在高风险儿科创伤患者中进行静脉血栓塞栓预防
Amanda B Witte1, Kyle Van Arendonk2, Carisa Bergner1
1Children's Wisconsin, Medical College of Wisconsin, Milwaukee.
JAMA surgery
|July 31, 2024
概括
化学静脉血栓塞栓症预防 (cVTE) 在高危儿科创伤患者中是安全的. 延迟cVTE启动会增加VTE的风险,这凸显了儿童创伤护理中及时预防的重要性.
科学领域:
- 儿科创伤护理 儿童创伤护理
- 静脉血栓栓塞的预防 预防 静脉血栓塞的预防
- 药理学 药理学是指药理学的学科.
背景情况:
- 在儿童创伤患者中,化学静脉血栓塞栓症预防 (cVTE) 的安全性和有效性尚未得到充分证实.
- 最近的建议提出了使用cVTE的高风险标准,但缺乏前性评估.
研究的目的:
- 预期评估高风险标准和儿童创伤患者中cVTE的使用.
- 评估cVTE在预防静脉血栓塞栓症 (VTE) 的安全性和有效性.
主要方法:
- 一项前性,多机构的队列研究,涉及8个I级儿科创伤中心.
- 包括儿童创伤患者 (<18岁) 满足定义的高风险标准.
- 评估接收,cVTE的时间,VTE率和安全结果 (出血并发症).
主要成果:
- 研究了460名高危儿科创伤患者,54.5%接受了cVTE.
- 在接受24小时内cVTE的患者中,VTE发生在1.6%,24小时后接受cVTE的患者为6.9%,没有接受cVTE的患者为5.3%.
- 延迟cVTE启动 (24小时后) 与增加VTE风险 (或1.01) 有显著的关联.
- 在使用cVTE时没有观察到出血并发症.
结论:
- 在高危儿科创伤患者中,cVTE是安全的,没有观察到出血并发症.
- 及时启动cVTE (24小时内) 对于有效预防VTE至关重要.
- 质量改进工作应集中于优化预防时间和解决实施障碍.
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