Related Experiment Videos
[Venous thrombosis following severe multiple trauma]
D Nast-Kolb1, C Waydhas, C Kerim-Sade
1Chirurgische Klinik und Poliklinik, Ludwig-Maximilians-Universität München.
Der Orthopade
|April 1, 1993
Summary
Severely injured patients show a low rate of clinically relevant deep venous thrombosis (DVT), despite high risk. Early fluid resuscitation and balanced coagulation/fibrinolysis systems may explain this finding.
Area of Science:
- Trauma Surgery
- Vascular Medicine
- Hematology
Context:
- Thromboembolic complications, particularly deep venous thrombosis (DVT), pose a significant risk for patients with multiple injuries.
- Previous studies report high DVT incidence (20-90%) in trauma patients using invasive diagnostics, but clinically relevant events are less frequent.
- This study investigates DVT rates and contributing factors in a prospective cohort of severely injured patients.
Purpose:
- To determine the incidence of clinically relevant deep venous thrombosis (DVT) in patients with multiple injuries.
- To analyze the role of coagulation and fibrinolytic systems in severely injured patients.
- To explore the potential prophylactic effect of early fluid resuscitation on thromboembolic complications.
Summary:
- A prospective study of 141 severely injured patients (mean Injury Severity Score 37) found only 1.4% developed clinically relevant DVT, despite 96% being high-risk.
- Analysis revealed simultaneous activation of coagulation and fibrinolytic systems, suggesting a balanced response to injury.
- Early prehospital fluid resuscitation (crystalloid and colloid) may contribute to preventing thromboembolic events.
Impact:
- Challenges the assumption of high DVT rates in all severely injured patients, highlighting the importance of clinical relevance.
- Provides insights into the hemostatic balance in trauma patients, with implications for thromboprophylaxis strategies.
- Suggests early fluid administration as a potential early preventive measure against DVT in trauma care.