Prevention of venous thromboembolism in critically ill surgery patients: a cross-sectional study.
J Crit Care
; 16(4): 161-6, 2001 Dec.
Article
en En
| MEDLINE
| ID: mdl-11815901
BACKGROUND: The risk for venous thromboembolism (VTE) and the risk for bleeding among critically ill surgical patients are both important in the early postoperative period. MATERIALS AND METHODS: To record VTE prophylaxis prescribed for surgical patients in the intensive care unit (ICU) within the first postoperative week. We conducted a prospective observational cross-sectional study of Canadian university affiliated ICUs. RESULTS: Of 29 ICU Directors approached, 28 (96.6%) participated, representing 34 ICUs and 589 ICU beds across Canada. Among 89 patients, surgical procedures were 32 abdominal (36.0%), 19 vascular (21.3%), 10 orthopedic (11.2%), 9 trauma (10.1%), 8 neurologic (9.0%), 5 thoracic (5.6%), 5 gynecologic (5.6%), and 1 for necrotizing fasciitis (1.1%). VTE prophylaxis with unfractionated heparin, low molecular weight heparin, and intermittent pneumatic compression was used in 35 of 89 (39.3%), 8 of 89 (9.0%), and 9 of 89 (10.1%) patients, respectively, whereas 8 of 89 (9.0%) patients were receiving therapeutic anticoagulation. Two methods of VTE prophylaxis were prescribed for 20 of 89 (22.5%) patients. Prophylaxis with unfractionated or low molecular weight heparin was significantly less likely to be prescribed for postoperative ICU patients requiring mechanical ventilation compared with those weaned from mechanical ventilation (odds ratio [OR] 0.36, P =.03). The use of intermittent pneumatic compression devices was significantly associated with current hemorrhage (OR 13.5, P =.02), and risk for future hemorrhage (OR 19.3, P =.001). CONCLUSIONS: VTE prevention for surgical ICU patients within the first postoperative week appear to be individualized, and influenced by current and future risks of thrombosis and bleeding.
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Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Complicaciones Posoperatorias
/
Premedicación
/
Tromboembolia
/
Heparina de Bajo-Peso-Molecular
/
Trombosis de la Vena
/
Cuidados Críticos
/
Unidades de Cuidados Intensivos
/
Anticoagulantes
Tipo de estudio:
Clinical_trials
/
Etiology_studies
/
Observational_studies
/
Prevalence_studies
/
Risk_factors_studies
Límite:
Adult
/
Aged
/
Humans
/
Middle aged
País/Región como asunto:
America do norte
Idioma:
En
Revista:
J Crit Care
Asunto de la revista:
TERAPIA INTENSIVA
Año:
2001
Tipo del documento:
Article
País de afiliación:
Canadá
Pais de publicación:
Estados Unidos