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Thromboprophylaxis AND trauma

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https://www.readbyqxmd.com/read/29153864/changes-in-markers-of-thrombin-generation-and-interleukin-6-during-unicondylar-knee-and-total-knee-arthroplasty
#1
Edwin P Su, Lauren E Mount, Allina A Nocon, Thomas P Sculco, George Go, Nigel E Sharrock
BACKGROUND: Total knee arthroplasty (TKA) is associated with a risk of thromboembolism requiring routine thromboprophylaxis, but there is debate about the risk with unicondylar knee arthroplasty (UKA) as it is a more minor procedure. We sought to investigate the relative risk of thromboembolism with UKA compared to TKA and one-staged bilateral TKA (BTKA) by measuring the increase in circulating biochemical markers of thrombin generation during the procedures. Degree of surgical trauma was also assessed by measuring interleukin-6, a marker of metabolic injury...
October 16, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29088950/neurosurgical-applications-of-viscoelastic-hemostatic-assays
#2
Svetlana Kvint, James Schuster, Monisha A Kumar
Patients taking antithrombotic agents are very common in neurosurgical practice. The perioperative management of these patients can be extremely challenging especially as newer agents, with poorly defined laboratory monitoring and reversal strategies, become more prevalent. This is especially true with emergent cases in which rapid reversal of anticoagulation is required and the patient's exact medical history is not available. With an aging patient population and the associated increase in diseases such as atrial fibrillation, it is expected that the use of these agents will continue to rise in coming years...
November 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/29078906/early-thromboprophylaxis-with-low-molecular-weight-heparin-is-safe-in-patients-with-pelvic-fracture-managed-nonoperatively
#3
Faisal Jehan, Terence O'Keeffe, Muhammad Khan, Albert Chi, Andrew Tang, Narong Kulvatunyou, Lynn Gries, Bellal Joseph
INTRODUCTION: Early initiation of thromboprophylaxis is highly desired in pelvic fracture patients, but it is often delayed due to the fear of hemorrhage. Aim of our study was to assess the safety of early initiation of venous thromboprophylaxis in patients with pelvic trauma managed nonoperatively. METHODS: Three-year (2010-2012) retrospective study of trauma patients with pelvic fractures who were managed nonoperatively and received thromboprophylaxis with low-molecular-weight heparin (LMWH)...
November 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/29071333/association-of-anti-factor-xa-guided-dosing-of-enoxaparin-with-venous-thromboembolism-after-trauma
#4
Charles A Karcutskie, Arjuna Dharmaraja, Jaimin Patel, Sarah A Eidelson, Anish B Padiadpu, Arch G Martin, Gabriel Lama, Edward B Lineen, Nicholas Namias, Carl I Schulman, Kenneth G Proctor
Importance: The efficacy of anti-factor Xa (anti-Xa)-guided dosing of thromboprophylaxis after trauma remains controversial. Objective: To assess whether dosing of enoxaparin sodium based on peak anti-Xa levels is associated with the venous thromboembolism (VTE) rate after trauma. Design, Setting, and Participants: Retrospective review of 950 consecutive adults admitted to a single level I trauma intensive care unit for more than 48 hours from December 1, 2014, through March 31, 2017...
October 25, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28900890/high-level-of-venous-thromboembolism-in-critically-ill-trauma-patients-despite-early-and-well-driven-thromboprophylaxis-protocol
#5
S R Hamada, C Espina, T Guedj, R Buaron, A Harrois, S Figueiredo, J Duranteau
BACKGROUND: Venous thromboembolism (VTE) is one of the most common preventable causes of in-hospital death in trauma patients surviving their injuries. We assessed the prevalence, incidence and risk factors for deep venous thrombosis (DVT) and pulmonary embolism (PE) in critically ill trauma patients, in the setting of a mature and early mechanical and pharmacological thromboprophylaxis protocol. METHODS: This was a prospective observational study on a cohort of patients from a surgical intensive care unit of a university level 1 trauma centre...
