Travma ve acil cerrahi yo�un bak�m hastalar�nda ven�z tromboemboli profilaksisi:  D���k molek�l a��rl�kl� heparin ile elastik �orap + aral�kl� pn�motik kompresyonun kar��la�t�r�lmas�

Serin, K�r�at; Yanar, Hakan; �zdenkaya, Ya�ar; Tu�rul, Simru; Kurto�lu, Mehmet

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H�zl� Arama

Travma ve acil cerrahi yo�un bak�m hastalar�nda ven�z tromboemboli profilaksisi: D��k molek�l a��rl�kl� heparin ile elastik �orap + aral�kl� pn�motik kompresyonun kar��la�t�r�lmas� [Ulus Travma Acil Cerrahi Derg]

Ulus Travma Acil Cerrahi Derg. 2010; 16(2): 130-134

Travma ve acil cerrahi yo�un bak�m hastalar�nda ven�z tromboemboli profilaksisi: D��k molek�l a��rl�kl� heparin ile elastik �orap + aral�kl� pn�motik kompresyonun kar��la�t�r�lmas�

K�r�at Serin¹, Hakan Yanar¹, Ya�ar �zdenkaya¹, Simru Tu�rul², Mehmet Kurto�lu¹
¹�stanbul �niversitesi �stanbul T�p Fak�ltesi Genel Cerrahi Ana Bilim Dal�
²�stanbul �niversitesi �stanbul T�p Fak�ltesi Anesteziyoloji Ve Reanimasyon Ana Bilim Dal�

AMA�
Travma ve acil cerrahi yo�un bak�m hastalar�nda ven�z tromboembolide (VTE) d��k molek�l a��rl�kl� heparin (DMAH) ile elastik �orap ve aral�kl� pn�matik kompresyon (E�+APK) profilaksi y�ntemlerinin VTE riski a��s�ndan etkinli�i ve g�venirlili�i ara�t�r�ld�.
GERE� VE Y�NTEM
Haziran 2005 ile Haziran 2007 tarihleri aras�nda 7 g�nden uzun s�re mekanik ventilat�re ba��ml� olarak yo�un bak�mda yatan 259 hasta prospektif olarak yat��lar�n�n 3. ve 7. g�n�nde alt ekstremite ven�z Doppler ultrasonografi ile de�erlendirildi. Hastalar�n 152�sinde (%59) DMAH, 94 hastada (%36) E� ve APK kullan�ld�.

BULGULAR
DMAH grubunda �� hastada (%2) derin ven trombozu (DVT) saptan�rken, E� ve APK grubunda bir hastada (%1) DVT saptand�. Kanama 15 hastada (%11) g�r�ld�. VTE s�kl�� %1,5 (4/259) olarak saptand�. PE geli�en d�rt hastadan ikisinde �l�mc�l pulmoner emboli geli�ti (%0,7).
SONU�
�stanbul T�p Fak�ltesi Acil Cerrahi biriminde, y�ksek mortalite ve morbiditenin oldu�u yo�un bak�m hastalar�nda uygulanan VTE profilaksi protokol�n� yeterli ve g�venli oldu�una inan�yoruz.

Anahtar Kelimeler: Travma ve acil cerrahi, ven�z tromboemboli; yo�un bak�m.

Venous thromboembolism prophylaxis methods in trauma and emergency surgery intensive care unit patients: low molecular weight heparin versus elastic stockings + intermittent pneumatic compression

K�r�at Serin¹, Hakan Yanar¹, Ya�ar �zdenkaya¹, Simru Tu�rul², Mehmet Kurto�lu¹
¹Department Of General Surgery, �stanbul Medical Faculty, �stanbul University
²Department Of Anesthesiology And Intensive Care, Istanbul Medical Faculty, Istanbul University

BACKGROUND
We aimed to evaluate the efficacy and safety of low molecular weight heparin (LMWH) compared to elastic stockings in combination with intermittent pneumatic compression (ES+IPC) in venous thromboembolism (VTE) prophylaxis in the intensive care unit (ICU) of trauma and emergency surgery.
METHODS
From June 2005 to June 2007, 259 patients who were on mechanic ventilation in the ICU were assigned to two groups as either LMWH (152 patients) or ES+IPC (94 patients). Color flow Doppler sonography was performed on the 3rd and 7th days.
RESULTS
Deep venous thrombosis was determined in 3 (2%) of the LMWH group and in 1 (1%) in the ES+IPC group. Minor bleeding was seen in 15 patients. The frequency of VTE was 1.5%. Two patients suffered from fatal pulmonary embolism (PE) among a total of 4 patients with PE.

CONCLUSION
We believe that the protocol applied for VTE prophylaxis in the Emergency Surgery Department of Istanbul Medical Faculty is effective and safe in this group with such high mortality and morbidity.

Keywords: Trauma and emergency surgery, venous thromboembolism; intensive care unit.

K�r�at Serin, Hakan Yanar, Ya�ar �zdenkaya, Simru Tu�rul, Mehmet Kurto�lu. Venous thromboembolism prophylaxis methods in trauma and emergency surgery intensive care unit patients: low molecular weight heparin versus elastic stockings + intermittent pneumatic compression. Ulus Travma Acil Cerrahi Derg. 2010; 16(2): 130-134

Sorumlu Yazar: Ya�ar �zdenkaya, T�rkiye
Makale Dili: T�rk�e

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H�zl� Arama

Travma ve acil cerrahi yo�un bak�m hastalar�nda ven�z tromboemboli profilaksisi: D���k molek�l a��rl�kl� heparin ile elastik �orap + aral�kl� pn�motik kompresyonun kar��la�t�r�lmas�

Venous thromboembolism prophylaxis methods in trauma and emergency surgery intensive care unit patients: low molecular weight heparin versus elastic stockings + intermittent pneumatic compression

Travma ve acil cerrahi yo�un bak�m hastalar�nda ven�z tromboemboli profilaksisi: D��k molek�l a��rl�kl� heparin ile elastik �orap + aral�kl� pn�motik kompresyonun kar��la�t�r�lmas