Preferences in traumatic intracranial hemorrhage bleeding vs. clotting 英文参考文献.docVIP

Chan and Zilberberg Critical Care 2010,14:153 /content/14/3/153 COMMENTARY Preferences in traumatic intracranial hemorrhage: bleeding vs. clotting Chee M Chan* and Marya D Zilberberg 1 2,3 See related research by Scales et al., /content/14/2/R72 function and possibly precipitating deat e paucity of Abstract clinical trials addressing the safety and e? cacy of chemical thromboprophylaxis in this patient population leaves clinicians guessing in regard to the appropriate dose, timing, and duration for thromboprophylaxis in the Patients with traumatic brain injury and resultant intracranial hemorrhage (ICH) are at high risk for developing venous thromboembolism (VTE). The use of thromboprophylaxis is e?ective at decreasing presence of an IC us, it is left to the physician at the bedside to weigh the risks versus bene? ts of anti- coagulation in the face of the existing potential for a the rate of VTE, but at the potential expense of an increased risk of ICH progression. Physicians must carefully consider both the bene?ts and risks of VTE prophylaxis before prescribing chemical anticoagulants to these patients. To help clarify this di?cult choice, Scales and colleagues performed a decision analysis to determine whether the bene?ts of thromboprophylaxis outweigh the potential risk of worsening ICH. There is increasing evidence that bleeding risks are not as prominent as previously thought. Although the results were largely inconclusive, the present study has identi?ed areas for future research. serious PE or the progression of a head blee e pivotal question is: how much preventive bene? t must be provided in order to outweigh the potential bleeding risk? In the previous issue of Critical Care, Scales and colleagues [1] attempted to address this question and illustrate the di? culty of making this choice in t