Wednesday, April 29
7:00 am - 9:00 am
304 Precision Medicine for Individualized VTE Prophylaxis in the Neurosurgical Patient, including Trauma and Critical Care
Moderator(s): Randy S. Bell, MD, FAANS
Panelist(s): Daniel Bernard Michael, MD, PhD, FAANS; Jeffrey M. Sorenson, MD, FAANS; Jamie S. Ullman, MD, FAANS
Venous thromboembolism prophylaxis is a contentious aspect of our common management of all neurosurgical patients and is even more controversial in trauma and critical care. This topic is poorly addressed in neurosurgical training, mostly relying on idiosyncratic approaches, when going into more pragmatic clinical details than the overarching principles clearly stipulated in the BTF guidelines. EAST vs. WEST consensus statements also give conflicting messages. The hematology, chest, trauma, neurotrauma, neurosurgery, critical care, vascular neurology and neurocritical care communities give dissonant guidance on that topic. We propose to cover all points of views and reconcile.
- Compare and reconcile ACCP, AHA, BTF, NCS, neurosurgical and critical care guidelines as well as their respective stratification by subgroups of neurosurgical patients.
- Identify subgroup-specific pragmatic prophylactic strategies with early mobilization, use of intermittent pneumatic compression and early adequate tailored anticoagulation.
- Utilize risk assessment models for thrombosis and hemorrhage in various surgical groups and neurosurgical critical care subgroups.
- Adopt individualized prophylaxis by neurosciences subgroups, encompassing neurotrauma, craniotomy, skull base surgery, spinal surgery and subarachnoid hemorrhage.
- As well as decompressed malignant infarcts, decompressed intracerebral hemorrhage and other critical illnesses.