ReviewTH open : companion journal to thrombosis and haemostasis2024
Management of Therapeutic-intensity Unfractionated Heparin: A Narrative Review on Critical Points.
Review in TH open : companion journal to thrombosis and haemostasis, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
8 citing papers in PubMed.
- Fully Synthetic Non-Carbohydrate Heparin Mimetics-Perspectives for Therapeutic Anticoagulation and Beyond?Archiv der Pharmazie · 2026Review
- Viscoelastic point-of-care testing for monitoring unfractionated heparin in critically ill patients: a prospective observational study comparing ClotPro® IN/HI-Test, aPTT and Anti-Xa activity.BMC anesthesiology · 2026Observational
- Case Report: Heparin resistance as the harbinger of heparin-induced thrombocytopenia in acute pulmonary embolism.Frontiers in medicine · 2026Article
- Molecular biomarkers in dialysis-related thrombosis and anticoagulation monitoring: thrombin-antithrombin complex, plasmin-α2-antiplasmin complex, soluble thrombomodulin, tPA/PAI-1/tPAIC, and Anti-Xa.Frontiers in medicine · 2026Review
- Monitoring unfractionated heparin in ECMO and cardiac surgery: the search for a valid reference standard.Frontiers in medicine · 2026Article
- The Impact of Dextran Sulfate on Anti-Xa Assay Outcomes after Unfractionated Heparin Reversal by Excessive Protamine.Indian journal of hematology & blood transfusion : an official journal of Indian Society of Hematology and Blood Transfusion · 2025Article
- Impact of asundexian on a panel of coagulation assays.Research and practice in thrombosis and haemostasis · 2025Article
- "Unraveling the Clot-Miscarriage Nexus: Mechanisms, Management, and Future Directions in Thrombosis-Related Recurrent Pregnancy Loss".Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/HemostasisReview
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Nowadays, unfractionated heparin (UFH) use is limited to selected patient groups at high risk of both bleeding and thrombosis (patients in cardiac surgery, in intensive care unit, and patients with severe renal impairment), rendering its management extremely challenging, with many unresolved questions despite decades of use. In this narrative review, we revisit the fundamental concepts of therapeutic anticoagulation with UFH and address five key points, summarizing controversies underlying the use of UFH and discussing the few recent advances in the field: (1) laboratory tests for UFH monitoring have significant limitations; (2) therapeutic ranges are not well grounded; (3) the actual influence of antithrombin levels on UFH's anticoagulant activity is not well established; (4) the concept of UFH resistance lacks supporting data; (5) scarce data are available on UFH use beyond acute venous thromboembolism. We therefore identified key issues to be appropriately addressed in future clinical research: (1) while anti-Xa assays are often considered as the preferred option, we call for a vigorous action to improve understanding of the differences between types of anti-Xa assays and to solve the issue of the usefulness of added dextran; (2) therapeutic ranges for UFH, which were defined decades ago using reagents no longer available, have not been properly validated and need to be confirmed or reestablished; (3) UFH dose adjustment nomograms require full validation.
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Registered trials
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