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Prevalencia de la trombosis venosa profunda entre los pacientes en cuidados intensivos médicos
D R Hirsch1, E P Ingenito, S Z Goldhaber
1Department of Medicine, Brigham and Women's Hospital, Boston, MA 02115, USA.
JAMA
|July 26, 1995
Resumen
La trombosis venosa profunda (TVP) se produjo en el 33% de los pacientes de la unidad de cuidados intensivos médicos (UCIM), a pesar de la profilaxis. Los factores de riesgo tradicionales no predijeron el desarrollo de TVP en esta población de alto riesgo.
Área de la Ciencia:
- Medicina de cuidados críticos Medicina de cuidados críticos.
- La medicina vascular es una medicina vascular.
- Imágenes de diagnóstico por imágenes.
Sus antecedentes:
- La trombosis venosa profunda (TVP) es una preocupación significativa en pacientes en estado crítico.
- Es crucial identificar los factores de riesgo de TVP y las estrategias efectivas de prevención en la unidad de cuidados intensivos médicos (UCIM).
Objetivo del estudio:
- Para determinar la incidencia de TVP en pacientes ingresados en una unidad de cuidados intensivos médicos (UCIM).
- Evaluar la efectividad de los factores de riesgo tradicionales de TVP en la predicción de TVP en pacientes de cuidados intensivos.
Principales métodos:
- Prospectiva serie de casos de ultrasonido que involucran a 100 pacientes elegibles de MICU.
- Ultrasonografía con imágenes Doppler en color realizadas dos veces por semana y antes del alta.
- Criterios de inclusión: pacientes >18 años de edad con estadía anticipada en la UCI MICU >48 horas.
Principales resultados:
- La TVP se detectó en el 33% de los pacientes, con TVP proximal de las extremidades inferiores en el 48% y TVP de las extremidades superiores en el 15%.
- No se encontraron diferencias significativas en los factores de riesgo tradicionales (edad, IMC, cáncer, cirugía) entre los pacientes con y sin TVP.
- A pesar de que el 61% recibió profilaxis de TVP, la tasa de TVP fue inesperadamente alta.
Conclusiones:
- La incidencia de TVP en pacientes de UCIM es más alta de lo que se reconocía anteriormente.
- Los factores de riesgo tradicionales de TVP son insuficientes para identificar a los pacientes de alto riesgo en la UTI.
- La vigilancia de ultrasonido de rutina o la profilaxis mejorada pueden ser necesarias para los pacientes de la UCIM.
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