Of 119 articles, 46 good quality studies were selected, including 27 with high-value evidence-based medicine. Based on their analysis they make a Level 1 recommendation for all patients on mechanical ventilation, or who have coagulopathy, traumatic brain injuries and major burns. Their recommendations are level 2 for patients with multiple trauma, sepsis and renal failure and level 3 for cases of APACHE II Score, high ISS injury Severity Score, and patients who require high-dose corticosteroids.
En un reciente metanálisis de alta calidad del Eastern Association for Surgery of Trauma, se seleccionaron 46 estudios y se encontró, en el análisis de factores de riesgo, una recomendación nivel 1 de profilaxis a todo paciente con ventilación mecánica, coagulopatía, injuria cerebral traumática y quemadura mayor; recomendación nivel 2 en pacientes politraumatizados, sepsis y falla renal; recomendación nivel 3 en caso de Score APACHE II o ISS Score de severidad de injuria elevado, y requerimientos de altas dosis de corticosteroides.