The Turkish Journal of Vascular Surgery

Yazarlar: Mehmet KURTOĞLU, Kemal DOLAY, Recep GÜLOĞLU, Ahmet NECEFLİ

Konular:-

Anahtar Kelimeler:Multiple trauma patients,Venous trom boem bolism,Prophylaxis of enoxaparin.

Özet: Between February 1996 and May 19 97, 40 mg Enoxaparin sodium (Cle xan; Eczacıb aşı, Rhoune-Pou lenc) was given subcutaneously once daily to the immob ilized multiple trauma patie nts who were managed at the lnten­ sive Care Unit of Emergency Surgery Deparment of Med ic al School of lst anbu l Uni versit y after their d iag nose s were established. Seventy-six patients who stayed at the hospit al at lea st 7 days were in cluded in this study and Clexan administ ration (40 mg per day) was contin ued until the patie nts were mo bilize d. Ali t rauma patient s wit h one or more follow ing risk fa ctors for the development of VTE (age >45 years and enforced bed rest> 3 days; previous history of venous thromboembolism; Glascow Come Scale > 7; quadriplegia / parap leg ia; spine, lowe r extremity or pelvisfra ctures; in jury of a major lowe r extre mity vein; complex wound of lower extrem it y) were assigned to the hig h-risk group. lf none of the factors vwere present, the patient was assigned ta the lo w-risk g roup. Twenty-six patients in high-risk group underwent bilateral co ntrast venograpy with nonionic contrast (Omniopaque 300 mg) to screen DIT at seven th day routinely after injury. Six patie nts suspected of having PE on clinical findings (tachycardia, tachypnea, chest pain) in high-risk g roup underwent vent ilation perfusion scan­ ning. Three of 50 patients suspected of h aving DVT based on clinical findings (pain, swe lling, calf te nde rness) in low - risk g roup underwent venography . There were no findings suspicious of PE in t his group. None of the patients developed DVT, a vent ilatio n perfusion scann ing was assesed being as a suspected PE. Ble eding comp­ lications du e to the use of Clexan were not observed. As a result, the use of enoxaparin in pre venting VTE in multiple trauma patients is effective and necessary.

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