Traumacast EAST/AAST/AAST-AMC: SCC Review Series - Hematology II
Apr 28, 2025
In this engaging discussion, expert Dr. Martin Schreiber from the Uniformed Services University of the Health Sciences shares his insights on critical hematology topics. The conversation delves into the management of venous thromboembolism and anticoagulation strategies, shedding light on when to use IVC filters. They also discuss trauma-induced coagulopathy, the vital role of fibrinogen, and conditions like von Willebrand disease and sickle cell disease. Plasmapheresis applications in critical care and its significance in sepsis treatment round out this informative session.
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IVC Filter Usage Guidelines
- Use retrievable IVC filters only when anticoagulation is contraindicated due to bleeding risks or instability.
- Avoid prophylactic filters as they do not reduce mortality and may cause complications.
Anticoagulation Selection Tips
- Choose unfractionated heparin for unstable patients and those at risk of bleeding due to its rapid onset and reversibility.
- For stable patients who can take oral meds, use NOACs like apixaban unless antiphospholipid syndrome is present.
VTE Treatment Duration Advice
- Continue anticoagulation therapy for at least three months, then reevaluate the patient's risk profile.
- If long-term anticoagulation is refused, consider aspirin if no contraindications exist.