Venous thromboembolism in morbid obesity and trauma. A review of literature.
Deep venous thromboembolism (DVT) is common and leads to disability, economic loss and even death. The aims of this paper are to start from the basic knowledge that we have about DVT and to tailor our knowledge to the treatment and diagnosis of thromboembolism in obese patients and trauma patients, which are among the patients who have a high risk of developing DVT and pulmonary embolism. Venous thromboembolism is a common complication in patients with major trauma, and effective, safe prophylactic regimens are needed. The patients are treated effectively with heparin and low molecular weight heparins, which are shown to be safe and effective. Morbid obesity is a disease that affects 10% of Americans and increases the incidence of DVT. Forty mg of enoxaparin subcutaneously twice a day seems to be a better DVT prophylaxis than the 30 mg twice a day. Many patients admitted to the hospital are morbidly obese; therefore, we suggest they start on low molecular heparin. The high morbidity of these patients is because most of them are bedridden, which increases the chance of DVT and death from pulmonary embolism. Trauma increases the chance of having DVT. Low molecular weight heparin or heparin is a safe and extremely effective method of preventing DVT in high-risk trauma patients.
Frezza
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Department of Surgery, Division of General Surgery, Texas Tech University, Health Sciences Center, Lubbock, Texas 79145, USA. eldo.frezza@ttuhsc.edu
Chiriva-Internati
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D006801:Humans; D009767:Obesity, Morbid / Q000150:complications*; D012307:Risk Factors; D013923:Thromboembolism / Q000209:etiology* / Q000628:therapy; D014947:Wounds and Injuries / Q000150:complications*