NURS5069 Assessment 1: DVT, Heparin, and Thrombus Reformation Search

This assignment details a literature search strategy for a research question focusing on the treatment of deep vein thrombosis (DVT). The student employed the PICOT framework to structure the research question, specifically comparing the effectiveness of heparin injection versus enoxaparin (Clexane) injection in reducing thrombus reformation in adult patients with DVT. The assignment includes a clear articulation of the research question, identification of key concepts, and a justification for the chosen database. It also describes the development of a search syntax to comprehensively cover relevant terms and synonyms. The student explains their methodology and the rationale behind the search strategy, aiming to identify research articles for a critical review of the literature, which will inform subsequent assessments. The assignment adheres to APA 6th referencing guidelines. The exclusion criteria for the studies is also defined in the assignment.

Appendix 2
Author Yea
r
PUBMedId Data patients Intervention Comparator outcome Included/
Excluded
Alaraj, A.,
Wallace, A.,
Tesoro, E.,
Ruland, S.,
Amin-Hanjani,
S., Charbel, F.
T., &Aletich, V.
2010 21990651
With augmented
exposure to heparin
during
neurointerventional
procedures, HIT
incidence would
carry on to amplify.
Patients developing
HIT-II are at greater
risk of suffering
from adverse
thromboembolic
complications.
neurological
patients
heparin Argatroban,
warfarin,
lepirudin.
Bivalirudin,
Danaparoid
heparin induced
thrombocytopeni
a (HIT)
Excuded- No
comparison with
enoxaparin

Antman, E. M.,
Morrow, D. A.,
McCabe, C. H.,
Murphy, S. A.,
Ruda, M.,
Sadowski, Z., ...
& White, H. D.
(2006).
2006 16537665 Myocardial
infarction
management with
enoxaparin during
index hospitalization
is better to
management with
unfractionated
heparin for
approximately 48
hours, however is
connected with an
augmentation in
significant bleeding
episodes.
ST-elevation
myocardial
infarction
heparin enoxaparin nonfatal recurrent
myocardial
infarction or
death
Exc- No DVT
Armstrong, P. 2006 16682709 Enoxaparin had ASSENT-3 and heparin enoxaparin Reinfarction, Exc- No DVT

W., Chang, W.
C., Wallentin,
L., Goldstein,
P., Granger, C.
B., Bogaerts,
K., ... & Van de
Werf, F.
greater benefits
amongst urgently
revascularized
patients, but was
associated to excess
of ICH during the
ASSENT-3 PLUS
trial, particularly
amid females
ASSENT-3 PLUS
patients
mortality, or
refractory
ischemia
Brieger, D.,
Collet, J. P.,
Silvain, J.,
Landivier, A.,
Barthélémy, O.,
Beygui, F., ...
&Costagliola,
2001 20578166 Enoxaparin was
responsible for a
decrease in every one
of ischemic
complications,
additionally
recurrent therapeutic
Primary PCI
(pPCI) patients for
ST elevation
heparin enoxaparin Safety and
efficacy
endpoints
Exc- No DVT

D. anticoagulation, and
failed to induce any
major bleeding
event, in contrast to
unfractionated
heparin. Patients
who had been
administered
enoxaparin
demonstrated an
increased likelihood
of being
therapeutically
anticoagulated for
the duration of the
process (68% vs.

50%, P < 0.0001)
and also
demonstrated a
decreased
susceptibility to
suffer from recurrent
myocardial
infarction (MI) while
being admitted to the
hospital or death
(adjusted OR 0.28
95% CI (0.12–0.68)
or by 30 days
(adjusted OR 0.35
95% CI 0.16–0.81).
A decrease was also

observed in all cause
mortality in hospital
(adjusted OR 0.32,
95% CI (0.12–0.85)
and to 30 days
(adjusted OR 0.40
95% CI 0.17–0.99).
Bugiardini, R.,
Dorobantu, M.,
Vasiljevic, Z.,
Kedev, S.,
Knežević, B.,
Miličić, D., ...
& Ricci, B.
2015
25988359
Combination of UFH
and Clopidogrel was
allied with a
significant mortality
decrease amongst
STEMI patients who
did not undergo
reperfusion therapy,
and failed to
Patients from
International
Survey on Acute
Coronary
Syndromes in
Transition
Countries
unfractionated
heparin
enoxaparin in-hospital
mortality,
clinically
significant
bleeding, and
intracranial
hemorrhages
Exc-No
comparison with
enoxaparin

