Heparin therapy: a randomized prospective study.

Eighty patients were assigned randomly either to continuous or to intermittent heparin therapy, with control by the Lee-White Clotting Time (LWCT). Major bleeding complications occurred in 7.5 per cent and minor complications in 18 per cent of the entire group. The incidence of major bleeding complications in the continuous group (5 per cent) did not differ significantly from the incidence in the intermittent group (10 per cent). In contrast, bleeding complications were significantly more frequent in patients with soft-tissue trauma due to such procedures as thoracenteses and cut-downs, vascular damage due to other causes, and LWCTs over 35 minutes for 2 consecutive days. The incidence of bleeding complications appear to be the same in patients receiving intermittent as in those receiving continuous heparin therapy. Thoracenteses, cut-downs, and other forms of soft-tissue injury predispose to bleeding complications while laboratory monitoring with the LWCT may help to reduce bleeding complications.