A survey of current practice patterns in prophylaxis against venous thromboembolism (VTE) and gastrointestinal (GI) ulceration among Canadian burn centers

Burns. 2011 Nov;37(7):1182-6. doi: 10.1016/j.burns.2011.06.006. Epub 2011 Jul 20.

Abstract

Prospective data on efficacy of routine thromboprophylaxis in burn population remains limited. We believe that this uncertainty has lead to diverse management practices across Canada. Similarly, despite data supporting effectiveness of early enteral nutrition (EEN) for gastrointestinal (GI) ulcer prophylaxis, we hypothesize that many burn centers continue to use additional medical prophylaxis. A questionnaire was sent to 16 Canadian burn units regarding their practices of venous thromboembolism (VTE) and GI ulcer prophylaxis. We had 50% response rate. Fifty percent of respondents reported routine use of VTE prophylaxis in all their burn patients regardless of risk factors, 75% of these were among the largest burn centers in Canada. Only 1 center reported use of low molecular weight heparin, Enoxaparin, as their only mode of prophylaxis. With regards to GI ulcer prophylaxis, 62.5% of respondents indicated limiting use of ulcer prophylactic medications to ICU patients. Three (37.5%) centers reported practicing EEN for prophylaxis, 1 of which administered it as the sole modality. 7 of 8 centers used additional pharmacologic prophylaxis, most commonly an H2-blocker, ranitidine. There remains lack of consensus among Canadian burn centers in areas of VTE and GI ulcer prophylaxis, reflecting the limited prospective data in these fields.

Publication types

  • Multicenter Study

MeSH terms

  • Anti-Ulcer Agents / therapeutic use*
  • Anticoagulants / therapeutic use*
  • Burn Units* / statistics & numerical data
  • Canada
  • Enoxaparin / therapeutic use
  • Heparin / therapeutic use
  • Humans
  • Practice Patterns, Physicians'*
  • Prospective Studies
  • Stomach Ulcer / prevention & control*
  • Surveys and Questionnaires
  • Venous Thromboembolism / prevention & control*

Substances

  • Anti-Ulcer Agents
  • Anticoagulants
  • Enoxaparin
  • Heparin