Evaluation of Heparin Prophylaxis Protocol on Deep Venous Thrombosis and Pulmonary Embolism in Traumatic Brain Injury

2013 ◽  
Vol 79 (10) ◽  
pp. 1050-1053
Author(s):  
Mayin Lin ◽  
Joseph Vivian Davis ◽  
David T. Wong
Keyword(s):  
Traumatic Brain Injury ◽  
Pulmonary Embolism ◽  
Brain Injury ◽  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Clear Trend ◽  
Accepted Standard ◽  
Before And After ◽  
Head Computed Tomography ◽  
Heparin Prophylaxis

There is currently no accepted standard for deep venous thrombosis (DVT) and pulmonary embolism (PE) prophylaxis in patients with traumatic brain injury (TBI). The objective of our study was to evaluate the effects of implementing a subcutaneous heparin prophylaxis protocol for patients with TBI that began in our hospital as of June 2009. In our retrospective cohort study, we examined 3812 TBI records between January 2007 and December 2011. A significant reduction in the risk of DVT/PE development was not demonstrated by comparing DVT and PE incidences before and after protocol implementation. A clear trend between heparin use and DVT occurrence could not be determined from a review of TBI records after June 2009. The use of heparin after initiation of our protocol among operative TBI cases without intracranial hemorrhage (ICH) based on admission head computed tomography was 58 per cent. ICH complication from heparin prophylaxis was 10.6 per cent for patients with TBI with ICH on admission (five of 47 cases) compared with 0.7 per cent for those without ICH on admission (four of 535 cases).

Deep Venous Thrombosis Management Following Traumatic Brain Injury

2006 ◽  
Vol 21 (6) ◽  
pp. 483-490 ◽  
Author(s):  
Mary C. Carlile ◽  
Stuart A. Yablon ◽  
W. Jerry Mysiw ◽  
Alan B. Frol ◽  
David Lo ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Venous Thrombosis ◽  
Deep Venous Thrombosis

Comparative Effects Of Tissular Urokinase And Urinary Urokinase In The Treatment Of 30 Patients With Pulmonary Embolism And Deep Venous Thrombosis

1981 ◽  
Author(s):  
M F Lorient-Roudaut ◽  
C Vergnes ◽  
J Bonnet ◽  
M R Boisseau ◽  
H Bricaud
Keyword(s):  
Pulmonary Embolism ◽  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Biological Effects ◽  
Clinical Situation ◽  
Point Of View ◽  
Biological Study ◽  
Serial Determination ◽  
Before And After ◽  
D Dimer

Two types of Urokinase are actually available for the clinical use : tissular urokinase (tUK), isolated from cell culture and urinary urokinase (uUK), partially purified from human urine. Their clinical and biological effects have to be compared.In this study 30 patients with acute pulmonary embolism and/or deep venous thrombosis were treated, using tUK or uUK, 4500 units/kg, during 12 hours.In the clinical field pulmonary angiographies, scintigrams, and phlebographies were obtained before and after the treatment. The biological study was first established on serial determination of fibrinogen, platelets, Quick Time, FDP using two methods and euglo- biiin lysis time. At the end of the treatment plasmatic samples of each patients were studied by immunoprecipitations followed by polyacrylamid gel electrophoresis, in the view of evaluation of the D dimer E complex. Two methods were used (LANE D.A. and al., 1977and WHITAKER A.N. and al, 1980).The results showed a quick similar improvement of the clinical situation. In return tUK appeared to be more effective on the biological point of view. Significant differences were found in : decrease of fibrinogen, increase of FDP and the presence of D dimer fragments. The better action of tUK, especially on the fibrin depositions, is so far unexplained.

