Saudi Critical Care Society clinical practice guidelines on the prevention of venous thromboembolism in adults with trauma: reviewed for evidence-based integrity and endorsed by the Scandinavian Society of Anaesthesiology and Intensive Care Medicine
Abstract Background To develop evidence-based clinical practice guidelines on venous thromboembolism (VTE) prevention in adults with trauma in inpatient settings. Methods The Saudi Critical Care Society (SCCS) sponsored guidelines development and included 22 multidisciplinary panel members who compl...
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| Format: | Article |
| Language: | English |
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SpringerOpen
2023-05-01
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| Series: | Annals of Intensive Care |
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| Online Access: | https://doi.org/10.1186/s13613-023-01135-8 |
| _version_ | 1797827387455438848 |
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| author | Marwa Amer Mohammed S. Alshahrani Yaseen M. Arabi Ahmed Al-jedai Hassan M. Alshaqaq Abdulaziz Al-Sharydah Faisal A. Al-Suwaidan Hosam Aljehani Thamer Nouh Hassan Mashbari Nehal Tarazan Saad Alqahtani Wail Tashkandi Khalid Maghrabi Muneerah Albugami Samaher Hashim Norah M. Alsubaie Mohammad Alsenani Haifa Algethamy Thamir M. Alshammari Ali Alaklabi Nadia Ismail Esraa S. Altawil Alyaa Elhazmi Ahmed Nahhas Maha Aljuaid Naif Alsadoon Yasser Binbraik Yuhong Yuan Waleed Alhazzani |
| author_facet | Marwa Amer Mohammed S. Alshahrani Yaseen M. Arabi Ahmed Al-jedai Hassan M. Alshaqaq Abdulaziz Al-Sharydah Faisal A. Al-Suwaidan Hosam Aljehani Thamer Nouh Hassan Mashbari Nehal Tarazan Saad Alqahtani Wail Tashkandi Khalid Maghrabi Muneerah Albugami Samaher Hashim Norah M. Alsubaie Mohammad Alsenani Haifa Algethamy Thamir M. Alshammari Ali Alaklabi Nadia Ismail Esraa S. Altawil Alyaa Elhazmi Ahmed Nahhas Maha Aljuaid Naif Alsadoon Yasser Binbraik Yuhong Yuan Waleed Alhazzani |
| author_sort | Marwa Amer |
| collection | DOAJ |
| description | Abstract Background To develop evidence-based clinical practice guidelines on venous thromboembolism (VTE) prevention in adults with trauma in inpatient settings. Methods The Saudi Critical Care Society (SCCS) sponsored guidelines development and included 22 multidisciplinary panel members who completed conflict-of-interest forms. The panel developed and answered structured guidelines questions. For each question, the literature was searched for relevant studies. To summarize treatment effects, meta-analyses were conducted or updated. Quality of evidence was assessed using the Grading Recommendations, Assessment, Development, and Evaluation (GRADE) approach, then the evidence-to-decision (EtD) framework was used to generate recommendations. Recommendations covered the following prioritized domains: timing of pharmacologic VTE prophylaxis initiation in non-operative blunt solid organ injuries; isolated blunt traumatic brain injury (TBI); isolated blunt spine trauma or fracture and/or spinal cord injury (SCI); type and dose of pharmacologic VTE prophylaxis; mechanical VTE prophylaxis; routine duplex ultrasonography (US) surveillance; and inferior vena cava filters (IVCFs). Results The panel issued 12 clinical practice recommendations—one, a strong recommendation, 10 weak, and one with no recommendation due to insufficient evidence. The panel suggests starting early pharmacologic VTE prophylaxis for non-operative blunt solid organ injuries, isolated blunt TBIs, and SCIs. The panel suggests using low molecular weight heparin (LMWH) over unfractionated heparin (UFH) and suggests either intermediate–high dose LMWH or conventional dosing LMWH. For adults with trauma who are not pharmacologic candidates, the panel strongly recommends using mechanical VTE prophylaxis with intermittent pneumatic compression (IPC). The panel suggests using either combined VTE prophylaxis with mechanical and pharmacologic methods or pharmacologic VTE prophylaxis alone. Additionally, the panel suggests routine bilateral lower extremity US in adults with trauma with elevated risk of VTE who are ineligible for pharmacologic VTE prophylaxis and suggests against the routine placement of prophylactic IVCFs. Because of insufficient evidence, the panel did not issue any recommendation on the use of early pharmacologic VTE prophylaxis in adults with isolated blunt TBI requiring neurosurgical intervention. Conclusion The SCCS guidelines for VTE prevention in adults with trauma were based on the best available evidence and identified areas for further research. The framework may facilitate adaptation of recommendations by national/international guideline policymakers. |
