Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia.
Crit Care Resusc. 2012 Mar;14(1):10-3.
Intensive care patients with traumatic brain injury (TBI) are at high risk of developing deep vein thrombosis (DVT). A high rate of DVT was reported before routine thromboprophylaxis, but the current DVT rate in TBI patients receiving best-practice mechanical and pharmacological prophylaxis is unknown.
To determine the prevalence of DVT among TBI patients.
DESIGN, PARTICIPANTS AND SETTING: A prospective observational pilot study of adult patients admitted to the intensive care unit of a level 1 trauma centre within 72 hours of sustaining a TBI (Glasgow Coma Scale score _14).
Rate of DVT determined using twice-weekly compression ultrasound; rate of pulmonary embolism (PE) and length of stay.
36 patients (28 men; mean age, 40.3 years) were included. Six had moderate and 21 had severe TBI. Two patients (6%) developed a DVT and two patients (6%) developed a PE. The proximal leg DVT rate was 3%, but the overall venous thromboembolism rate was 11% (4 patients).
Mechanical and pharmacological prophylaxis appeared to be effective. The incidence of clinically identified PE is of concern and suggests that thromboembolic sources other than large leg veins may not be being adequately controlled by modern thromboprophylaxis regimens.
创伤性脑损伤（TBI）的重症监护患者有发生深静脉血栓形成（DVT）的高风险。在常规血栓预防之前，报告的 DVT 发生率很高，但目前接受最佳实践机械和药物预防的 TBI 患者的 DVT 发生率尚不清楚。
确定 TBI 患者中 DVT 的患病率。
设计、参与者和设置：一项前瞻性观察性初步研究，纳入了在创伤性脑损伤后 72 小时内入住 1 级创伤中心重症监护病房的成年患者（格拉斯哥昏迷量表评分_14）。
使用每周两次的压缩超声确定 DVT 发生率；肺栓塞（PE）发生率和住院时间。
纳入 36 例患者（28 例男性；平均年龄 40.3 岁）。6 例患者为中度 TBI，21 例患者为重度 TBI。2 例患者（6%）发生 DVT，2 例患者（6%）发生 PE。近端腿部 DVT 发生率为 3%，但总的静脉血栓栓塞症发生率为 11%（4 例）。
机械和药物预防似乎有效。临床上确定的 PE 发生率令人担忧，这表明现代血栓预防方案可能无法充分控制除大腿部静脉以外的血栓形成源。
