Abstract | PURPOSE: Although anticoagulant thromboprophylaxis reduces the incidence of venous thromboembolism in critically ill patients, it may increase the risk of devastating bleeding complications in neurosurgical patients. For this population, anticoagulant thromboprophylaxis remains controversial and randomized controlled studies are sparse. Our goal was to establish sufficient clinical equipoise to facilitate future research in this area. MATERIALS AND METHODS: We conducted a survey of Canadian neurosurgeons and neurointensivists to better understand current practice. We developed a novel self-administered questionnaire on anticoagulant thromboprophylaxis for different neurosurgical subgroups using illustrative clinical scenarios. The instrument was evaluated for clinical sensibility by 20 nurses, neurosurgeons, and intensivists and then mailed to Canadian neurosurgeons (Canadian Neurosurgery Society) and intensivists (Canadian Critical Care Society). RESULTS: CONCLUSIONS: Most Canadian physicians reported using anticoagulant thromboprophylaxis after neurosurgery, although practice patterns differed as to when and for whom. Future research should quantify the benefits and risks in relation to the time of initiation in different neurosurgical subgroups. Our results suggest there is equipoise regarding the use of anticoagulation thromboprophylaxis in neurosurgical patients. Therefore randomized controlled trials are justifiable and needed to guide clinicians.
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Authors | Damon C Scales, Jay Riva-Cambrin, Thao Lan Le, Ruxandra Pinto, Deborah J Cook, John T Granton, Canadian Critical Care Trials Group |
Journal | Journal of critical care
(J Crit Care)
Vol. 24
Issue 2
Pg. 176-84
(Jun 2009)
ISSN: 1557-8615 [Electronic] United States |
PMID | 19501306
(Publication Type: Journal Article)
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Chemical References |
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Topics |
- Anticoagulants
(therapeutic use)
- Canada
- Critical Illness
- Humans
- Intensive Care Units
- Neurosurgical Procedures
(classification, methods)
- Time Factors
- Venous Thromboembolism
(prevention & control)
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