| first_indexed | 2024-04-09T12:47:27Z |
| format | Article |
| id | doaj.art-8e07d4c64e474397a737a5be4d4806c7 |
| institution | Directory Open Access Journal |
| issn | 2110-5820 |
| language | English |
| last_indexed | 2024-04-09T12:47:27Z |
| publishDate | 2023-05-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | Annals of Intensive Care |
| spelling | doaj.art-8e07d4c64e474397a737a5be4d4806c72023-05-14T11:27:36ZengSpringerOpenAnnals of Intensive Care2110-58202023-05-0113112710.1186/s13613-023-01135-8Saudi Critical Care Society clinical practice guidelines on the prevention of venous thromboembolism in adults with trauma: reviewed for evidence-based integrity and endorsed by the Scandinavian Society of Anaesthesiology and Intensive Care MedicineMarwa Amer0Mohammed S. Alshahrani1Yaseen M. Arabi2Ahmed Al-jedai3Hassan M. Alshaqaq4Abdulaziz Al-Sharydah5Faisal A. Al-Suwaidan6Hosam Aljehani7Thamer Nouh8Hassan Mashbari9Nehal Tarazan10Saad Alqahtani11Wail Tashkandi12Khalid Maghrabi13Muneerah Albugami14Samaher Hashim15Norah M. Alsubaie16Mohammad Alsenani17Haifa Algethamy18Thamir M. Alshammari19Ali Alaklabi20Nadia Ismail21Esraa S. Altawil22Alyaa Elhazmi23Ahmed Nahhas24Maha Aljuaid25Naif Alsadoon26Yasser Binbraik27Yuhong Yuan28Waleed Alhazzani29Medical/Critical Pharmacy Division, King Faisal Specialist Hospital and Research CenterDepartment of Emergency and Critical Care, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal UniversityIntensive Care Department, Ministry of National Guard Health Affairs, King Abdullah International Medical Research Center, King Saud Bin Abdulaziz University for Health SciencesCollege of Medicine and Pharmacy, Alfaisal UniversityEmergency Medicine Department, King Saud Medical CityDiagnostic and Interventional Radiology Department, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal UniversityClinical Excellence Administration and King Fahad Medical City, Second Health Cluster in Riyadh, Ministry of HealthDepartment of Interventional Neuroradiology, Neurosurgery, Neurocritical Care, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal UniversityTrauma and Acute Care Surgery Unit, King Saud UniversityDepartment of Surgery, Jazan UniversityDepartment of Medicine, McMaster UniversityDepartment of Orthopedic Surgery, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal UniversityDepartment of Surgery, King Abdulaziz UniversityDepartment of Critical Care Medicine, King Faisal Specialist Hospital and Research CenterDepartment of Internal Medicine, King Faisal Specialist Hospital and Research CenterPulmonary and Critical Care Department, International Medical Center/First ClinicDepartment of Surgery, King Saud University Medical CityTrauma Center, King Saud Medical CityDepartment of Anesthesia and Critical Care, King Abdulaziz UniversityCollege of Applied Medical Sciences, King Saud UniversityDepartment of Medicine, King Saud Bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research CenterDepartment of Pharmacy, Imam Abdulrahman Bin Faisal UniversityPharmacy Department, Clinical Pharmacy Services, King Saud University Medical CityDr Sulaiman Al-Habib Medical Group, Critical Care DepartmentDepartment of Critical Care Medicine, King Faisal Specialist Hospital and Research CenterClinical Nursing Department, King Abdulaziz Medical CityAlshaya International Trading CompanyDepartment of Medicine, McMaster UniversityDivision of Gastroenterology, Department of Medicine, McMaster UniversityDepartment of Medicine, McMaster UniversityAbstract Background To develop evidence-based clinical practice guidelines on venous thromboembolism (VTE) prevention in adults with trauma in inpatient settings. Methods The Saudi Critical Care Society (SCCS) sponsored guidelines development and included 22 multidisciplinary panel members who completed conflict-of-interest forms. The panel developed and answered structured guidelines questions. For each question, the literature was searched for relevant studies. To summarize treatment effects, meta-analyses were conducted or updated. Quality of evidence was assessed using the Grading Recommendations, Assessment, Development, and Evaluation (GRADE) approach, then the evidence-to-decision (EtD) framework was used to generate recommendations. Recommendations covered the following prioritized domains: timing of pharmacologic VTE prophylaxis initiation in non-operative blunt solid organ injuries; isolated blunt traumatic brain injury (TBI); isolated blunt spine trauma or fracture and/or spinal cord injury (SCI); type and