创伤性脑损伤患者中基于体重的依诺肝素预防深静脉血栓形成的有效应用。
Effective use of weight-based enoxaparin for deep vein thrombosis chemoprophylaxis in patients with traumatic brain injury.
机构信息
Augusta University Medical Center, Department of Pharmacy, 1120 15th Street, Augusta, GA, 30912, USA.
Augusta University, Department of Surgery, 1120 15th Street, BI-4072, Augusta, GA, 30912, USA.
出版信息
Am J Surg. 2022 Jan;223(1):146-150. doi: 10.1016/j.amjsurg.2021.07.030. Epub 2021 Jul 28.
BACKGROUND
Enoxaparin is the recommended agent for deep vein thrombosis (DVT) chemoprophylaxis in trauma patients. Current literature suggests weight-based dosing is superior to standard dosing for adequate chemoprophylaxis. Literature regarding the use of weight-based enoxaparin in the setting of traumatic brain injury (TBI) however is limited.
METHODS
A retrospective analysis of adult trauma patients admitted between January 1, 2018 to February 28, 2019 was performed. Sixty-six patients with TBI receiving weight-based enoxaparin met inclusion criteria. Incidence of intracranial hemorrhage (ICH) expansion was the primary endpoint. Newly diagnosed venous thromboembolism (VTE) and death were secondary endpoints.
RESULTS
Two patients, out of sixty-six, had progression of their TBI requiring surgical intervention. Newly diagnosed VTE occurred in one patient. No deaths were due to ICH expansion or VTE.
CONCLUSIONS
Use of weight-based enoxaparin dosing in the setting of TBI shows promise without an increased incidence of ICH expansion when compared to other studies. Level of Evidence and Study Type: Level IV, Therapeutic.
背景
依诺肝素是创伤患者深静脉血栓（DVT）化学预防的推荐药物。现有文献表明，基于体重的给药优于标准剂量，可达到充分的化学预防效果。然而，关于在创伤性脑损伤（TBI）情况下使用基于体重的依诺肝素的文献有限。
方法
对 2018 年 1 月 1 日至 2019 年 2 月 28 日期间收治的成年创伤患者进行了回顾性分析。符合纳入标准的是 66 例接受基于体重的依诺肝素治疗的 TBI 患者。颅内出血（ICH）扩大的发生率是主要终点。新发静脉血栓栓塞（VTE）和死亡是次要终点。
结果
66 例患者中有 2 例 TBI 进展，需要手术干预。1 例患者新发 VTE。没有因 ICH 扩大或 VTE 导致的死亡。
结论
与其他研究相比，在 TBI 情况下使用基于体重的依诺肝素剂量给药具有良好的效果，且 ICH 扩大的发生率没有增加。证据水平和研究类型：IV 级，治疗性。
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