just made it more substantial...

kc ccurn · Jan 22, 2004

(hey KC, that 1mg/kg bid is a big dose for prophylaxis. We usually give 40mg sq qd for prevention(maybe more if patient weighs alot). The 1mg/kg/bid is more for chest pain/dvt)

I think I was having a brain fart or something, our dose is 30mg. sorry:imbar

allsorts · Mar 28, 2004

i agree w/ the previous post...i have seen a ton of RP bleeds, but they were usually post cath etc....i would guess that there was another pathology re: the bleed and that the lovonox just made it more substantial...

i would like your input on rp bleeds...we had a pat.post angioplasty,not on lovenox,not post cardiaccath,with AAA, PVD,who developed fatal rp bleed

Editorial Team / Admin · Mar 28, 2004

re: allsorts' post: "post angioplasty" to me means post angiogram, which increases risk of rp bleed. Was a closure device used??

allsorts · Mar 28, 2004

re: allsorts' post: "post angioplasty" to me means post angiogram, which increases risk of rp bleed. Was a closure device used??

yes,perclose was used

Editorial Team / Admin · Mar 29, 2004

Rp bleed IS one of the possible BIG BAD problems with closure devices. Any time one is used, I am automatically on guard, as it were, for a bleed. They are insidious and often when pt finally has s/sx, it's a HUGE bleed. Esp. if pt has had Lovenox or Plavix or IIB/IIIAs.

I did a quick web search and came up with the following link that may be helpful:

http://nsweb.nursingspectrum.com/ce/ce178.htm

I'm sure there are other sites with good info. Rp is scary.

allsorts · Mar 29, 2004

Rp bleed IS one of the possible BIG BAD problems with closure devices. Any time one is used, I am automatically on guard, as it were, for a bleed. They are insidious and often when pt finally has s/sx, it's a HUGE bleed. Esp. if pt has had Lovenox or Plavix or IIB/IIIAs.
I did a quick web search and came up with the following link that may be helpful:
http://nsweb.nursingspectrum.com/ce/ce178.htm
I'm sure there are other sites with good info. Rp is scary.

thanks for your input-i really appreciate it