September 12, 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28865588/the-effect-of-active-toe-movement-atom-on-calf-pump-function-and-deep-vein-thrombosis-in-patients-with-acute-foot-and-ankle-trauma-treated-with-cast-a-prospective-randomized-study
#6
Ben A Hickey, Andrew Cleves, Raza Alikhan, Neil Pugh, Len Nokes, Anthony Perera
BACKGROUND: Patients with foot and ankle trauma treated with cast are advised to perform toe movements to prevent venous thromboembolism (VTE). Our aim was to determine the effect of active toe movement on asymptomatic deep vein thrombosis (DVT) and venous calf pump function. METHODS: Patients aged 18-60 years with acute foot and ankle trauma requiring below knee non weight bearing cast were randomized to intervention (regular active toe movement) or control groups (n=100)...
September 2017: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28461962/anticoagulation-therapy-and-proximal-femoral-fracture-treatment-an-update
#7
Ioannis Ktistakis, Vasileios Giannoudis, Peter V Giannoudis
Hip fractures in the elderly population have become a 'disease' with increasing incidence.Most of the geriatric patients are affected by a number of comorbidities.Coagulopathies continue to be a special point of interest for the orthopaedic trauma surgeon, with the management of this high-risk group of patients a hot topic of debate among the orthopaedic community.While a universal consensus on how to manage thromboprophylaxis for this special cohort of patients has not been reached, multiple attempts to define a widely accepted protocol have been published...
August 2016: EFORT open reviews
https://www.readbyqxmd.com/read/28338589/managing-hip-fracture-and-lower-limb-surgery-in-the-emergency-setting-potential-role-of-non-vitamin-k-antagonist-oral-anticoagulants
#8
REVIEW
William Fisher
Trauma, immobilization, and subsequent surgery of the hip and lower limb are associated with a high risk of developing venous thrombo-embolism (VTE). Individuals undergoing hip fracture surgery (HFS) have the highest rates of VTE among orthopedic surgery and trauma patients. The risk of VTE depends on the type and location of the lower limb injury. Current international guidelines recommend routine pharmacological thromboprophylaxis based on treatment with heparins, fondaparinux, dose-adjusted vitamin K antagonists and acetylsalicylic acid for patients undergoing emergency HFS; however, not all guidelines recommend pharmacological prophylaxis for patients with lower limb injuries...
June 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28280942/perioperative-risk-factors-for-death-among-patients-with-symptomatic-pulmonary-thromboembolism
#9
REVIEW
(no author information available yet)
Perioperative pulmonary thromboembolism (PTE) is a fatal complication that may occur in patients who are undergoing surgery. This study aimed to identify risk factors for PTE-related death. This study evaluated data for the most recent 5-year period (2007-2011) from the Japanese Society of Anesthesiologists' database of patients who experienced perioperative PTE. We compared patients who died within 30 days of onset and patients who survived for > 30 days, and used logistic regression analysis to identify the independent risk factors...
June 2017: Journal of Anesthesia
https://www.readbyqxmd.com/read/28031644/ineffective-treatment-of-low-molecular-weight-heparin-in-obese-subject-with-traumatic-fractures-of-the-leg
#10
Egidio Imbalzano, Michele Creazzo, Giovanni Trapani, Giuseppina Lizio, Antonino Saitta
American College of Chest Physicians Evidence-Based Clinical Practice Guidelines, 9th edition, 2012, suggest no prophylaxis rather than pharmacological thromboprophylaxis in management of venous thromboembolism (VTE) risk of isolated lower leg injuries distal to knee requiring leg immobilization. Low-molecular-weight heparin (LMWH) is a class of drugs commonly used as antithrombotics in surgery and in case of prolonged bed rest and hypomobility. A 35-year-old obese man with no history of health disease (height, 170 cm; weight, 95 kg; and body mass index, 32...
December 2016: International Journal of Angiology: Official Publication of the International College of Angiology, Inc
https://www.readbyqxmd.com/read/27906870/effectiveness-of-low-molecular-weight-heparin-versus-unfractionated-heparin-to-prevent-pulmonary-embolism-following-major-trauma-a-propensity-matched-analysis
#11
James P Byrne, William Geerts, Stephanie A Mason, David Gomez, Christopher Hoeft, Ryan Murphy, Melanie Neal, Avery B Nathens
BACKGROUND: Pulmonary embolism (PE) is a leading cause of delayed mortality in patients with severe injury. While low-molecular-weight heparin (LMWH) is often favored over unfractionated heparin (UH) for thromboprophylaxis, evidence is lacking to demonstrate an effect on the occurrence of PE. This study compared the effectiveness of LMWH versus UH to prevent PE in patients following major trauma. METHODS: Data for adults with severe injury who received thromboprophylaxis with LMWH or UH were derived from the American College of Surgeons Trauma Quality Improvement Program (2012-2015)...
February 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27874908/rivaroxaban-for-thromboprophylaxis-after-nonelective-orthopedic-trauma-surgery-in-switzerland
#12
MULTICENTER STUDY
Pierre Hoffmeyer, Hanspeter Simmen, Marcel Jakob, Christoph Sommer, Andreas Platz, Thomas Ilchmann, Erik Grossen, Christian Ryf, Panayiotis Christofilopoulos, Michael Schueler, Michael Rud Lassen, Markus Rimle, Urs E Gasser
This study investigated the effectiveness and the outcomes of rivaroxaban vs the standard of care for venous thromboembolic prophylaxis in patients undergoing fracture-related surgery. A total of 413 patients undergoing fracture-related surgery from 9 Swiss orthopedic and trauma centers were enrolled. The authors selected the type of venous thromboembolic prophylaxis according to standardized medical practice at the participating centers before the inclusion of patients: 208 patients received rivaroxaban and 205 received the standard of care...
March 1, 2017: Orthopedics
https://www.readbyqxmd.com/read/27749357/contemporary-thromboprophylaxis-of-trauma-patients
#13
Philbert Y Van, Martin A Schreiber
PURPOSE OF REVIEW: The traumatically injured patient is at high risk for developing venous thromboembolism. Clinical practice guidelines developed by the American College of Chest Physicians and the Eastern Association for the Surgery of Trauma recognize the importance of initiating thromboprophylaxis, but the guidelines lack specific recommendations regarding the timing and dose of pharmacologic thromboprophylaxis. We review the literature regarding initiation of thromboprophylaxis in different injuries, the use of inferior vena cava filters, laboratory monitoring, dosing regimens, and the use of antiplatelet therapy...
December 2016: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/27627722/f11-rs2289252t-and-rs2036914c-polymorphisms-increase-the-activity-of-factor-xi-in-post-trauma-patients-with-fractures-despite-thromboprophylaxis
#14
Nan Song, Ai-Xian Tian, Jian-Min Zhang, Hong-Qiang Jiang, Jia-Cheng Zang, Xin-Long Ma
OBJECTIVE: To evaluate the association between F11 rs2289252, rs2036914 polymorphisms and the activity of clotting factor XI in post-trauma patients with fractures receiving routine anticoagulation therapy for deep venous thrombosis (DVT). METHODS: A case-control study involving 110 consecutive post-trauma patients with fractures and DVT in our hospital was conducted from April 2014 to October 2015; these patients comprised a DVT group. Another 40 sex- and age-matched patients with fractures but without DVT served as controls...
August 2016: Orthopaedic Surgery
https://www.readbyqxmd.com/read/27606807/asian-venous-thromboembolism-guidelines-updated-recommendations-for-the-prevention-of-venous-thromboembolism
#15
Ngoh C Liew, Gina V Alemany, Pantep Angchaisuksiri, Soo M Bang, Gordon Choi, Deidre A DE Silva, Ji M Hong, Limi Lee, Yong J Li, Ganesan N Rajamoney, John Suviraj, Thiam C Tan, Eric Tse, Li T Teo, Julie Visperas, Raymond S Wong, Lai H Lee
The Asian venous thromboembolism (VTE) prophylaxis guidelines were first published in 2012. Since its first edition, the Asian Venous Thrombosis Forum (AVTF) working group have updated the Asian VTE epidemiology and reviewed issues that were not addressed in the previous guidelines. The authors noted that the rising incidence of VTE across Asia may be attributable to aging population, dietary changes, and increasing incidence of obesity and diabetes. The new additions in the guideline include role of thrombophilia in VTE, bleeding risk in Asians, individual risk assessment, updates in the prevention of VTE in medically ill, bariatric surgery, cancer, orthopedic and trauma patients...
