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Are IVC filters required in combat support hospitals?
P Parent1, V J F Trottier, D R Bennett
1Canadian Forces Health Services Unit, Kandahar Air Field, Afghanistan, Role 3 MMU, Op Athena Roto 7, Ontario, Canada. philippe.parent@mac.com
Journal of the Royal Army Medical Corps
|April 20, 2010
Summary
Damage control resuscitation for trauma increases thrombotic risks. This case highlights the need for strategies like IVC filters to prevent complications in severely injured patients.
Area of Science:
- Trauma resuscitation
- Thrombotic complications
- Critical care medicine
Background:
- Damage control resuscitation (DCR) is standard for severe trauma, using a 1:1:1 ratio of blood products.
- DCR aims to promote thrombosis but elevates patient risk for thrombotic events.
- Early thromboprophylaxis is often challenging in severely injured patients.
Observation:
- A civilian trauma patient treated with DCR developed a massive pelvic hemorrhage.
- Following DCR, the patient experienced a severe pulmonary embolism.
- The case underscores the prothrombotic potential of DCR strategies.
Findings:
- The use of prothrombotic resuscitation strategies correlates with increased thrombotic complications.
- Severely injured patients in combat support hospitals are a high-risk population.
- Effective thromboprophylaxis remains a challenge in the acute phase of care.
Implications:
- Increased use of DCR necessitates proactive monitoring for thrombotic complications.
- Developing preventative strategies is crucial to maintain DCR's benefits.
- Temporary inferior vena cava (IVC) filters may be a viable option for thromboprophylaxis in high-risk trauma patients.
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