Praeger et al. (2012)

Australia

Cohort

N=36

Population: TBI; Mean Age=40.3yr; Gender: Male=28, Female=8; Mean GCS=8.

Treatment: Thromboprophylaxis included compression stockings and/or Low-Molecular-Weight Heparin (LMWH).

Outcome Measure: Rate of DVT and PE assessed with compression ultrasound.

1.        The rate of DVT was 6%, PE was 6%, and total VTE was 11%.

2.        Among individuals with severe TBI the rates of DVT, PE, and total VTE were 10%, 10% and 19%, respectively.

Minshall et al. (2011)

USA

Case Series

N=386

Population: TBI; Gender: Male=293, Female=93.

Intervention: Chart review of patients receiving LMWH (30 mg, 2x/day; n=158), unfractionated heparin (UFH; 5000 IU 3x/day; n=171) or sequential compression devices alone (n=57).

Outcome Measure: Rate of DVT, PE, and intracranial hemorrhage complications.

1.        Mortality in the sequential compression devices alone group was higher (47%) compared to the LMWH (5%) and UFH (16%) groups.

2.        Those in the UFH group had a significantly higher rate of DVT and PE than those in the LMWH group (p<0.05).

3.        Five percent of those in the LMWH group and 12% in the UFH group had progression of their intracranial hemorrhage, compared to 25% in the untreated group.

Kurtoglu et al. (2004)

Turkey

PCT

N=120

Population: TBI=103, Other=17; Median Age=37.1yr; Gender: Male=47, Female=73.

Intervention: Patients admitted to the Intensive Care Unit (ICU) were allocated to receive either Intermittent Pneumatic Compression devices (IPC; n=60) placed below the knee or Low-Molecular-Weight Heparin (LMWH) (n=60) (40 mg/day, enoxaparin sodium) for VTE prophylaxis.

Outcome Measure: Rate of DVT, PE and mortality.

1.       In the IPC group, there were 4 (6.6%) and 2 (3.3%) cases of DVT and PE, respectively.

2.       In the LMWH group, there were 3 (5%) and 4 (6.6%) cases of DVT and PE, respectively.

3.       Overall, 7 (11.6%) and 8 (13.3%) patients died in the IPC and the LMWH group, respectively.

4.       There were no significant differences between groups in rates of DVT (p=0.04), PE (p=0.07), or mortality (p=0.08).

Gersin et al. (1994)

USA

Cohort

N=32

Population: TBI; Group 1 (n=14): Mean Age=38.3yr; Gender: Male=10, Female=4; Mean GCS Score=7.1. Group 2 (n=18): Mean Age=36.1yr; Gender: Male=14, Female=4; Mean GCS Score=6.8.

Intervention: Patients admitted to the surgical Intensive care unit (ICU) either received (Group 1) or did not receive (Group 2) prophylactic sequential compression devices (SCDs). Technetium venoscans were conducted along with ventilation/perfusion (V/Q) lung scans within 6 days of admission and repeated weekly for 1 mo.

Outcome Measure: Incidence of DVT/PE.

1.       Of those who were given SCD prophylaxis, 4 developed PE and none developed DVT.

2.       Of those who did not receive prophylactic SCD, 2 developed PE and 2 developed DVT.

3.       The groups did not differ significantly in the development of DVT and PE (p=0.7).

Davidson et al. (1993)

USA

Pre-Post

N=24

Population: TBI=22, Other=2; Gender: Male=20, Female=4; Mean GCS Score=6.

Intervention: Patients admitted to the surgical or trauma intensive care unit received intermittent sequential pneumatic leg compressions (11s compression phase, 60 sec of deflation).

Outcome Measure: Mean Arterial Pressure (MAP), heart rate, central venous pressure, intracranial pressure, cerebral perfusion pressure. Measurements were obtained when the compression was initiated (time 0) and at 10, 20, and 30 min into therapy.