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Venous thromboembolism in the intensive care unit
Michael T Williams1, Natarajan Aravindan, Michael J Wallace
1U.T.M.D. Anderson Cancer Center, Box 112, 1515 Holcombe Blvd., Houston, TX 77030, USA. micwilliams@mdanderson.org
Critical Care Clinics
|April 18, 2003
Summary
Intensive care unit (ICU) patients face high risks for venous thromboembolism (VTE). Prophylaxis with heparin is crucial for prevention, with alternatives available for contraindicated cases.
Area of Science:
- Critical Care Medicine
- Vascular Surgery
- Hematology
Background:
- Intensive care unit (ICU) patients exhibit numerous risk factors for venous thromboembolism (VTE).
- High incidence of deep vein thrombosis (DVT) and pulmonary embolism (PE) in ICU populations is confirmed by autopsy findings.
- Clinical diagnosis of VTE in ICUs is challenging, necessitating reliable diagnostic methods.
Purpose of the Study:
- To review diagnostic investigations for VTE in ICU patients.
- To evaluate the sensitivity, specificity, and practicability of current diagnostic tools.
- To formulate recommended diagnostic algorithms for VTE in the ICU setting.
Main Methods:
- Systematic review of diagnostic investigations for VTE.
- Analysis of sensitivity, specificity, and practicability data.
- Development of diagnostic algorithms based on evidence.
Main Results:
- Currently available diagnostic investigations for VTE were reviewed.
- Recommended diagnostic algorithms were formulated for ICU patients.
- Prevention remains the cornerstone of VTE management in the ICU.
Conclusions:
- All ICU patients are at high risk for VTE and require prophylactic measures.
- Subcutaneous prophylactic heparin is recommended unless contraindicated.
- Alternative prophylactic methods should be considered for patients with contraindications to heparin.