Timing and dose of pharmacological thromboprophylaxis in adult trauma patients

Pharmacological venous thromboembolism prophylaxis in the trauma population is considered a real challenge. Issues like the ideal time to start therapy, type and dose of the medication, and how to monitor these patients are controversial. We searched PUBMED, EMBASE, and COCHRANE Databases. We also extracted the references from major review articles and recent guidelines. The timing to start thromboembolic prophylaxis in patients with traumatic brain injuries, Spinal Cord Injuries (SCI), and solid organ injuries is not very well defined in the literature. This is because of the associated bleeding risk. At the same time, the type of chemical prophylaxis and dose are not well defined as well. In this review, we present the most up to date studies done on this topic. We discuss the areas of controversy and the challenges behind starting chemical prophylaxis. We also discuss areas of future research potentials to do multicenter studies through the Saudi Critical Care Trials Group.