Venous Thromboembolism Risk and Thromboprophylaxis in Pediatric Neurosurgery and Spinal Injury: Current Trends and Literature Review

2021 ◽  
Author(s):  
Dimitrios Panagopoulos ◽  
Ploutarchos Karydakis ◽  
Georgios Noutsos ◽  
Marios Themistocleous
Keyword(s):  
Traumatic Brain Injury ◽  
Venous Thromboembolism ◽  
Brain Injury ◽  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Patient Population ◽  
Pediatric Patients ◽  
Spinal Injury ◽  
Neurosurgical Procedures ◽  
Number Of Patients

AbstractAlthough the entities of venous thromboembolism (VTE), deep venous thrombosis, pulmonary embolus, and thromboprophylaxis in adult patients undergoing brain tumor and spine surgery, traumatic brain injury and elective neurosurgical procedures are widely elucidated, the same is not valid when pediatric patients are under consideration. An attempt to review the peculiarities of these patients through a comprehensive bibliographic review is undertaken. We performed a narrative summary of the relevant literature dedicated to pediatric patients, centered on traumatic brain injury, the general incidence of thromboembolic disease in this patient population, the role of low molecular weight heparin (LMWH) in the treatment and prophylaxis of VTE, and its role in elective neurosurgical procedures, including spinal operations. Additionally, the risk of deep venous thrombosis in elective neurosurgical procedures is reviewed. Due to inherent limitations of the current studies, particularly a restricted number of patients, our data are underpowered to give a definitive protocol and guidelines for all the affected patients. Our current conclusions, based only on pediatric patients, argue that there is limited risk of VTE in pediatric patients suffering from brain tumors and that the possibility of VTE is very low in children undergoing elective neurosurgical procedures. There is no consensus regarding the exact incidence of VTE in traumatic brain injury patients. LMWH seems to be a safe and effective choice for the “at risk” pediatric patient population defined as being older than 15 years, venous catheterization, nonaccidental trauma, increased length of hospital stays, orthopaedic (including spinal) surgery, and cranial surgery.

scholarly journals Low Vitamin D Level Is Associated with Acute Deep Venous Thrombosis in Patients with Traumatic Brain Injury

2021 ◽  
Vol 11 (7) ◽  
pp. 849
Author(s):  
Matthew Moore ◽  
Yelena Goldin ◽  
Harsh Patel ◽  
Brian D. Greenwald
Keyword(s):  
Traumatic Brain Injury ◽  
Vitamin D ◽  
Brain Injury ◽  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Vitamin D Levels ◽  
Cord Injury ◽  
Normal Vitamin ◽  
Acute Rehabilitation ◽  
The Relationship

Vitamin D and its association with venous thromboembolism (VTE) have been studied in common rehabilitation populations, such as spinal cord injury and ischemic stroke groups. This study explores the relationship between vitamin D levels and acute deep venous thrombosis (DVT) in the traumatic brain injury (TBI) population. This is a retrospective cohort study that analyzes the relationship between vitamin D levels and the prevalence of DVT during acute inpatient rehabilitation. In this population, 62% (117/190) of patients had low vitamin D levels upon admission to acute rehabilitation. Furthermore, 21% (24/117) of patients in the low vitamin D group had acute DVT during admission to acute rehabilitation. In contrast, only 8% (6/73) of patients in the normal vitamin D group had acute DVT during admission to acute rehabilitation. Fisher’s exact tests revealed significant differences between individuals with low and normal vitamin D levels (p = 0.025). In conclusion, a vitamin D level below 30 ng/mL was associated with increased probability of the occurrence of acute DVT in individuals with moderate–severe TBI.

Perforation of inferior vena cava during filter placement

VASA ◽  
2011 ◽  
Vol 40 (2) ◽  
pp. 157-162 ◽  
Author(s):  
Piecuch ◽  
Wiewiora ◽  
Nowowiejska-Wiewiora ◽  
Szkodzinski ◽  
Polonski
Keyword(s):  
Pulmonary Embolism ◽  
Inferior Vena Cava ◽  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Inferior Vena ◽  
Vena Cava ◽  
Retroperitoneal Hematoma ◽  
Ivc Filter ◽  
Filter Placement ◽  
Therapeutic Method

The placement of an inferior vena cava (IVC) filter is a therapeutic method for selected patients with deep venous thrombosis and pulmonary embolism. However, insertion and placement of the filter may be associated with certain complications. For instance, retroperitoneal hematoma resulting from perforation of the wall by the filter is such a very rare but serious complication. We report the case of a 64-year-old woman with perforation of the IVC wall and consecutive hematoma caused by the filter who was treated surgically.

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