Antithrombotics in trauma care: Benefits and pitfalls

Abstract

Summary The use of LMWH for reducing the risk of DVT and PE has gained increasing popularity in trauma patients with pelvic fractures requiring operative fixation or prolonged (>5 days) bed rest, in patients with complex lower extremity fractures requiring operative fixation or prolonged bed rest, and in spinal cord-injured patients with complete or incomplete motor paralysis. However, the use of LMWH in trauma can be a challenge, necessitating a fine balance between bleeding risk and DVT/PE risk. There are many unresolved issues concerning the use of antithromboties in trauma patients, which require further investigation, especially in patients receiving continuous neuraxial analgesia.