Precision Medicine for Individualized VTE Prophylaxis in the Neurosurgical Patient, Including Trauma and Critical Care-New Innovations in VTE Chemoprophylaxis

Video Transcription

Video Summary

The video content is a presentation by Dr. Brad Dengler, a neurosurgeon and neurointensivist at Walter Reed National Military Medical Center. Dr. Dengler discusses the latest research on venous thromboembolism (VTE) chemoprophylaxis in neurosurgical patients.<br /><br />He begins by stating that the latest guidelines and recommendations for VTE chemoprophylaxis in cranial and spinal surgery often lag behind the latest research. He then goes on to present findings from various studies comparing different methods of chemoprophylaxis in the neurosurgical patient population.<br /><br />One study he discusses compares unfractionated heparin and low molecular weight heparin in trauma patients with head injuries. The study finds that low molecular weight heparin decreases mortality and overall rate of VTE events. However, there are concerns about the risks of using low molecular weight heparin as it is not as easily reversed as unfractionated heparin.<br /><br />Another study evaluates the timing of prophylaxis initiation in traumatic intracranial hemorrhage patients. The study finds no significant difference in hemorrhage expansion between early initiation (within 48 hours) and late initiation. However, early initiation is associated with a lower rate of VTE events.<br /><br />Dr. Dengler also mentions studies on dosing of low molecular weight heparin and identifies issues in the processes of care related to VTE chemoprophylaxis. He concludes by discussing a study that suggests continuous heparin infusion may be beneficial in preventing complications after subarachnoid hemorrhage.<br /><br />Overall, the video provides an overview of the latest research on VTE chemoprophylaxis in neurosurgical patients, highlighting the benefits and considerations of different approaches.

Keywords

Dr. Brad Dengler

neurosurgeon

VTE chemoprophylaxis

low molecular weight heparin

trauma patients

prophylaxis initiation

subarachnoid hemorrhage