February 2017: International Angiology: a Journal of the International Union of Angiology
https://www.readbyqxmd.com/read/27600864/combined-intermittent-pneumatic-leg-compression-and-pharmacological-prophylaxis-for-prevention-of-venous-thromboembolism
#16
REVIEW
Stavros K Kakkos, Joseph A Caprini, George Geroulakos, Andrew N Nicolaides, Gerard Stansby, Daniel J Reddy, Ioannis Ntouvas
BACKGROUND: It is generally assumed by practitioners and guideline authors that combined modalities (methods of treatment) are more effective than single modalities in preventing venous thromboembolism (VTE), defined as deep vein thrombosis (DVT) or pulmonary embolism (PE), or both. This is an update of the review first published in 2008. OBJECTIVES: The aim of this review was to assess the efficacy of combined intermittent pneumatic leg compression (IPC) and pharmacological prophylaxis versus single modalities in preventing venous thromboembolism...
September 7, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27488490/anti-xa-guided-enoxaparin-thromboprophylaxis-reduces-rate-of-deep-venous-thromboembolism-in-high-risk-trauma-patients
#17
George A Singer, Gina Riggi, Charles A Karcutskie, Tanaz M Vaghaiwalla, Howard M Lieberman, Enrique Ginzburg, Nicholas Namias, Edward B Lineen
BACKGROUND: Appropriate prophylaxis against venous thromboembolism (VTE) remains undefined. This study evaluated an anti-Xa-guided enoxaparin thromboprophylaxis (TPX) protocol on the incidence of VTE in high-risk trauma patients based on Greenfield's Risk Assessment Profile (RAP) score. METHODS: This is a retrospective observational study of patients admitted to a trauma intensive care unit over a 12-month period. Patients were included if they received anti-Xa-guided enoxaparin TPX...
December 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27487253/thrombelastography-based-dosing-of-enoxaparin-for-thromboprophylaxis-in-trauma-and-surgical-patients-a-randomized-clinical-trial
#18
RANDOMIZED CONTROLLED TRIAL
Christopher R Connelly, Philbert Y Van, Kyle D Hart, Scott G Louis, Kelly A Fair, Anfin S Erickson, Elizabeth A Rick, Erika C Simeon, Eileen M Bulger, Saman Arbabi, John B Holcomb, Laura J Moore, Martin A Schreiber
Importance: Prophylactic enoxaparin is used to prevent venous thromboembolism (VTE) in surgical and trauma patients. However, VTE remains an important source of morbidity and mortality, potentially exacerbated by antithrombin III or anti-Factor Xa deficiencies and missed enoxaparin doses. Recent data suggest that a difference in reaction time (time to initial fibrin formation) greater than 1 minute between heparinase and standard thrombelastogram (TEG) is associated with a decreased risk of VTE...
October 19, 2016: JAMA Surgery
https://www.readbyqxmd.com/read/27383732/association-between-enoxaparin-dosage-adjusted-by-anti-factor-xa-trough-level-and-clinically-evident-venous-thromboembolism-after-trauma
#19
Ara Ko, Megan Y Harada, Galinos Barmparas, Kevin Chung, Russell Mason, Dorothy A Yim, Navpreet Dhillon, Daniel R Margulies, Bruce L Gewertz, Eric J Ley
Importance: Trauma patients are at high risk for developing venous thromboembolism (VTE). The VTE rate when enoxaparin sodium is dosed by anti-factor Xa (anti-Xa) trough level is not well described. Objective: To determine whether targeting a prophylactic anti-Xa trough level by adjusting the enoxaparin dose would reduce the VTE rate in trauma patients. Design, Setting, and Participants: Single-institution, historic vs prospective cohort comparison study at an urban, academic, level I trauma center...
November 1, 2016: JAMA Surgery
https://www.readbyqxmd.com/read/27060749/risk-factors-and-co-morbidities-in-adolescent-thromboembolism-are-different-than-those-in-younger-children
#20
Titilope Ishola, Susan E Kirk, Danielle Guffey, Katherine Voigt, Mona D Shah, Lakshmi Srivaths
INTRODUCTION: In adolescent thromboembolism (TE), multiple risk factors (RFs) and co-morbidities (CMs) are reported, though overall prevalence has not been evaluated. We hypothesized that the spectrum of RFs/CMs in adolescent TE differs from children overall and sought to review Texas Children's Hospital's experience. PATIENTS/METHODS: Medical records of adolescents aged 12-21years, diagnosed with arterial or venous TE (AT/DVT) from 2004 to 2014, were retrospectively reviewed and analyzed with IRB approval...
May 2016: Thrombosis Research
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