AA

Key Points

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  • Deep venous thrombosis is common in spinal cord injured patients not receiving prophylaxis.
  • 5000 IU subcutaneously every 12 hours of unfractionated heparin does not prevent venous thrombosis post SCI while higher dose, adjusted unfractionated heparin is more effective, although risk of bleeding complications is higher.
  • Low-molecular-weight heparin reduces the risk of venous thromboembolism post SCI more effectively than standard or unfractionated heparin prophylaxis with fewer bleeding complications.
  • There appears to be no difference between enoxaparin and dalteparin, or enoxaparin and tinzaparin, in reducing the risk of venous thrombosis post-SCI.
  • Sequential pneumatic compression devices and gradient elastic stockings may reduce the incidence of venous thromboembolism post SCI.
  • Rotating treatment tables may reduce the incidence of venous thromboembolism post SCI.
  • A combined regiment of pneumatic compression, pressure stockings and low-dose heparin or low molecular weight heparin given prophylactically may reduce the incidence of venous thrombosis and this effect is better in early post SCI.
  • Inferior vena cava filters significantly reduce the risk of pulmonary emboli in high-risk SCI patients.
  • Enoxaparin subcutaneously may be considered as an alternative to intravenous heparin for acute DVTs post SCI.