What We Know and Don't Know about Deep Venous Thrombosis and Pulmonary Embolism!

Martin, Louis F.; Gouda, Biswanath P.

doi:10.1381/0960892053723457

Cited by 11 publications

(8 citation statements)

References 6 publications

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“…Thus, patients undergoing bariatric surgery are considered generally to be at moderate risk for lower extremity DVT and PE ( 396 (EL 4)) . PE may be the first manifestation of venous thromboembolism and is the leading cause of mortality in experienced bariatric surgery centers ( 397 (EL 4)) . Unfractionated heparin, 5,000 IU subcutaneously, or low‐molecular‐weight heparin therapy should be initiated shortly (within 30–120 min) before bariatric surgery and repeated every 8–12 h postoperatively until the patient is fully mobile ( 398 (EL 4)) .…”

Section: Appendix: Discussion Of the Clinical Evidencementioning

confidence: 99%

AMERICAN ASSOCIATION OF CLINICAL ENDOCRINOLOGISTS, THE OBESITY SOCIETY, AND AMERICAN SOCIETY FOR METABOLIC & BARIATRIC SURGERY MEDICAL GUIDELINES FOR CLINICAL PRACTICE FOR THE PERIOPERATIVE NUTRITIONAL, METABOLIC, AND NONSURGICAL SUPPORT OF THE BARIATRIC SURGERY PATIENT

Mechanick¹,

Kushner²,

Sugerman³

et al. 2009

Obesity

283

199

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American Association of Clinical Endocrinologists, The Obesity Society, and American Society for Metabolic & Bariatric Surgery Medical Guidelines for Clinical Practice are systematically developed statements to assist health‐care professionals in medical decision making for specific clinical conditions. Most of the content herein is based on literature reviews. In areas of uncertainty, professional judgment was applied. These guidelines are a working document that reflects the state of the field at the time of publication. Because rapid changes in this area are expected, periodic revisions are inevitable. We encourage medical professionals to use this information in conjunction with their best clinical judgment. The presented recommendations may not be appropriate in all situations. Any decision by practitioners to apply these guidelines must be made in light of local resources and individual patient circumstances. The American Society for Parenteral & Enteral Nutrition fully endorses sections of these guidelines that address the metabolic and nutritional management of the bariatric surgical patient.

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Section: Appendix: Discussion Of the Clinical Evidencementioning

confidence: 99%

AMERICAN ASSOCIATION OF CLINICAL ENDOCRINOLOGISTS, THE OBESITY SOCIETY, AND AMERICAN SOCIETY FOR METABOLIC & BARIATRIC SURGERY MEDICAL GUIDELINES FOR CLINICAL PRACTICE FOR THE PERIOPERATIVE NUTRITIONAL, METABOLIC, AND NONSURGICAL SUPPORT OF THE BARIATRIC SURGERY PATIENT

Mechanick¹,

Kushner²,

Sugerman³

et al. 2009

Obesity

283

199

View full text Add to dashboard Cite

show abstract

“…The risk of thromboembolism and its complications has to be balanced with the increased bleeding risk. In the literature, there have been no randomized studies examining the correlation between DVT, PE, and the various options for prophylaxis of thromboembolism in bariatric surgery [8]. In addition, there are only a few reports in the bariatric literature with evidencebased data on preventing thrombosis and its complications.…”

Section: Introductionmentioning

confidence: 99%

Evidence of Thromboembolism Prophylaxis in Bariatric Surgery—Results of a Quality Assurance Trial in Bariatric Surgery in Germany from 2005 to 2007 and Review of the Literature

Stroh

Birk²,

Flade-Kuthe

et al. 2009

OBES SURG

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In Germany, a trend from GB to sleeve gastrectomy (SG) and malabsorptive approach has been evaluated. This trend is associated with differences of the DVT prophylaxis regimen in the profile of bariatric surgical patients depending on BMI and the type of bariatric procedure. Despite the low incidence of DVT and pulmonary embolism (PE) detected, there is a lack of evidence on a reasonable regimen for sufficient DVT prophylaxis in bariatric surgery; instead, there are only recommendations from the guidelines and statements of a specific medical society. Therefore, prospective studies are necessary to determine the optimal DVT prophylaxis for bariatric surgical patients as well as obese patients undergoing surgery.

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“…The risk of VTE and its complications has to be balanced with the increased bleeding risk. In the literature, there have been no randomized studies examining the correlation between VTE, pulmonary embolism (PE), and the various options for VTE prophylaxis in bariatric surgery [8]. Recent published meta-analysis show the relatively low risk with standard regimen for antithrombotic prophylaxis, but an increasing bleeding risk, when weight-adjusted dose of heparin were used [9].…”

Section: Introductionmentioning

confidence: 99%

Actual Situation of Thromboembolic Prophylaxis in Obesity Surgery: Data of Quality Assurance in Bariatric Surgery in Germany

et al. 2012

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Background. Evidence-based data on optimal approach for prophylaxis of deep venous thrombosis (VTE) and pulmonary embolism (PE) in bariatric operations is discussed. Using antithrombotic prophylaxis weight adjusted the risk of VTE and its complications have to be balanced with the increased bleeding risk. Methods. Since 2005 the current situation for bariatric surgery has been examined by quality assurance study in Germany. As a prospective multicenter observational study, data on the type, regimen, and time course of VTE prophylaxis were documented. The incidences of clinically diagnosed VTE or PE were derived during the in-hospital course and follow up. Results. Overall, 11,835 bariatric procedures were performed between January 2005 and December 2010. Most performed procedures were 2730 gastric banding (GB); 4901 Roux-en-Y-gastric bypass (RYGBP) procedures, and 3026 sleeve gastrectomies (SG). Study collective includes 72.5% (mean BMI 48.1 kg/m2) female and 27.5% (mean BMI 50.5 kg/m2) male patients. Incidence of VTE was 0.06% and of PE 0.08%. Conclusion. VTE prophylaxis regimen depends on BMI and the type of procedure. Despite the low incidence of VTE and PE there is a lack of evidence. Therefore, prospective randomized studies are necessary to determine the optimal VTE prophylaxis for bariatric surgical patients.

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What We Know and Don't Know about Deep Venous Thrombosis and Pulmonary Embolism!

Cited by 11 publications

References 6 publications

AMERICAN ASSOCIATION OF CLINICAL ENDOCRINOLOGISTS, THE OBESITY SOCIETY, AND AMERICAN SOCIETY FOR METABOLIC & BARIATRIC SURGERY MEDICAL GUIDELINES FOR CLINICAL PRACTICE FOR THE PERIOPERATIVE NUTRITIONAL, METABOLIC, AND NONSURGICAL SUPPORT OF THE BARIATRIC SURGERY PATIENT

AMERICAN ASSOCIATION OF CLINICAL ENDOCRINOLOGISTS, THE OBESITY SOCIETY, AND AMERICAN SOCIETY FOR METABOLIC & BARIATRIC SURGERY MEDICAL GUIDELINES FOR CLINICAL PRACTICE FOR THE PERIOPERATIVE NUTRITIONAL, METABOLIC, AND NONSURGICAL SUPPORT OF THE BARIATRIC SURGERY PATIENT

Evidence of Thromboembolism Prophylaxis in Bariatric Surgery—Results of a Quality Assurance Trial in Bariatric Surgery in Germany from 2005 to 2007 and Review of the Literature

Actual Situation of Thromboembolic Prophylaxis in Obesity Surgery: Data of Quality Assurance in Bariatric Surgery in Germany

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