considerably
augment the danger
of major bleeding.
Çaça, I., Şahin,
A., Cingü, A.
K., Ari, Ş.,
Alakuş, F.,
&Çinar, Y.
2012 23166871 Cataract
surgery complication
s connected with
postoperative
inflammatory
response appeared to
reduce with
administration of
enoxaparin in
intraocular infusion
solution.
53 children having
congenital cataract
enoxaparin none inflammatory
response
Exc- congenita
cataract surgery
and no comparison
Dee, B.,
Thomas, L. L.,
2014 24733133 A 63-year-old male
suffering from renal
63-year-old
Caucasian male
Argatroban
and alteplase
none HITT Exc- No
comparison o

& Gulbis, A. amyloidosis, in
addition to superior
vena cava syndrome
(SVC) secondary to
heparin-induced
thrombocytopenia
with thrombosis
(HITT) underwent
successful treatment
with argatroban
administration and
CDT with alteplase
administration.
heparin with
enoxaparin
El-Rayes, M.,
Schampaert, E.,
Tardif, J. C.,
2010 20931096 No substantial
variation among
unfractionated
STEMI patients
obtaining
fibrinolytic therapy
unfractionated
heparin
enoxaparin safety and
efficacy
Exc- Acute
Myocardial
Infarction, no DVT

Eisenberg, M.
J., Afilalo, M.,
Kouz, S., ...
&Dery, J. P.
heparin and
enoxaparin group in
safety and
effectiveness
Gabriel, R. S.,
& White, H. D.
2007 17867915 The overall clinical
advantage of
enoxaparin greater
than unfractionated
heparin was
maintained not
considering if all
patients had been
administered
clopidogrel, or if
percutaneous
coronary
Patients from
ExTRACT-TIMI 2
5 trial
Unfractionated
heparin
enoxaparin nonfatal
myocardial
infarction, major
bleeding or death
Exc- Myocardia
infarction, no DVT

intervention had
been conducted.
Hardy, R. G.,
Williams, L., &
Dixon, J. M.
2008 18425795 LMWH
thromboprophylaxis
demonstrated a
significant
association with an
augmentation in
haemorrhagic
complications
following breast
surgery, in
comparison to UFH.
Patients with
postoperative
breast haematoma
unfractionated
heparin
enoxaparin Haematoma
rates, surgical
intervention
Exc- breast surgery
Heyes, G. J.,
Tucker, A.,
Michael, A. L.
2015 26037973 Conservative
treatment for the
management of
945 consecutive
patients
none none incidence of
DVT, incidence
of pulmonary
Exc- DVT
incidence, no
comparison

R., & Wallace,
R. G. H.
Tendo Achilles was
associated with a
significant increase
in the occurrence of
symptomatic DVT in
the general
population
embolism
Ikesaka, R.,
Delluc, A., Le
Gal, G., &
Carrier, M.
2014 24508449 Adjustment in the
dosage of heparin for
thromboprophylaxis
after bariatric
surgery
demonstrated a
correlation with
decreased hospital
VTE rate, in contrast
6 studies Heparin
prophylaxis
none hospital rate of
VTE and major
bleeding
Exc- No
comparison with
enoxaparin

to not adjusting
heparin dosage, even
though there was no
statistical
significance.
Joannidis, M.,
Kountchev, J.,
Rauchenzauner,
M.,
Schusterschitz,
N., Ulmer, H.,
Mayr, A.,
&Bellmann, R.
2007 17563874 Enoxaparin can be
carefully
administered for
anticoagulation at the
time of CVVH
causing greater filter
lifespan, in contrast
to unfractionated
heparin.
40 adult surgical
ICU and medical
patients
unfractionated
heparin
enoxaparin filter life span,
major bleeding,
cost analysis
Exc- continuous
veno-venous
hemofiltration, no
DVT
Jones, H. U.,
Muhlestein, J.
2005 16039196 Early postoperative
administration of
2,977 successive
valve or open-
unfractionated
heparin
enoxaparin surgical re-
exploration and
Exc-No DVT