Novel therapeutic medications for venous thromboembolism prevention in trauma patients: Findings from the Consensus Conference to Implement Optimal Venous Thromboembolism Prophylaxis in Trauma.

J Trauma Acute Care Surg

From the R Adams Cowley Shock Trauma Center (N.K.D.), University of Maryland; Division of Acute Care Surgery, Department of Surgery (E.R.H.), Department of Anesthesiology and Critical Care Medicine (E.R.H.), and Department of Emergency Medicine (E.R.H.), The Johns Hopkins University School of Medicine; The Armstrong Institute for Patient Safety and Quality (E.R.H.), Johns Hopkins Medicine; Department of Health Policy and Management, The Johns Hopkins Bloomberg School of Public Health (E.R.H.), Baltimore, Maryland; Coalition for National Trauma Research (M.A.P.), San Antonio, Texas; Division of Trauma, Surgical Critical Care, and Burns, and Acute Care Surgery, Department of Surgery (T.W.C.), University of California San Diego School of Medicine, San Diego, California; Division of Acute Care Surgery (A.L.T.), Rutgers-Robert Wood Johnson School of Medicine, New Brunswick, New Jersey; Division of Acute Care Surgery, Department of Surgery (B.A.C.), McGovern Medical School, Memorial Hermann Hospital, Houston, Texas; and Department of Surgery (E.J.L.), Cedars-Sinai Medical Center, Los Angeles, California.

Published: March 2023

Trauma patients are at high risk for venous thromboembolism (VTE). Despite evidence-based guidelines and concerted efforts in trauma centers to implement optimal chemoprophylaxis strategies, VTE remains a frequent diagnosis in trauma patients. Current chemoprophylaxis strategies largely focus on the subcutaneous injection of low-molecular-weight heparin, which is administered twice daily. Novel approaches to pharmacologic VTE prophylaxis have the potential to reduce VTE rates by improving patient compliance through oral administration or through their ability to target alternative pathways that mediate thrombosis. While novel pharmacologic VTE prophylaxis strategies have been studied in nontrauma patients, there is a paucity of literature in trauma patients where the risk of thrombosis versus hemorrhage must be carefully considered. As a component of the 2022 Consensus Conference to Implement Optimal VTE Prophylaxis in Trauma, this review provides an update of the novel chemoprophylaxis agents for potential use in trauma patients. Here, we will consider the relative risks and benefits related to the use of these drugs, evaluate the current literature in nontrauma patients, and consider future directions that could potentially improve posttrauma VTE prophylaxis.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9974825PMC
http://dx.doi.org/10.1097/TA.0000000000003853DOI Listing

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