Efficacy of Deep Venous Thrombosis Prophylaxis in the Medical Intensive Care Unit

Abstract

The purpose of this study was to determine the incidence of deep venous thrombosis in medical intensive care unit patients receiving deep venous thrombosis prophylaxis. This was a prospective cohort study of 141 consecutive adult patients anticipated to remain in the medical intensive care unit for >48 hours. Deep venous thrombosis prophylaxis was provided using subcutaneous unfractionated heparin or a sequential compression device according to risk-stratified protocol. Compression ultrasound was performed. Fourteen patients (9.9%) developed deep venous thrombosis on follow-up studies. Incidence of deep venous thrombosis was 7.9% per person year (95% confidence interval, 4.8-12.8). Two of 14 developed pulmonary embolism. Eight patients required full anticoagulation with intravenous heparin or coumadin. In-hospital mortality was similar in both groups. Patients with deep venous thrombosis had a statistically higher risk of pulmonary embolism: 14.2% (95% confidence interval, 2.0-43.0) versus 0.0% (95% confidence interval, 0-3; P = .009). Incidence of deep venous thrombosis is high in medical intensive care unit patients receiving standard prophylaxis. Adherence to strict deep venous thrombosis prophylaxis protocol and exploration of other prophylaxis regimens should be pursued.

Reduction in deep vein thrombosis incidence in intensive care after a clinician education program

“…Accordingly, the 4.5% DVT incidence found in our prospective phase is consistent with outcome rates reported in other studies involving critically ill patients receiving thromboprophylaxis [4,23,24,27]. In reality, the reduction in DVT incidence that we obtained after implementation of prophylaxis was beyond what we might have expected.…”

“…Cook et al [23] and Khouli et al [27], using regular ultrasound screening, estimated the incidence of DVT in ICU medical-surgical patients to approach 10%; in trauma patients the DVT incidence ranged from 8% to 12% when ultrasound was used as a screening tool [4]. Accordingly, the 4.5% DVT incidence found in our prospective phase is consistent with outcome rates reported in other studies involving critically ill patients receiving thromboprophylaxis [4,23,24,27].…”

An evaluation of practice pattern for venous thromboembolism prevention in Lebanese hospitals

“…In addition, co-morbidity conditions added points to the risk score, resulting in the high-risk category. The analysis in this study focused on ICU versus non-ICU patients [1,9,[48][49][50][51][52] because specific guidelines for the ICU population are established [9,[53][54][55][56][57][58][59][60][61][62]. In the ICU group, two-thirds of the patients received appropriate prophylaxis.…”

EEG-Monitoring zur Sedierungsüberwachung: Verkürzung der intensivstationären Behandlungsdauer

“…Sowohl eine zu geringe als auch eine zu tiefe Sedierung kann den Krankheitsverlauf ung ü nstig beeinfl ussen [1,5] und das Auftreten von Sekund ä rkomplikationen f ö rdern [6,7] . Die Zielstellung, Patienten so tief zu sedieren, dass sie in einem narkose ä hnlichen Zustand sind, wurde in den letzten Jahren zunehmend verlassen.…”