A total of 50 patients will be enrolled in this double-blinded, randomized, controlled trial. Inclusion criteria: subjects>40 yrs of age with an expected hospital stay in the Medical Intensive Care or Regional Heart Unit at LVH Muhlenberg of 6 days or longer (4 days bedridden) will be enrolled. Total drug treatment will be 6-14 days while in the hospital. A follow up phone call will be performed by the study team approximately 30 days after hospital discharge. Primary endpoint: bleeding rate (minor vs major) between study days 1-14. Secondary endpoint: DVT study days 1-14 (confirmed with LE duplex ultrasonogram).

Inclusion Criteria:

• Male or female > 40 years of age.

• Pt with expected stay in hospital 6 days or >, with expectation to be bedridden for

  4 days.

• Pts admitted to the MICU, Regional Heart Units of LV-MHC

Exclusion Criteria:

• Surgical primary admission diagnosis

• Recent surgery within the past 12 weeks

• Planned surgery on the current admission

• Pregnancy

• Vent-dependent respiratory failure requiring intubation for >24 hours.

• Known current DVT or PE prior to enrollment in study.

• Creatinine clearance < 30 mL/min (calculated by the Cockcroft-Gault method) in a well-hydrated patient.

• Hx of prior or current lower upper or lower GI bleed.

• Platelet count < 100,000 per cubic millimeter

• Current or prior anticoagulation within the prior 48 hours, excluding a single dose &lor 24 hour period of prophylactic agent

• Bacterial endocarditis.

• Hemophilia

• Hypersensitivity to aspirin.

• Hypersensitivity to Arixtra or Lovenox

• Hx of hemorrhagic or ischemic stroke < 3 months prior to enrolling

• Hematocrit < 28%.

• SBP >200 mmHg or DBP >120 mmHg

• Positive for occult blood in stool.

• Admission to hospital for > 48 hours prior to randomization

• Documented congenital or acquired bleeding disorder

• Indwelling intrathecal or epidural catheter

• Life expectancy < 30 days

• Inability to have a flu assessment post-discharge from the hospital