2026 Critical Care Congress Skip to main content
2026 Critical Care Congress Main banner
Final Program


Advance Program
Icon Legend
This session is not in your schedule.
This session is in your schedule. Click again to remove it.
Session Icons
Thought Leader Session
Thought Leader Session
Guidelines Session
Guidelines Session
Aging Adult Track
Aging Adult Track
Additional Registration Fee
Additional Registration Fee

Research Snapshot Theater: Pharmacology, Adult III

Venous Thromboembolism Prophylaxis Agents in Penetrating Traumatic Brain Injury

Sunday, March 22, 2026
12:15 PM - 1:15 PM Central Time
Location: Connections Central - RST 08
Introduction: Penetrating traumatic brain injury (pTBI) has been associated with an increased rate of in-hospital mortality and venous thromboembolism (VTE) compared to those with blunt injuries. Current guidelines from Brain Trauma Foundation recommend initiating both mechanical and chemical VTE prophylaxis, but no recommendation is made regarding a preferred agent or dose due to the limited available data. The purpose of this study was to evaluate the rate of VTE events among patients with pTBI based on chemical VTE prophylaxis regimen.


Methods: This was a retrospective study of adult pTBI patients admitted to a level 1 trauma center between April 1, 2016-March 31, 2025. Patients were divided into two groups: those initiated on low-molecular-weight heparin (LMWH) and those initiated on unfractionated heparin (UFH) for chemical VTE prophylaxis. The primary outcomes were rate of VTE, including pulmonary embolism or deep vein thrombosis, and occurrence of new or expanding intracranial hemorrhage (ICH) on radiographic imaging after initiation of chemical VTE prophylaxis.


Results: Of the 462 patients screened, 32 patients were ultimately included in the study: 21 received UFH and 11 received LMWH. The majority of included patients were male (87.5%) with an average age of 34.1 years. The average injury severity score was 23.8, with a median Glasgow Coma Scale score of 10 on admission. Isolated head traumas accounted for 81.3% of all patients, and 20 patients underwent an intracranial procedure while hospitalized. Only one patient who received LMWH experienced a VTE event seven days following initiation of VTE prophylaxis (p-value=0.17). New or expanding ICH did not occur in any of the patients. Three patients expired, all of whom were in the UFH group.


Conclusions: This study found no difference in the incidence of VTE or ICH when comparing the use of LMWH to UFH for chemical VTE prophylaxis in patients with pTBI. The results of this study demonstrate that LMWH may be a safe alternative to UFH for chemical VTE prophylaxis in this patient population.