PMID- 38390905
OWN - NLM
STAT- MEDLINE
DCOM- 20240306
LR  - 20240314
IS  - 1473-6500 (Electronic)
IS  - 0952-7907 (Linking)
VI  - 37
IP  - 2
DP  - 2024 Apr 1
TI  - Thrombosis prophylaxis following trauma.
PG  - 139-143
LID - 10.1097/ACO.0000000000001351 [doi]
AB  - PURPOSE OF REVIEW: This review explores the persistent occurrence of venous 
      thromboembolic events (VTE) in major trauma patients despite standard thrombosis 
      prophylaxis with low-molecular-weight heparin (LMWH) or unfractionated heparin 
      (UFH). It investigates the inadequacies of standard pharmacologic prophylaxis and 
      proposes alternative approaches not covered in current trauma guidelines. RECENT 
      FINDINGS: Recent studies highlight the effectiveness of monitoring and adjusting 
      subcutaneous LMWH doses based on anti-Xa levels for the purpose of reducing VTE 
      in trauma patients. The need for dose adaptation arises due to factors like 
      fluctuating organ function, varying antithrombin levels, interaction with plasma 
      proteins, and altered bioavailability influenced by oedema or vasopressor use. 
      Additionally, promising alternatives such as intravenous LMWH, UFH, and 
      argatroban have shown success in intensive care settings. SUMMARY: The standard 
      dosing of subcutaneous LMWH is often insufficient for effective thrombosis 
      prophylaxis in trauma patients. A more personalised approach, adjusting doses 
      based on specific effect levels like anti-Xa or choosing an alternative mode of 
      anticoagulation, could reduce the risk of insufficient prophylaxis and subsequent 
      VTE.
CI  - Copyright (c) 2024 Wolters Kluwer Health, Inc. All rights reserved.
FAU - Bosch, Johannes
AU  - Bosch J
AD  - Department for Anaesthesiology and Intensive Care Medicine, Medical University of 
      Innsbruck, Innsbruck, Austria.
FAU - Bachler, Mirjam
AU  - Bachler M
AD  - Institute for Sports Medicine, Alpine Medicine and Health Tourism, UMIT - 
      University for Health Sciences, Medical Informatics and Technology, Hall in 
      Tirol, Austria.
FAU - Fries, Dietmar
AU  - Fries D
AD  - Department for Anaesthesiology and Intensive Care Medicine, Medical University of 
      Innsbruck, Innsbruck, Austria.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20240123
PL  - United States
TA  - Curr Opin Anaesthesiol
JT  - Current opinion in anaesthesiology
JID - 8813436
RN  - 0 (Anticoagulants)
RN  - 9005-49-6 (Heparin)
RN  - 0 (Heparin, Low-Molecular-Weight)
SB  - IM
MH  - Humans
MH  - Anticoagulants/therapeutic use
MH  - Heparin/therapeutic use
MH  - Heparin, Low-Molecular-Weight/therapeutic use
MH  - *Thrombosis/prevention & control
MH  - *Venous Thromboembolism/etiology
MH  - *Wounds and Injuries/complications/drug therapy
EDAT- 2024/02/23 12:42
MHDA- 2024/03/06 06:43
CRDT- 2024/02/23 08:00
PHST- 2024/03/06 06:43 [medline]
PHST- 2024/02/23 12:42 [pubmed]
PHST- 2024/02/23 08:00 [entrez]
AID - 00001503-990000000-00166 [pii]
AID - 10.1097/ACO.0000000000001351 [doi]
PST - ppublish
SO  - Curr Opin Anaesthesiol. 2024 Apr 1;37(2):139-143. doi: 
      10.1097/ACO.0000000000001351. Epub 2024 Jan 23.