Video Experimental Relacionado
Updated: Mar 18, 2026
06:45
Point-Of-Care Ultrasound Screening for Proximal Lower Extremity Deep Venous Thrombosis
Published on: February 10, 2023
16.8K
Trombosis venosa profunda y embolia pulmonar
Marcello Di Nisio1, Nick van Es2, Harry R Büller2
1Department of Medical, Oral and Biotechnological Sciences, Gabriele D'Annunzio University, Chieti, Italy; Department of Vascular Medicine, Academic Medical Centre, Amsterdam, Netherlands.
Lancet (London, England)
|July 5, 2016
Resumen
El diagnóstico del tromboembolismo venoso (TEV) incluye reglas clínicas y pruebas de D-dimero. Los anticoagulantes orales directos son los tratamientos preferidos, con un tratamiento prolongado considerado para los pacientes de alto riesgo.
Área de la Ciencia:
- La medicina
- Cardiología
- Hematología
Sus antecedentes:
- El tromboembolismo venoso (TEV), que abarca la trombosis venosa profunda y la embolia pulmonar, presenta un desafío significativo para la salud mundial.
- Las estrategias de diagnóstico actuales para la sospecha de TEV implican un enfoque gradual que combina las reglas de decisión clínica y las pruebas de D-dimero.
Objetivo del estudio:
- Esbozar las directrices de diagnóstico y tratamiento para la tromboembolía venosa.
- Enfatizar el papel de los anticoagulantes orales directos como terapia de primera línea y discutir la duración del tratamiento.
Principales métodos:
- Aplicación secuencial de las reglas de decisión clínica y pruebas de D-dimero para descartar la TEV.
- Ultrasonografía para la sospecha de trombosis venosa profunda y tomografías computarizadas para la sospecha de embolia pulmonar.
- Comparación de los anticoagulantes orales directos con los antagonistas de la vitamina K para la eficacia y seguridad del tratamiento.
Principales resultados:
- Los pacientes con baja probabilidad de TEV y un D-dimer normal pueden evitar con seguridad la imagen y la anticoagulación.
- Los anticoagulantes orales directos demuestran un menor riesgo de sangrado y una mejor usabilidad en comparación con los antagonistas de la vitamina K.
- La trombólisis está reservada para los casos de embolia pulmonar hemodinámicamente inestable.
Conclusiones:
- La vía de diagnóstico identifica efectivamente a los pacientes que pueden renunciar a una mayor investigación y tratamiento.
- Los anticoagulantes orales directos son el tratamiento inicial preferido para la TEV.
- Se recomienda la administración de anticoagulantes durante al menos 3 meses, con la consideración de un tratamiento prolongado basado en la evaluación del riesgo individual de recurrencia frente a la hemorragia.
Videos de Conceptos Relacionados
01:29Pulmonary Embolism I: Introduction
1.1K
Pulmonary embolism (PE) occurs when a thrombus, fat or air embolus, amniotic fluid, or tumor tissue blocks one or more pulmonary arteries. These blockages originate in the venous system or the right side of the heart.EtiologyPE primarily arises from deep vein thrombosis (DVT) and other hypercoagulable states, such as inherited thrombophilias. Additional etiological factors include venous stasis, commonly seen in obesity, and endothelial injury from surgery and trauma. Less common causes include...
1.1K
01:30Venous Thrombosis I: Introduction
641
Venous thrombosis, the most common disorder of the veins, involves the formation of a thrombus or blood clot associated with vein inflammation. It can be classified as either superficial vein thrombosis or deep vein thrombosis.Superficial Vein Thrombosis: This involves the formation of a thrombus in a superficial vein, usually the greater or lesser saphenous vein. Though less severe than deep vein thrombosis (DVT), SVT can lead to complications if untreated.Deep Vein Thrombosis (DVT): This...
641
01:27Pulmonary Embolism III: Nursing Management
618
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...
618
01:29Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care
629
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...
629
01:20Venous Thrombosis II: Clinical Manifestations and Diagnostic Studies
422
The key difference between Superficial Vein Thrombosis (SVT) and Deep Vein Thrombosis (DVT) lies in their location and severity.Clinical ManifestationsSVT typically presents with localized pain, tenderness, and redness along the course of a superficial vein, often accompanied by a palpable, cord-like structure under the skin. This condition is usually less dangerous than DVT but can be uncomfortable and may lead to complications such as cellulitis or, rarely, a clot extension into the deep...
422
01:29Venous Thrombosis III: Interprofessional Care
455
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...
455