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Current Pulmonology Reports
Published in: Current Pulmonology Reports 2/2017

01-06-2017 | Pulmonology in Combat Medicine (G Eapen, Section Editor)

Combat Venous Thromboembolism

Authors: Matthew Koroscil, Aaron Holley

Published in: Current Pulmonology Reports | Issue 2/2017

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Abstract

Purpose of Review

Service members (SMs) injured by high energy weapons are at increased risk for hemorrhagic shock and venous thromboembolism (VTE). Military physicians must decide when to initiate thromboprophylaxis or therapeutic anticoagulation in combat casualties after massive transfusion and multiple surgeries.

Recent Findings

Resuscitation with blood components is associated with VTE in the combat casualty, as are amputation and injury from improvised explosive devices (IEDs). There are no formalized scores available to estimate VTE and bleeding risk for the trauma patient. The optimal agent and dosing regimen for chemoprophylaxis have not yet been identified. Diagnosis will generally be made by imaging studies, and modern CT scanners identify emboli that may not need to be treated. When treatment is indicated, duration is a minimum of 3 months.

Summary

Combat casualties suffer higher VTE rates than their civilian counterparts do. Prophylaxis, diagnosis, and treatment are challenging. Future research should focus on risk scores to be used on admission and the proper approach to isolated subsegmental pulmonary embolism.
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Metadata
Title
Combat Venous Thromboembolism
Authors
Matthew Koroscil
Aaron Holley
Publication date
01-06-2017
Publisher
Springer US
Published in
Current Pulmonology Reports / Issue 2/2017
Electronic ISSN: 2199-2428
DOI
https://doi.org/10.1007/s13665-017-0173-0

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