Chapter title |
Deep Vein Thrombosis in Intensive Care
|
---|---|
Chapter number | 114 |
Book title |
Thrombosis and Embolism: from Research to Clinical Practice
|
Published in |
Advances in experimental medicine and biology, September 2016
|
DOI | 10.1007/5584_2016_114 |
Pubmed ID | |
Book ISBNs |
978-3-31-922107-6, 978-3-31-922108-3
|
Authors |
Maria Boddi M.D., Ph.D., Adriano Peris M.D., Maria Boddi, Adriano Peris |
Editors |
Md. Shahidul Islam |
Abstract |
Venous thromboembolism (VTE) which includes deep vein thrombosis (DVT) and pulmonary embolism (PE) is a severe complication in critically ill patients generally affected by multiorgan disfunction associated with immobilization also prolonged.Nowadays, VTE prophylaxis is included in the requirements of hospital accreditation and evaluation of the maintenance of standards of quality of care. ICU patients are characterized by a dynamic day-to-day variation both of thromboembolic that bleeding risk and DVT incidence in presence of thromboprophylaxis ranges between 5 and 15 %.Patient-centered methods for the assessment of both thrombotic and bleeding risk are recommended because pre-existent factors to ICU admission, diagnosis, emerging syndromes, invasive procedures and pharmacological treatments daily induce important changes in clinical condition.General consensus currently establishes use of heparin in pharmacological prophylaxis at the time of admission to the ICU and the temporary suspension of heparin in patients with active bleeding or severe (<50,000/cc) thrombocytopenia. Individualized thromboprophylaxis regimens were proposed but there is still no consensus based on evidence.DVT diagnosis is not clinical but imaging-based and in each ICU data on DVT incidence (DVT diagnosed 72 h after ICU admission) should be obtained by weekly ultrasound screening standardized for the anatomical sites of compression used, taking into account the persistence of DVT-risk throughout ICU stay. A role for mechanical thromboprophylaxis by elastic stockings or pneumatic compression was reported but no general consensus was reached about its use at the best. Much work has to be done but ICU remain the last frontier for VTE prophylaxis. |
Mendeley readers
Geographical breakdown
Country | Count | As % |
---|---|---|
Unknown | 108 | 100% |
Demographic breakdown
Readers by professional status | Count | As % |
---|---|---|
Other | 15 | 14% |
Student > Master | 14 | 13% |
Researcher | 9 | 8% |
Student > Postgraduate | 8 | 7% |
Student > Bachelor | 7 | 6% |
Other | 19 | 18% |
Unknown | 36 | 33% |
Readers by discipline | Count | As % |
---|---|---|
Medicine and Dentistry | 50 | 46% |
Nursing and Health Professions | 6 | 6% |
Pharmacology, Toxicology and Pharmaceutical Science | 2 | 2% |
Social Sciences | 2 | 2% |
Business, Management and Accounting | 1 | <1% |
Other | 5 | 5% |
Unknown | 42 | 39% |