The use of prophylactic inferior vena cava filters in trauma patients: A systematic review

详细信息	查看全文 | 推荐本文 |

• 作者：Biniam Kidane^a ; ^b ; ^{bkidane@uwo.ca} ; Amin M. Madani^b ; ^{mmadani2011@meds.uwo.ca} ; Kelly Vogt^a ; ^b ; ^{kelly.vogt@londonhospitals.ca} ; Murray Girotti^a ; ^b ; ^e ; Richard A. Malthaner^a ; ^b ; ^c ; ^e ; ^{richard.malthaner@lhsc.on.ca} ; Neil G. Parry^a ; ^b ; ^d ; ^e ; ^{neil.parry@lhsc.on.ca}
• 关键词：Polytrauma ; Venous thromboembolism ; Prophylaxis ; Vena cava filter ; Systematic review
• 刊名：Injury
• 出版年：2012
• 期刊代码：120_00201383
• 类别：med
• 出版时间：May, 2012
• 卷：43
• 期：5
• 页码：542-547
• 文件大小：251 K

摘要

Introduction

Pulmonary embolisms (PE) are an often preventable cause of late morbidity and mortality after trauma. Although there is evidence for the use of therapeutic inferior vena cava (IVC) filters (defined as IVC filters implanted in those with proven deep venous thrombosis [DVT] in order to prevent PE), there is not as much evidence to support the use of prophylactic IVC filters. Thus, we undertook a systematic review of the literature to assess the following in prophylactic IVC filters: efficacy in PE reduction, prevalence of filter-related complications and the indications for use.

Materials and methods

After screening 249 studies, 24 studies met inclusion criteria for qualitative synthesis.

Results

Overall, the literature is supportive of the use of prophylactic IVC filters in high-risk poly-trauma patients who may have contraindications to DVT prophylaxis. Filter-associated complications are uncommon and, when they do occur, tend to be of limited clinical significance. Limited data, mostly in the form of case series, supports a reduction in PE and PE-related mortality. There has been increasing use of retrievable filters as well as the ability to safely retrieve them at longer intervals.

Conclusion

Despite the addition of a few matched-control studies, the literature is still plagued by a lack of high quality data, and therefore the true efficacy of prophylactic IVC filters for prevention of PE in trauma patients remains unclear. Further studies are required to determine the true role of prophylactic IVC filters in trauma patient.