[Venous thromboembolism prophylaxis with low molecular weight heparins in polytraumatized patients in intensive care unit (extended serie)].
BACKGROUND
In our study we aimed to evaluate, retrospectively, the bleeding and the Venousthrombo Emblism (VTE) complications in trauma patients in Intensive Care Unit (ICU) under the prophylaxis of enoxaparin sodium. The results will guide us to establish a protocol for use of Enoxaparin Sodium in trauma patients. In trauma patients, Low Molecular Weight Heparine (LMWH) has better efficiency than unfractionned heparin and intermittant pneumatic compression for VTE prophylaxis.


METHODS
457 polytraumatized patients treated in ICU are included to the study group. All patients received 40 mg/day of Enoxaparin Sodium. Severity of trauma was assessed with Apache II Scoring System and bleeding diagnosed by observing a sudden drop of 2 g/dl in hemoglobin concentration and pulmonary embolism was diagnosed by a sudden change in blood gases and deterioration of the clinical outlook which was confirmed by a spiral CT scan. Statistical correlation was made by Pearson's correlation test.


RESULTS
Mean Apache II score was 13.8 with a total mortality of 41%. 42 patients (9,2%) had bleeding due to Enoxiparine Sodium prophylaxis. 12 patients (2,6%) had pulmonary embolism and 8 of them (1,7%) had died.


CONCLUSIONS
Verified by the literature and our study, LMWH prophylaxis significantly reduces the Pulmoner Embolism (PE) incidence in polytraumatized patients (p<0,05). On the other hand, the bleeding risk has slightly increased without showing any significance (p>0.05). Prophylaxis with LMWH is safe and efficient in polytraumatized ICU patients.
Kurtoğlu
Mehmet
M
Istanbul Tip Fakultesi Genel Cerrahi, Capa, Turkey. metlevkurt@superonline.com
Büyükkurt
C Dinçay
CD
Kurtoğlu
Metin
M
Dural
Cem A
CA
Güloğlu
Recep
R
Akar
Uğur
U
D018806:APACHE; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000009:adverse effects*; D017984:Enoxaparin / Q000009:adverse effects*; D005260:Female; D006470:Hemorrhage / Q000139:chemically induced / Q000401:mortality*; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma / Q000473:pathology*; D017410:Practice Guidelines as Topic; D011655:Pulmonary Embolism / Q000401:mortality*; D012189:Retrospective Studies; D014421:Turkey / Q000453:epidemiology; D020246:Venous Thrombosis / Q000517:prevention & control*
D000925:Anticoagulants; D017984:Enoxaparin