ICU Management: Venous Thromboembolism View Full Text


Ontology type: schema:Chapter     


Chapter Info

DATE

2022-06-01

AUTHORS

Takahiro Niikura

ABSTRACT

Polytrauma patients treated in the intensive care unit (ICU) are at high risk of venous thromboembolism (VTE). The primary goal of treatment is the prevention of symptomatic deep vein thrombosis/pulmonary embolism (PE) and fatal PE. VTE screening using imaging examination is insufficient for this purpose. Chemical prophylaxis is the main modality of VTE prophylaxis for polytrauma patients treated in the ICU. While the applicability of mechanical prophylaxis in polytrauma patients is limited, mechanical prophylaxis can be applied alongside chemical prophylaxis. Low-molecular-weight or low-dose unfractionated heparin is recommended for use in polytrauma patients. A history of heparin-induced thrombocytopenia is a contraindication for heparin use in chemical thromboprophylaxis; instead, Xa inhibitors may be considered. Chemical thromboprophylaxis using anticoagulants is recommended once the initial bleeding caused by the trauma has been stopped. Approximately 2 days after the initial trauma, the thrombosis risk is considered to be greater than the bleeding risk. Therefore, the appropriate period to commence chemical thromboprophylaxis falls between 3 and 8 ICU days. The contraindications for chemical thromboprophylaxis include active bleeding or risk of bleeding, intracranial hemorrhage, spinal injury, abdominal organ injury, and coagulopathy. The indications for inferior vena cava filter use in polytrauma patients remain controversial. More... »

PAGES

553-563

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/978-3-030-95906-7_38

DOI

http://dx.doi.org/10.1007/978-3-030-95906-7_38

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1148297602


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