How is deep vein thrombosis (DVT) prevented in traumatic brain injury (TBI)?

Updated: Mar 02, 2020
  • Author: Percival H Pangilinan, Jr, MD; Chief Editor: Stephen Kishner, MD, MHA  more...
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Answer

Answer

Prophylaxis for DVT should be started as soon as possible. These measures include use of elastic compression stockings, intermittent pneumatic compression, vena cava filters, warfarin, unfractionated heparin (UH), and/or low–molecular weight heparin (LMWH). Mechanical methods of prophylaxis are generally used in patients with a high risk of bleeding or in combination with anticoagulation. [33] The choice of prophylaxis should be patient specific and based on his/her existing comorbidities.

A study by Frisoli et al suggested that in patients with traumatic intracranial hemorrhage, the initiation of early venous thromboembolism (VTE) chemoprophylaxis (ie, less than 24 hours after injury) is safe. Outcome rates, including for radiographic intracranial hemorrhage expansion, the need for delayed decompressive surgery for refractory intracranial pressure elevation, and all-cause mortality, were similar to those for patients who underwent VTE chemoprophylaxis more than 48 hours after injury. [34]


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