PMID- 34491950
OWN - NLM
STAT- MEDLINE
DCOM- 20210917
LR  - 20210917
IS  - 1078-7496 (Print)
IS  - 1078-7496 (Linking)
VI  - 28
IP  - 5
DP  - 2021 Sep-Oct 01
TI  - Venous Thromboembolism Chemoprophylaxis in Trauma and Emergency General Surgery 
      Patients: A Systematic Review.
PG  - 323-331
LID - 10.1097/JTN.0000000000000606 [doi]
AB  - BACKGROUND: Appropriate venous thromboembolism (VTE) chemoprophylaxis in trauma 
      and emergency general surgery (EGS) patients is crucial. OBJECTIVE: The purpose 
      of this study is to review the recent literature and offer recommendations for 
      VTE chemoprophylaxis in trauma and EGS patients. METHODS: We conducted a 
      literature search from 2000 to 2021 for articles investigating VTE 
      chemoprophylaxis in adult trauma and EGS patients. This study was conducted in 
      accordance with the Preferred Reporting Items for Systematic Reviews and 
      Meta-Analysis (PRISMA) guidelines. RESULTS: Our search resulted in 34 articles. 
      Most studies showed low-molecular-weight heparin (LMWH) is similar to 
      unfractionated heparin (UFH) for VTE prevention; however, LMWH was more commonly 
      used. Adjusted chemoprophylaxis dosing did not change the VTE rate but the timing 
      did. Direct oral anticoagulants (DOACs) have been shown to be safe and effective 
      in trauma and traumatic brain injury (TBI)/spinal cord injury (SCI). Studies 
      showed VTE prophylaxis in EGS can be inconsistent and improves with guidelines 
      that lower VTE events. CONCLUSIONS: There may be no benefit to receiving LMWH 
      over UFH in trauma patients. In addition, different drugs under the class of LMWH 
      do not change the incidence of VTE. Adjusted dosing of enoxaparin does not seem 
      to affect VTE incidence. The use of DOACs in the trauma TBI and SCI setting has 
      been shown to be safe and effective in reducing VTE. One important consideration 
      with VTE prophylaxis may be the timing of prophylaxis initiation, specifically as 
      it relates to TBI, with a higher likelihood of developing VTE as time progresses. 
      EGS patients are at a high risk of VTE. Improved compliance with clinical 
      guidelines in this population is correlated with decreased thrombotic events.
CI  - Copyright (c) 2021 Society of Trauma Nurses.
FAU - Sanchez, Carol
AU  - Sanchez C
AD  - Division of Trauma and Surgical Critical Care, Department of Surgery, Kendall 
      Regional Medical Center, Miami, Florida (Mss Sanchez, Nguyen, Baroutjian, and 
      Gill and Drs McKenney and Elkbuli); and Department of Surgery, University of 
      South Florida, Tampa (Dr McKenney).
FAU - Nguyen, Jackie
AU  - Nguyen J
FAU - Baroutjian, Amanda
AU  - Baroutjian A
FAU - Gill, Sabrina
AU  - Gill S
FAU - McKenney, Mark
AU  - McKenney M
FAU - Elkbuli, Adel
AU  - Elkbuli A
LA  - eng
PT  - Journal Article
PT  - Systematic Review
PL  - United States
TA  - J Trauma Nurs
JT  - Journal of trauma nursing : the official journal of the Society of Trauma Nurses
JID - 9512997
RN  - 0 (Anticoagulants)
RN  - 0 (Heparin, Low-Molecular-Weight)
RN  - 9005-49-6 (Heparin)
MH  - Adult
MH  - Anticoagulants/adverse effects
MH  - Chemoprevention
MH  - Heparin
MH  - Heparin, Low-Molecular-Weight
MH  - Humans
MH  - *Venous Thromboembolism/etiology/prevention & control
EDAT- 2021/09/08 06:00
MHDA- 2021/09/18 06:00
CRDT- 2021/09/07 17:21
PHST- 2021/09/07 17:21 [entrez]
PHST- 2021/09/08 06:00 [pubmed]
PHST- 2021/09/18 06:00 [medline]
AID - 00043860-202109000-00009 [pii]
AID - 10.1097/JTN.0000000000000606 [doi]
PST - ppublish
SO  - J Trauma Nurs. 2021 Sep-Oct 01;28(5):323-331. doi: 10.1097/JTN.0000000000000606.