The efficacy of sequential compression devices in multiple trauma patients with severe head injury
Autor: | Keith Gersin, Victor W. Lee, Riad Cachecho, Suzanne K. Wedel, Gene A. Grindlinger, Dennis Rc |
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Rok vydání: | 1994 |
Předmět: |
Adult
Male medicine.medical_specialty medicine.medical_treatment Critical Care and Intensive Care Medicine Ventilation/perfusion ratio Injury Severity Score medicine Pressure Ventilation-Perfusion Ratio Craniocerebral Trauma Humans cardiovascular diseases Prospective Studies Vein Technetium Tc 99m Aggregated Albumin Mechanical ventilation Vascular disease business.industry Multiple Trauma Glasgow Coma Scale Thrombosis medicine.disease Pulmonary embolism Surgery Venous thrombosis medicine.anatomical_structure Anesthesia Female business Pulmonary Embolism Xenon Radioisotopes |
Zdroj: | The Journal of trauma. 37(2) |
ISSN: | 0022-5282 |
Popis: | Thirty-two multiple trauma patients with severe head injury and a Glasgow Coma Scale (GCS) score of 8 or less were prospectively studied to assess the occurrence of deep venous thrombosis (DVT) and pulmonary embolism (PE). All patients required mechanical ventilation. A sequential compression device (SCD) was used in 14 patients and 18 patients received no prophylaxis for thromboembolism. Bilateral lower extremity technetium venoscans and ventilation/perfusion (V/Q) lung scans were performed within 6 days of admission and every week for 1 month or until the patient developed DVT or PE or was discharged from the SICU. Deep venous thrombosis occurred in two patients (6%) at 16 and 28 days following trauma. Twenty-five patients had normal or low probability V/Q scans. Six had high probability V/Q scans confirmed by pulmonary arteriograms (PAGs) at 12.5 +/- 4 days. Clinical signs of PE were absent in all patients with a positive PAG. There were no differences in age, Injury Severity Score (ISS), GCS Score, APACHE II Score, or Trauma Score between the patients who developed DVT or PE and those who did not. A SCD was used in four of the eight patients with DVT or PE. All but one patient with DVT or PE underwent placement of a vena caval filter. Multiple trauma patients with severe head injury (GCS score < or = 8) are at high risk for thromboembolism. The available means of prevention and diagnosis of DVT or PE in multiple trauma patients with severe head injury are not entirely effective. |
Databáze: | OpenAIRE |
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