• Adrian J Praeger, Andrew J Westbrook, Alistair D Nichol, Ruwan Wijemunige, Andrew R Davies, Stuart M Lyon, Judy L Wills, Michael Bailey, Jeffrey V Rosenfeld, and D James Cooper.
• Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia.
• Crit Care Resusc. 2012 Mar 1; 14 (1): 10-3.

BackgroundIntensive care patients with traumatic brain injury (TBI) are at high risk of developing deep vein thrombosis (DVT). A high rate of DVT was reported before routine thromboprophylaxis, but the current DVT rate in TBI patients receiving best-practice mechanical and pharmacological prophylaxis is unknown.ObjectivesTo determine the prevalence of DVT among TBI patients.Design, Participants And SettingA prospective observational pilot study of adult patients admitted to the intensive care unit of a level 1 trauma centre within 72 hours of sustaining a TBI (Glasgow Coma Scale score _14).Main Outcome MeasuresRate of DVT determined using twice-weekly compression ultrasound; rate of pulmonary embolism (PE) and length of stay.Results36 patients (28 men; mean age, 40.3 years) were included. Six had moderate and 21 had severe TBI. Two patients (6%) developed a DVT and two patients (6%) developed a PE. The proximal leg DVT rate was 3%, but the overall venous thromboembolism rate was 11% (4 patients).ConclusionsMechanical and pharmacological prophylaxis appeared to be effective. The incidence of clinically identified PE is of concern and suggests that thromboembolic sources other than large leg veins may not be being adequately controlled by modern thromboprophylaxis regimens.

24 keywords...

hide…