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Venous thromboembolism in multiple trauma patients

B L Erstad1

  • 1Department of Pharmacy Practice and Science, College of Pharmacy, University of Arizona, Tucson 85721-0207, USA.

Pharmacotherapy
|October 3, 1998
PubMed
Summary

Low-molecular-weight heparin is more effective than unfractionated heparin for preventing blood clots in trauma patients. Vena cava filters are an option for high-risk individuals unable to use anticoagulants.

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Area of Science:

  • Trauma and Emergency Medicine
  • Vascular Surgery
  • Pharmacology

Background:

  • Thromboembolic complications are a significant concern in patients sustaining multiple traumas.
  • The prophylactic effectiveness of unfractionated heparin for venous thrombosis in this population remains uncertain.

Purpose of the Study:

  • To evaluate the efficacy of different prophylactic strategies for thromboembolic complications in multiple trauma patients.
  • To compare low-molecular-weight heparin, unfractionated heparin, and compression devices.

Main Methods:

  • Review of limited prospective data comparing anticoagulant therapies and mechanical prophylaxis.
  • Analysis of outcomes related to thromboembolic event prevention.

Main Results:

  • Low-molecular-weight heparin demonstrates greater efficacy than unfractionated heparin for venous thrombosis prophylaxis.
  • Low-molecular-weight heparin shows comparable effectiveness to compression devices.
  • Vena cava filters are indicated for high-risk patients who cannot receive anticoagulants, but carry a risk of recurrent thromboembolism if used long-term without anticoagulation.

Conclusions:

  • Low-molecular-weight heparin is a preferred anticoagulant for thromboembolic prophylaxis in multiple trauma patients.
  • Compression devices offer an alternative prophylactic measure.
  • Vena cava filters serve as a last resort for select high-risk patients, necessitating careful consideration of long-term risks.

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