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Optimizing Venous Thromboembolic Prophylaxis

Optimizing Venous Thromboembolic Prophylaxis Optimizing Venous Thromboembolic Prophylaxis Invited Commentary Invited Commentary Is Thromboelastography the Answer? Matthew J. Martin, MD Despite being one of the more common sources of morbidity achieved the targeted change in reaction time, and the dose and mortality among critically ill or injured patients, venous adjustment did not increase anti–Factor Xa levels until day 6. thromboembolic disease (VTE) remains poorly understood, Finally, the number of bleeding complications increased in pa- inadequately characterized, tients in the TEG-adjusted group (13.5% vs 5.6%). It is also im- and minimally responsive to portant to note that the observed VTE rate of 6.5% was sig- Related article at both mechanical and pharma- nificantly lower than the prestudy estimate, resulting in an jamasurgery.com cologic prophylaxis. As a re- underpowered sample size. sult, approaches to preven- This well-done study highlights several critical points re- tion and diagnosis of VTE can fairly be categorized as ranging garding posttraumatic VTE. Even in the setting of a random- from fanaticism to nihilism, with most practitioners (includ- ized trial, there were a significant amount of missed doses and ing this author) falling somewhere in the middle. However, this held doses and a long delay to achieving any measurable effect should http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png JAMA Surgery American Medical Association

Optimizing Venous Thromboembolic Prophylaxis

JAMA Surgery , Volume 151 (10) – Oct 3, 2016

Optimizing Venous Thromboembolic Prophylaxis

Abstract

Optimizing Venous Thromboembolic Prophylaxis Invited Commentary Invited Commentary Is Thromboelastography the Answer? Matthew J. Martin, MD Despite being one of the more common sources of morbidity achieved the targeted change in reaction time, and the dose and mortality among critically ill or injured patients, venous adjustment did not increase anti–Factor Xa levels until day 6. thromboembolic disease (VTE) remains poorly understood, Finally, the number of bleeding complications...
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Publisher
American Medical Association
Copyright
Copyright 2016 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.
ISSN
2168-6254
eISSN
2168-6262
DOI
10.1001/jamasurg.2016.2081
pmid
27486696
Publisher site
See Article on Publisher Site

Abstract

Optimizing Venous Thromboembolic Prophylaxis Invited Commentary Invited Commentary Is Thromboelastography the Answer? Matthew J. Martin, MD Despite being one of the more common sources of morbidity achieved the targeted change in reaction time, and the dose and mortality among critically ill or injured patients, venous adjustment did not increase anti–Factor Xa levels until day 6. thromboembolic disease (VTE) remains poorly understood, Finally, the number of bleeding complications increased in pa- inadequately characterized, tients in the TEG-adjusted group (13.5% vs 5.6%). It is also im- and minimally responsive to portant to note that the observed VTE rate of 6.5% was sig- Related article at both mechanical and pharma- nificantly lower than the prestudy estimate, resulting in an jamasurgery.com cologic prophylaxis. As a re- underpowered sample size. sult, approaches to preven- This well-done study highlights several critical points re- tion and diagnosis of VTE can fairly be categorized as ranging garding posttraumatic VTE. Even in the setting of a random- from fanaticism to nihilism, with most practitioners (includ- ized trial, there were a significant amount of missed doses and ing this author) falling somewhere in the middle. However, this held doses and a long delay to achieving any measurable effect should

Journal

JAMA SurgeryAmerican Medical Association

Published: Oct 3, 2016

References