retroperitoneal bleed

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I have been taking care of a pt that had a retroperitoneal bleed secondary to Lovenox injection. This is the first time I have heard of this and was wondering how frequently you see this in your practice???

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i assume this was post-op??

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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.

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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.

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Specializes in CCU/CVU/ICU.

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)

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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...

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(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

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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
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Specializes in RETIRED Cath Lab/Cardiology/Radiology.

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

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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
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Specializes in RETIRED Cath Lab/Cardiology/Radiology.

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.

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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
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