Skip to main content

Anticoagulation in Penetrating Trauma

  • Chapter
  • First Online:
Penetrating Trauma
  • 1870 Accesses

Abstract

Coagulopathy after trauma remains significantly associated with complications and death. If coexisting traumatic brain injury is present, there is a dramatic increase of all-cause mortality compared to non-brain-injured patients. As an extension of this concept, the use of anticoagulants following severe injury may be associated with worsened outcomes. Anticoagulation following penetrating trauma may be considered under some select circumstances; however, careful evaluation of these patients should be undertaken to exclude contraindications. Injury burden will dictate the decision to consider the use of anticoagulants, if they are indicated for a particular injury.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 169.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 219.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Similar content being viewed by others

Recommended Reading

  1. Allard CB, Scarpelini S, Rhind SG, Baker AJ, Shek PN, Tien H, Fernando M, Tremblay L, Morrison LJ, Pinto R, Rizoli SB (2009) Abnormal coagulation tests are associated with progression of traumatic intracranial hemorrhage. J Trauma 67(5):959–967

    Article  PubMed  Google Scholar 

  2. Brown J, Lethaby A, Maxwell H, Wawrzyniak AJ, Prins MHE (2008) Antiplatelet agents for preventing thrombosis after peripheral arterial bypass surgery. Cochrane Database Syst Rev (4):CD000535

    Google Scholar 

  3. Callcut RA, Acher CW, Hoch J, Tefera G, Turnipseed W, Mell MW (2009) Impact of intraoperative arteriography on limb salvage for traumatic popliteal artery injury. J Trauma 67(2):252–257; discussion 257–258

    Article  PubMed  Google Scholar 

  4. Daenens K, Schepers S, Fourneau I, Houthoofd S, Nevelsteen A (2009) Heparin-bonded ePTFE grafts compared with vein grafts in femoropopliteal and femorocrural bypasses: 1- and 2-year results. J Vasc Surg 49(5):1210–1216

    Article  PubMed  Google Scholar 

  5. Davidovic LB, Cinara IS, Ille T, Kostic DM, Dragas MV, Markovic DM (2005) Civil and war peripheral arterial trauma: review of risk factors associated with limb loss. Vascular 13(3):141–147

    Article  PubMed  Google Scholar 

  6. Frykberg ER (2002) Popliteal vascular injuries. Surg Clin North Am 82(1):67–89

    Article  PubMed  Google Scholar 

  7. Gando S, Kameue T, Matsuda N, Hayakawa M, Ishitani T, Morimoto Y, Kemmotsu O (2002) Combined activation of coagulation and inflammation has an important role in multiple organ dysfunction and poor outcome after severe trauma. Thromb Haemost 88(6):943–949

    CAS  PubMed  Google Scholar 

  8. Gifford SM, Aidinian G, Clouse WD, Fox CJ, Porras CA, Jones WT, Zarzabal LA, Michalek JE, Propper BW, Burkhardt GE, Rasmussen TE (2009) Effect of temporary shunting on extremity vascular injury: an outcome analysis from the Global War on terror vascular injury initiative. J Vasc Surg 50(3):549–555; discussion 555–556

    Article  PubMed  Google Scholar 

  9. Guerrero A, Gibson K, Kralovich KA, Pipinos I, Agnostopolous P, Carter Y, Bulger E, Meissner M, Karmy-Jones R (2002) Limb loss following lower extremity arterial trauma: what can be done proactively? Injury 33(9):765–769

    Article  PubMed  Google Scholar 

  10. Huynh TT, Pham M, Griffin LW, Villa MA, Przybyla JA, Torres RH, Keyhani K, Safi HJ, Moore FA (2006) Management of distal femoral and popliteal arterial injuries: an update. Am J Surg 192(6):773–778

    Article  PubMed  Google Scholar 

  11. MacLeod J, Lynn M, McKenney MG, Jeroukhimov I, Cohn SM (2004) Predictors of mortality in trauma patients. Am Surg 70(9):805–810

    PubMed  Google Scholar 

  12. Mullenix PS, Steele SR, Andersen CA, Starnes BW, Salim A, Martin MJ (2006) Limb salvage and outcomes among patients with traumatic popliteal vascular injury: an analysis of the National Trauma Data Bank. J Vasc Surg 44(1):94–100

    Article  PubMed  Google Scholar 

  13. Sagraves SG, Conquest AM, Albrecht RJ, Toschlog EA, Schenarts PJ, Bard MR, Powell CS, Rotondo MF (2003) Popliteal artery trauma in a rural level I trauma center. Am Surg 69(6):485–489; discussion 490

    PubMed  Google Scholar 

  14. Sala F, Hassen-Khodja R, Lecis A, Bouillanne PJ, Declemy S, Batt M (2003) Long-term outcome of femoral above-knee popliteal artery bypass using autologous saphenous vein versus expanded polytetrafluoroethylene grafts. Ann Vasc Surg 17(4):401–407

    Article  PubMed  Google Scholar 

  15. Sawamura A, Hayakawa M, Gando S, Kubota N, Sugano M, Wada T, Katabami K (2009) Disseminated intravascular coagulation with a fibrinolytic phenotype at an early phase of trauma predicts mortality. Thromb Res 124(5):608–613

    Article  CAS  PubMed  Google Scholar 

  16. Smith LM, Block EF, Buechter KJ, Draughn DC, Watson D, Hedden W (1999) The natural history of extremity venous repair performed for trauma. Am Surg 65(2):116–120

    CAS  PubMed  Google Scholar 

  17. Talving P, Benfield R, Hadjizacharia P, Inaba K, Chan LS, Demetriades D (2009) Coagulopathy in severe traumatic brain injury: a prospective study. J Trauma 66(1):55–61; discussion 61–62

    Article  PubMed  Google Scholar 

  18. Vertrees A, Fox CJ, Quan RW, Cox MW, Adams ED, Gillespie DL (2009) The use of prosthetic grafts in complex military vascular trauma: a limb salvage strategy for patients with severely limited autologous conduit. J Trauma 66(4):980–983

    Article  CAS  PubMed  Google Scholar 

  19. White NJ, Martin EJ, Brophy DF, Ward KR (2010) Coagulopathy and traumatic shock: characterizing hemostatic function during the critical period prior to fluid resuscitation. Resuscitation 81(1):111–116

    Article  PubMed  Google Scholar 

  20. Woodward EB, Clouse WD, Eliason JL, Peck MA, Bowser AN, Cox MW, Jones WT, Rasmussen TE (2008) Penetrating femoropopliteal injury during modern warfare: experience of the Balad Vascular Registry. J Vasc Surg 47(6):1259–1264; discussion 1264–1265

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to David R. King .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2017 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

King, D.R. (2017). Anticoagulation in Penetrating Trauma. In: Velmahos, G., Degiannis, E., Doll, D. (eds) Penetrating Trauma. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-49859-0_75

Download citation

  • DOI: https://doi.org/10.1007/978-3-662-49859-0_75

  • Published:

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-662-49857-6

  • Online ISBN: 978-3-662-49859-0

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics