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.
Am J Surg. 2022 Jan;223(1):146-150. doi: 10.1016/j.amjsurg.2021.07.030. Epub 2021 Jul 28.
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.
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.
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.
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.
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。
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。
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。
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。
