Advances in thromboprophylaxis in trauma patients, based on current guidelines and research

Abstract

Introduction. Thromboprophylaxis remains a significant element in the operative and non-operative treatment of trauma patients due to high risk of thromboembolic incidents. This problem concerns a major part of trauma patients. Objective. The aim of the study is to review and evaluate the efficacy of the pharmacological and non-pharmacological methods of venous thromboembolic (VTE) prophylaxis. Brief state of knowledge. There are a few pharmacological methods of VTE prevention, such as: unfractionated heparin (UFH), low molecular weight heparin (LMWH), vitamin K antagonists (VKA), factor Xa inhibitors and direct thrombin Inhibitor. There are also a couple of non-pharmacological methods: intermittent pneumatic compression and graduated compression stockings. The choice of method should be guided by the type of trauma, patient's health status, and potential contraindications for other methods of prophylaxis. Methods. The authors analyzed recent guidelines and research using the most up-to-date sources. The types of traumas were categorized, and a summary compiled of the best way of VTE prophylaxis for each type of trauma. Recommended methods were also rated with the risk of VTE and haemorrhage. Conclusions. The conclusions show that there are still too few studies and the guidelines extant are unambiguous (ambiguous?). Improvment must be sought for in thromboprophylaxis and toward defining uniform guidelines. Due to the large number of surgeries in the treatment of traumas, there is a need to retain all the guidelines in one article. Every operation is connected with high risk of venous thromboembolism, therefore optimal prophylaxis is crucial.