Pulmonary embolism prevention by clinical management guideline in high risk trauma patients admitted to an icu using duplex surveillance

TY - JOUR

T1 - Pulmonary embolism prevention by clinical management guideline in high risk trauma patients admitted to an icu using duplex surveillance

AU - Gupta, Rajan

AU - Dabrowsld, G. P.

AU - Jertans, D. H.

AU - Remy, P. M.

AU - Gaskel, S.

AU - Carpenter, J. P.

AU - Kauder, D. R.

AU - Schwab, C. W.

PY - 1998

Y1 - 1998

N2 - Introduction: The optimal diagnostic and prophylactic management of occult deep venous thrombosis (DVT) for PE prevention in trauma patients has yet to be described. The result of implementation of a cfinical management guideline for surveManee duplex in high risk trauma patients admitted to the intensive care unit was studied. Methods: Trauma patients admitted to an ICU in a Level I Trauma Center between March and July, 1997 were stratified into DVT risk categories (low, high, or very high) based upon presence of known risk actors. High risk patients received either sequential compression devices (SCO's) or low dose subcutaneous heparin, and underwent a weekly duplex screening. The number and results of screening duplex examinations in these patents were reviewed. Results: Over the course of the study period, 64 high risk patients in the ICU underwent 105 duplex screenings. Of these, 13 patients (20%) were found to have occult deep venous thromboses. One study patient developed a non-fatal pulmonary emboism (1.6%). One additional study patient had a DVT diagnosed nddentaly by CT scan (1.6%). Conclusions: We conclude that routine survefence duplex scans directed by a cfirücal management guidelne in high risk trauma patients in the intensive care unit aids in the diagnosis of occut DVT. Pulmonary embolism, in this review, occurred less frequently than the 4-14% rate cited in the current literature for high risk trauma patients.

AB - Introduction: The optimal diagnostic and prophylactic management of occult deep venous thrombosis (DVT) for PE prevention in trauma patients has yet to be described. The result of implementation of a cfinical management guideline for surveManee duplex in high risk trauma patients admitted to the intensive care unit was studied. Methods: Trauma patients admitted to an ICU in a Level I Trauma Center between March and July, 1997 were stratified into DVT risk categories (low, high, or very high) based upon presence of known risk actors. High risk patients received either sequential compression devices (SCO's) or low dose subcutaneous heparin, and underwent a weekly duplex screening. The number and results of screening duplex examinations in these patents were reviewed. Results: Over the course of the study period, 64 high risk patients in the ICU underwent 105 duplex screenings. Of these, 13 patients (20%) were found to have occult deep venous thromboses. One study patient developed a non-fatal pulmonary emboism (1.6%). One additional study patient had a DVT diagnosed nddentaly by CT scan (1.6%). Conclusions: We conclude that routine survefence duplex scans directed by a cfirücal management guidelne in high risk trauma patients in the intensive care unit aids in the diagnosis of occut DVT. Pulmonary embolism, in this review, occurred less frequently than the 4-14% rate cited in the current literature for high risk trauma patients.

UR - https://www.scopus.com/pages/publications/0008958556

UR - https://www.scopus.com/pages/publications/0008958556#tab=citedBy

U2 - 10.1097/00003246-199801001-00088

DO - 10.1097/00003246-199801001-00088

M3 - Article

SN - 0090-3493

VL - 26

SP - A48

JO - Critical care medicine

JF - Critical care medicine

IS - 1 SUPPL.

ER -