A modern approach to the study of the problem of pathogenesis and prevention venous thromboembolic complications in patients with trauma (literature review)

Abstract

Relevance. Patients with trauma are at increased risk of venous thromboembolic complications (VTE), which includes deep vein thrombosis of the lower extremities (DVT) and pulmonary embolism (PE). Within surgical and trauma clinics, thromboembolic complications are the most common preventable cause of in-hospital mortality. Numerous studies have shown that the incidence rate of deep vein thrombosis (DVT) in trauma patients without prevention varies from 5 to 80%.Aim. To analyze the pathogenesis of the development of venous thrombosis and explore existing approaches to prevent VTE in trauma patients.Materials and methods. In the course of the work, topical literary sources of domestic and foreign authors on a given topic were analyzed.Results. The mechanism of thrombus formation in trauma involves slowing blood flow, damage to the vessel wall and impaired blood clotting in the form of hypercoagulation. The state of hypercoagulation combined with prolonged immobility increases the risk of VTE. LMWH is the treatment of choice for the prevention of VTE in trauma. Today, there are ongoing studies related to the correction of preventive doses of LMWH and the search for a single standard, depending on numerous factors.Conclusion. Severity and multiplicity of lesions correlate with severity of systemic inflammation, hypercoagulation, and incidence of venous thrombosis. However, this correlation has not been sufficiently studied in the scientific literature. The search for specific methods for the prevention of deep vein thrombosis leading to PE is an urgent problem of surgery of injuries both peaceful and wartime.