Purpose: To compare the safety and efficacy of low molecular weight heparin (LMH) with conventional unfractionated heparin (UH) in preventing deep venous thrombosis (DVT) in trauma patients with moderate injuries. Methods: We performed a prospective double-blind randomized trial at a level I trauma center. After informed consent, trauma patients meeting inclusion criteria (age>45 or requiring >2 days bedrest) received LMH or UH twice daily. Patients were excluded if they had severe brain injuries or bleeding injuries not accessible to hemostatic control (eg: severe visceral contusions). Clinical examination and weekly venous duplex ultrasound evaluations were performed to identify DVT. Results: 104 moderately injured trauma patients (mean ISS=12±11) were randomized, 53 patients to receive UH and 51 to receive LMH. 32 UH and 34 LMH of the enrolled patients completed the study. There were no significant differences between groups with regard to age, sex, ISS or doses of drug given. There were two DVT's in the UH group and none in the LMH group (p=.493 by Fisher exact test). Length of stay in SICU, hospital days were also not different between groups. There were 5 major bleeding complications in each group. Conclusions: The incidence of DVT in injured patients receiving prophylaxis appears to be quite low (3%) if individuals such as those with severe head injury or visceral contusions are excluded. Clinical Implications: LMH is not clearly beneficial when compared to UH for preventing venous thrombosis in moderate injured trauma patients.
|Original language||English (US)|
|Issue number||4 SUPPL.|
|State||Published - Oct 1 1998|
ASJC Scopus subject areas
- Pulmonary and Respiratory Medicine
- Critical Care and Intensive Care Medicine
- Cardiology and Cardiovascular Medicine