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Chronic Thromboembolic Pulmonary Hypertension and Assessment of Right Ventricular Function in the Piglet
Published on: November 4, 2015
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Thromboembolism prophylaxis in orthopaedics: an update
Dimitrios A Flevas1, Panayiotis D Megaloikonomos1, Leonidas Dimopoulos1
1First Department of Orthopaedics, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece.
EFORT Open Reviews
|May 22, 2018
Summary
Venous thromboembolism (VTE) is a preventable cause of death in hospitalized patients. Prophylaxis significantly reduces VTE risk, with low molecular weight heparin often being the most effective method.
Area of Science:
- Orthopedics
- Vascular Surgery
- Internal Medicine
Background:
- Venous thromboembolism (VTE) is a significant and preventable cause of in-hospital mortality.
- VTE incidence ranges from 10-40% in general medical/surgical patients to 40-60% in major orthopaedic surgery without prophylaxis.
- Routine VTE prophylaxis dramatically reduces fatal pulmonary embolism and symptomatic VTE rates in orthopaedic patients.
Purpose of the Study:
- To review current methods of VTE prophylaxis.
- To discuss the efficacy and controversies surrounding various VTE prophylaxis agents and indications.
Main Methods:
- Review of mechanical prophylaxis methods including mobilization, compression stockings, and pneumatic devices.
- Review of pharmacological prophylaxis including aspirin, heparin, vitamin K antagonists, fondaparinux, and newer oral anticoagulants.
- Analysis of comparative efficacy, particularly highlighting low molecular weight heparin (LMWH).
Main Results:
- Mechanical prophylaxis methods are detailed.
- Pharmacological agents include a range of anticoagulants with varying efficacies.
- Low molecular weight heparin (LMWH) appears to be the most efficient agent overall.
- Aspirin use is questioned for major orthopaedic procedures, and prophylaxis in certain conditions remains debated.
Conclusions:
- VTE prophylaxis is crucial for hospitalized patients, especially in orthopaedics.
- Low molecular weight heparin (LMWH) is a highly effective prophylactic agent.
- Further research and consensus are needed for specific patient groups and prophylaxis strategies.
