{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,17]],"date-time":"2025-10-17T00:35:13Z","timestamp":1760661313531,"version":"build-2065373602"},"reference-count":8,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[1989,5,1]],"date-time":"1989-05-01T00:00:00Z","timestamp":609984000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Parenter Enteral Nutr"],"published-print":{"date-parts":[[1989,5]]},"abstract":"<jats:p>The use of small amounts of a dilute solution of heparin (\u2264100 IU) to keep indwelling intravenous needles or catheters patent for intermittent venous access either for intravenous therapy or timed blood sampling is a common clinical practice. It is considered safe since the amount of heparin required is much less than that required for heparinization. Herein, we describe a 13\u2010yr\u2010old patient with malabsorption who developed clinically significant bleeding shortly after a diagnostic test which required multiple small injections of heparin for intermittent venous access (total amount of heparin administered was 600 units over 5 hr). The coagulopathy was corrected by a single dose (10 mg) of parenteral vitamin K. As our patient had multiple risk factors for the development of vitamin K deficiency including malabsorption, decreased food intake, and antibiotic use, we postulate that the small amount of heparin precipitated the coagulopathy by increasing the anti\u2010protease activity of antithrombin III on abnormal factors X and II formed in the vitamin K deficient state. We would therefore recommend administration of vitamin K to patients who are at risk of developing vitamin K deficiency before using even small amounts of heparin. (<jats:italic>Journal of Parenteral and Enteral Nutrition<\/jats:italic> <jats:bold>13<\/jats:bold>:324\u2013325, 1989)<\/jats:p>","DOI":"10.1177\/0148607189013003324","type":"journal-article","created":{"date-parts":[[2008,5,14]],"date-time":"2008-05-14T19:51:26Z","timestamp":1210794686000},"page":"324-325","source":"Crossref","is-referenced-by-count":1,"title":["Hazards of Small Amounts of Heparin in a Patient with Subclinical Vitamin K Deficiency"],"prefix":"10.1002","volume":"13","author":[{"given":"M.C.","family":"Shah","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"K.B.","family":"Schwarz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[1989,5]]},"reference":[{"key":"e_1_2_1_2_1","doi-asserted-by":"crossref","first-page":"4095","DOI":"10.1016\/S0021-9258(19)41391-4","article-title":"The functional significance of vitamin K action","volume":"250","author":"Esmon CT","year":"1975","journal-title":"J Biol Chem"},{"key":"e_1_2_1_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3476(85)80656-9"},{"key":"e_1_2_1_4_1","doi-asserted-by":"crossref","first-page":"712","DOI":"10.1542\/peds.73.5.712","article-title":"Vitamin K deficiency in newborns: A case report in alpha\u20101\u2010antitrypsin deficiency and a review of factors predisposing to hemorrhage","volume":"73","author":"Payne NR","year":"1984","journal-title":"Pediatrics"},{"key":"e_1_2_1_5_1","doi-asserted-by":"crossref","first-page":"391","DOI":"10.1111\/j.1365-2141.1973.tb01662.x","article-title":"Factor X inactivation by antithrombin III and evidence for biological stabilization of factor X by factor V phospholipid complex","volume":"24","author":"Marciniak E.","year":"1973","journal-title":"Br J Haematol"},{"key":"e_1_2_1_6_1","first-page":"1348","volume-title":"Goodman and Gilman's The Pharmacologic Basis of Therapeutics","author":"O'Reily RA","year":"1980"},{"key":"e_1_2_1_7_1","doi-asserted-by":"crossref","first-page":"639","DOI":"10.1093\/ajcn\/41.3.639","article-title":"The prevalence of vitamin K deficiency in chronic gastrointestinal disorders","volume":"41","author":"Krasinki SD","year":"1985","journal-title":"Am J Clin Nutr"},{"key":"e_1_2_1_8_1","first-page":"56","volume-title":"Nutrition in Pediatrics, Basic Science and Clinical Application","author":"Schwarz KB","year":"1985"},{"key":"e_1_2_1_9_1","doi-asserted-by":"crossref","first-page":"1916","DOI":"10.1001\/jama.1987.03400140078028","article-title":"Coagulopathy caused by vitamin K deficiency in critically ill, hospitalized patients","volume":"258","author":"Alperin JB","year":"1987","journal-title":"JAMA"}],"container-title":["Journal of Parenteral and Enteral Nutrition"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/aspenjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1177\/0148607189013003324","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,16]],"date-time":"2025-10-16T18:56:36Z","timestamp":1760640996000},"score":1,"resource":{"primary":{"URL":"https:\/\/aspenjournals.onlinelibrary.wiley.com\/doi\/10.1177\/0148607189013003324"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1989,5]]},"references-count":8,"journal-issue":{"issue":"3","published-print":{"date-parts":[[1989,5]]}},"alternative-id":["10.1177\/0148607189013003324"],"URL":"https:\/\/doi.org\/10.1177\/0148607189013003324","archive":["Portico"],"relation":{},"ISSN":["0148-6071","1941-2444"],"issn-type":[{"type":"print","value":"0148-6071"},{"type":"electronic","value":"1941-2444"}],"subject":[],"published":{"date-parts":[[1989,5]]}}}