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Prophylaxis Against Venous Thromboembolism (VTE) in Patients with Traumatic Brain Injury (TBI)

Schott, Ulf LU and Steiness, Morten Zebitz (2020) p.509-514
Abstract
Several recent national guidelines and reviews conclude that pharmacologic, in addition to mechanical thromboprophylaxis, appears to be safe among TBI patients with stabilized hemorrhagic patterns. Despite this, there are many issues concerning efficiency and safety in severe TBI, especially in patients with coagulopathies.
Please use this url to cite or link to this publication:
author
and
organization
publishing date
type
Chapter in Book/Report/Conference proceeding
publication status
published
subject
keywords
neurotrauma, thromboprophylaxis
host publication
Management of Severe Traumatic Brain Injury
editor
Sundstrøm, T ; Grände, P-O ; Luoto, T ; Rosenlund, C ; Undén, J and Wester, KG
edition
2
pages
509 - 514
publisher
Springer
ISBN
978-3-030-39382-3
language
English
LU publication?
yes
additional info
Tips, Tricks, and Pitfalls • Today we have no optimal laboratory technique to monitor various anticoagulants or thromboprophylactic drugs. • There is a thin balance between aggravating TBI haemorrage with too early pharmacologic thromboprophylaxis and increasing risk for thromboembolism by delaying it. • Clinical judgement and evaluation from repetitive CT scans during the first 2–5 (or longer) days is the mainstay. • Calf compression and then starting with low dose LMWH thromboprophylaxis after 2–4 days if the TBI induced haemorrhage seems to be stabilised is recommended by most guidelines. • High alert to stop LMWH if haemorrhage is expanded – protamin can revert some of its effect depending on the anti- Xa/anti-Iia ratio of the specific LMWH. • LMWH should be stopped 12 h before manipulation or withdrawal of intracerebral pressure monitoring/ventricular drainage catheters. • Simultaneous DIC, thrombocytopenia should be resolved/treated before considering LMWH.
id
9c34fef5-3a83-47d4-91c7-8ad4b627abf8
alternative location
https://link.springer.com/chapter/10.1007/978-3-030-39383-0_71
date added to LUP
2019-09-07 16:50:47
date last changed
2021-12-01 11:55:12
@inbook{9c34fef5-3a83-47d4-91c7-8ad4b627abf8,
  abstract     = {{Several recent national guidelines and reviews conclude that pharmacologic, in addition to mechanical thromboprophylaxis, appears to be safe among TBI patients with stabilized hemorrhagic patterns. Despite this, there are many issues concerning efficiency and safety in severe TBI, especially in patients with coagulopathies.}},
  author       = {{Schott, Ulf and Steiness, Morten Zebitz}},
  booktitle    = {{Management of Severe Traumatic Brain Injury}},
  editor       = {{Sundstrøm, T and Grände, P-O and Luoto, T and Rosenlund, C and Undén, J and Wester, KG}},
  isbn         = {{978-3-030-39382-3}},
  keywords     = {{neurotrauma; thromboprophylaxis}},
  language     = {{eng}},
  month        = {{07}},
  pages        = {{509--514}},
  publisher    = {{Springer}},
  title        = {{Prophylaxis Against Venous Thromboembolism (VTE) in Patients with Traumatic Brain Injury (TBI)}},
  url          = {{https://link.springer.com/chapter/10.1007/978-3-030-39383-0_71}},
  year         = {{2020}},
}