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Related Concept Videos

Venous Thrombosis III: Interprofessional Care01:29

Venous Thrombosis III: Interprofessional Care

Venous thrombosis requires effective prevention and treatment strategies to improve patient outcomes and reduce potential complications.Prevention StrategiesHealthcare providers must prioritize preventing venous thromboembolism (VTE) for all adult patients upon admission. Interventions depend on bleeding and thrombosis risk, medical history, current medications, diagnoses, planned procedures, and patient preferences. Patients on bed rest should change positions every two hours and, if not...
Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care01:29

Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care

Diagnosing Pulmonary EmbolismDiagnosing pulmonary embolism (PE) involves clinical assessment and advanced imaging tests. The preferred diagnostic tool is the spiral (helical) CT scan or CT angiography (CTA), which uses intravenous contrast media to visualize the pulmonary vasculature and identify emboli.A ventilation-perfusion (V/Q) scan is an alternative for patients unable to receive contrast media. This scan includes both perfusion and ventilation scanning. Perfusion scanning involves...
Peripheral Artery Disease III: Interprofessional Care01:27

Peripheral Artery Disease III: Interprofessional Care

Peripheral Artery Disease (PAD) is characterized by narrowed arteries that diminish blood flow to the extremities. Effective management of PAD requires an interprofessional approach involving various healthcare professionals. The critical aspects of interprofessional care for PAD patients focus on risk factor modification, drug therapy, exercise therapy, nutrition therapy, critical limb ischemia care, and interventional radiology and surgical procedures.The primary treatment goal for PAD...
Pulmonary Embolism III: Nursing Management01:27

Pulmonary Embolism III: Nursing Management

A pulmonary embolism occurs when a thrombus, amniotic fluid, tumor tissue, fat, or air embolus blocks one or more pulmonary arteries. Effective nursing management and patient education are crucial for improving outcomes and preventing recurrence.Nursing management starts with obtaining a comprehensive patient history, particularly noting any history of deep vein thrombosis (DVT). Assess for clinical manifestations, including dyspnea, chest pain, crackles, heart murmurs, and signs of right-sided...
Venous Thrombosis IV: Nursing Management01:30

Venous Thrombosis IV: Nursing Management

Nursing management begins with a thorough assessment of the patient's health history. Key factors include trauma to veins, peripherally inserted central catheters, varicose veins, recent pregnancy or childbirth, surgery, bacteremia, prolonged bed rest, atrial fibrillation, COPD, heart failure, cancer, coagulation disorders, myocardial infarction, spinal cord injury, stroke, prolonged travel, recent bone fractures, and dehydration. Review medication intake, particularly oral contraceptives,...
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Treatment for Pulmonary Arterial Hypertension: Prostacyclin Receptor Agonists

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Intermittent pneumatic compression and pharmacologic thrombosis prophylaxis.

Joseph A Caprini1

  • 1Division of Vascular Surgery, NorthShore University HealthSystem, Evanston, USA. jcaprini2@aol.com

Current Opinion in Pulmonary Medicine
|May 30, 2009
PubMed
Summary

Venous thromboembolism prophylaxis remains a challenge, with only 50% of at-risk patients receiving adequate treatment. New oral anticoagulants show promise for reducing deep vein thrombosis and pulmonary embolism events, especially after hospital discharge.

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Area of Science:

  • Medical research
  • Cardiovascular medicine
  • Thrombosis management

Background:

  • Venous thromboembolism (VTE), encompassing deep vein thrombosis and pulmonary embolism, is a significant healthcare concern.
  • Despite initiatives like the Surgeon General's 'call to action,' VTE prophylaxis is underutilized, with only 50% of at-risk patients receiving appropriate treatment.
  • Existing prophylaxis measures include intermittent pneumatic compression and traditional anticoagulants.

Purpose of the Study:

  • To review current data on VTE prophylaxis strategies.
  • To evaluate the efficacy and safety of novel anticoagulants and mechanical prophylaxis methods.
  • To identify optimal approaches for reducing VTE incidence in surgical patients.

Main Methods:

  • Review of recent clinical data and studies on VTE prophylaxis.
  • Analysis of efficacy and safety profiles of new oral anticoagulants.
  • Assessment of intermittent pneumatic compression in conjunction with anticoagulants.

Main Results:

  • New data support the use of intermittent pneumatic compression.
  • Novel oral anticoagulants demonstrate comparable or improved efficacy and safety versus traditional anticoagulants in orthopedic surgery.
  • These new agents are orally administered pills, simplifying outpatient management.

Conclusions:

  • Combining intermittent pneumatic compression with parenteral anticoagulants offers maximal efficacy in high-risk surgical patients.
  • New oral anticoagulants provide a safe, effective, and convenient alternative to existing parenteral options, requiring no routine monitoring.
  • Given that most VTE events occur post-discharge, these novel agents hold significant potential for reducing overall VTE incidence.