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Combat Venous Thromboembolism

  • Pulmonology in Combat Medicine (G Eapen, Section Editor)
  • Published:
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Abstract

Purpose of Review

Service members (SMs) injured by high energy weapons are at increased risk for hemorrhagic shock and venous thromboembolism (VTE). Military physicians must decide when to initiate thromboprophylaxis or therapeutic anticoagulation in combat casualties after massive transfusion and multiple surgeries.

Recent Findings

Resuscitation with blood components is associated with VTE in the combat casualty, as are amputation and injury from improvised explosive devices (IEDs). There are no formalized scores available to estimate VTE and bleeding risk for the trauma patient. The optimal agent and dosing regimen for chemoprophylaxis have not yet been identified. Diagnosis will generally be made by imaging studies, and modern CT scanners identify emboli that may not need to be treated. When treatment is indicated, duration is a minimum of 3 months.

Summary

Combat casualties suffer higher VTE rates than their civilian counterparts do. Prophylaxis, diagnosis, and treatment are challenging. Future research should focus on risk scores to be used on admission and the proper approach to isolated subsegmental pulmonary embolism.

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  1. Pulmonary and Critical Care Medicine Service, San Antonio Military Medical Center, San Antonio, TX, USA

    Matthew Koroscil & Aaron Holley

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  1. Matthew Koroscil
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  2. Aaron Holley
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Correspondence to Aaron Holley.

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Matthew Koroscil and Aaron Holley declare no conflict of interest.

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This article is part of the Topical Collection on Pulmonology in Combat Medicine

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Koroscil, M., Holley, A. Combat Venous Thromboembolism. Curr Pulmonol Rep 6, 124–130 (2017). https://doi.org/10.1007/s13665-017-0173-0

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