dose of pharmacologic VTE prophylaxis; mechanical VTE prophylaxis; routine duplex ultrasonography (US) surveillance; and inferior vena cava filters (IVCFs). Results The panel issued 12 clinical practice recommendations—one, a strong recommendation, 10 weak, and one with no recommendation due to insufficient evidence. The panel suggests starting early pharmacologic VTE prophylaxis for non-operative blunt solid organ injuries, isolated blunt TBIs, and SCIs. The panel suggests using low molecular weight heparin (LMWH) over unfractionated heparin (UFH) and suggests either intermediate–high dose LMWH or conventional dosing LMWH. For adults with trauma who are not pharmacologic candidates, the panel strongly recommends using mechanical VTE prophylaxis with intermittent pneumatic compression (IPC). The panel suggests using either combined VTE prophylaxis with mechanical and pharmacologic methods or pharmacologic VTE prophylaxis alone. Additionally, the panel suggests routine bilateral lower extremity US in adults with trauma with elevated risk of VTE who are ineligible for pharmacologic VTE prophylaxis and suggests against the routine placement of prophylactic IVCFs. Because of insufficient evidence, the panel did not issue any recommendation on the use of early pharmacologic VTE prophylaxis in adults with isolated blunt TBI requiring neurosurgical intervention. Conclusion The SCCS guidelines for VTE prevention in adults with trauma were based on the best available evidence and identified areas for further research. The framework may facilitate adaptation of recommendations by national/international guideline policymakers.https://doi.org/10.1186/s13613-023-01135-8Venous thromboembolismPharmacologic VTE prophylaxisTraumatic brain injurySpinal cord injuryNon-operative solid organ injuriesLow molecular weight heparin |
| spellingShingle | Marwa Amer Mohammed S. Alshahrani Yaseen M. Arabi Ahmed Al-jedai Hassan M. Alshaqaq Abdulaziz Al-Sharydah Faisal A. Al-Suwaidan Hosam Aljehani Thamer Nouh Hassan Mashbari Nehal Tarazan Saad Alqahtani Wail Tashkandi Khalid Maghrabi Muneerah Albugami Samaher Hashim Norah M. Alsubaie Mohammad Alsenani Haifa Algethamy Thamir M. Alshammari Ali Alaklabi Nadia Ismail Esraa S. Altawil Alyaa Elhazmi Ahmed Nahhas Maha Aljuaid Naif Alsadoon Yasser Binbraik Yuhong Yuan Waleed Alhazzani Saudi Critical Care Society clinical practice guidelines on the prevention of venous thromboembolism in adults with trauma: reviewed for evidence-based integrity and endorsed by the Scandinavian Society of Anaesthesiology and Intensive Care Medicine Annals of Intensive Care Venous thromboembolism Pharmacologic VTE prophylaxis Traumatic brain injury Spinal cord injury Non-operative solid organ injuries Low molecular weight heparin |
| title | Saudi Critical Care Society clinical practice guidelines on the prevention of venous thromboembolism in adults with trauma: reviewed for evidence-based integrity and endorsed by the Scandinavian Society of Anaesthesiology and Intensive Care Medicine |
| title_full | Saudi Critical Care Society clinical practice guidelines on the prevention of venous thromboembolism in adults with trauma: reviewed for evidence-based integrity and endorsed by the Scandinavian Society of Anaesthesiology and Intensive Care Medicine |
| title_fullStr | Saudi Critical Care Society clinical practice guidelines on the prevention of venous thromboembolism in adults with trauma: reviewed for evidence-based integrity and endorsed by the Scandinavian Society of Anaesthesiology and Intensive Care Medicine |
| title_full_unstemmed | Saudi Critical Care Society clinical practice guidelines on the prevention of venous thromboembolism in adults with trauma: reviewed for evidence-based integrity and endorsed by the Scandinavian Society of Anaesthesiology and Intensive Care Medicine |
| title_short | Saudi Critical Care Society clinical practice guidelines on the prevention of venous thromboembolism in adults with trauma: reviewed for evidence-based integrity and endorsed by the Scandinavian Society of Anaesthesiology and Intensive Care Medicine |
| title_sort | saudi critical care society clinical practice guidelines on the prevention of venous thromboembolism in adults with trauma reviewed for evidence based integrity and endorsed by the scandinavian society of anaesthesiology and intensive care medicine |
| topic | Venous thromboembolism Pharmacologic VTE prophylaxis Traumatic brain injury Spinal cord injury Non-operative solid organ injuries Low molecular weight heparin |
| url | https://doi.org/10.1186/s13613-023-01135-8 |
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