[Prevention of venous thromboembolism in internal medicine patients]

In the entirety of medical patients, mechanical prophylactic measures and subcutaneous application of heparin have a documented efficiency and few side effects. With them the hospital mortality can be lowered by about 30%. When analysing the risks for patients of internal medicine, immobilisation respectively absence of the muscle pump play a central role in the list of risk factors. Possibilities for improving prophylaxis comprise an individual adjustment of heparin dosing (the improved efficiency in comparison with fixed dosing is not yet proven, but probable on the basis of experience made with surgical patients), the combination with mechanical/physical measures and the more consistent realisation in patients at risk. For achieving this the dosing only once per day with low molecular heparin is favourable, the latter being at least equally efficient.