Venous Thromboembolism Prophylaxis: A Narrative Review With a Focus on the High-Risk Critically Ill Patient

Journal of Intensive Care Medicine
Tyler C LewisJohn Papadopoulos

Abstract

Venous thromboembolism (VTE) is a major health concern associated with significant morbidity and mortality. Critically ill patients are at an increased risk of VTE compared to general medical patients due to unique risk factors: prolonged immobilization, invasive lines and devices, certain medications, and acquired thrombophilia. Furthermore, VTE in the critically ill is associated with increased duration of mechanical ventilation, increased length of intensive care unit and hospital stay, and a trend toward increased mortality. Clinical practice guidelines therefore recommend VTE prophylaxis with either subcutaneous heparin or low-molecular-weight heparin for all critically ill patients without contraindication. Yet, many patients will develop VTE despite appropriate pharmacologic prophylaxis, which has led to interest in risk-stratifying critically ill patients for more aggressive prophylaxis strategies. Recent research identified patients at highest risk of failure of thromboprophylaxis and provided insight into the pathophysiologic mechanisms. Obesity and the receipt of vasopressors are 2 risk factors consistently identified in observational studies; further clinical data support decreased absorption of anticoagulant admini...Continue Reading

References

Dec 1, 1975·British Journal of Haematology·M BrozovićJ Abbosh
Apr 20, 1991·Lancet·C KroonH C Schoenmaker
Aug 1, 1991·American Journal of Surgery·A J RuizR E Berry
May 30, 1991·The New England Journal of Medicine·J Hirsh
Jul 1, 1974·Journal of Clinical Pathology·S Sevitt
Jul 1, 1982·Critical Care Medicine·J F Cade
Oct 1, 1996·Archives of Surgery·J T Owings, F W Blaisdell
Apr 20, 2001·The New England Journal of Medicine·U Seligsohn, A Lubetsky
May 16, 2001·European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery·A H ChenB E Sumpio
Nov 13, 2001·Mayo Clinic Proceedings·J A HeitW M O'Fallon
Apr 10, 2002·Critical Care Medicine·Emad H IbrahimWilliam Shannon
May 8, 2003·The British Journal of Surgery·S G FrederiksenL Norgren
Apr 23, 2004·Journal of Thrombosis and Haemostasis : JTH·H Bounameaux, P de Moerloose
May 22, 2004·Critical Care : the Official Journal of the Critical Care Forum·Deborah CookUNKNOWN Canadian Critical Care Trials Group
May 28, 2004·The New England Journal of Medicine·Vittorio PengoUNKNOWN Thromboembolic Pulmonary Hypertension Study Group
Jun 10, 2004·Obesity Surgery·Michele F ShepherdMichael L Schwartz
Nov 26, 2004·Journal of Clinical Pathology·R AlikhanA T Cohen
Nov 10, 2005·Critical Care : the Official Journal of the Critical Care Forum·Stefan JochbergerMartin W Dünser
Nov 29, 2005·Journal of Critical Care·Mark A CrowtherPhillip S Wells
Dec 20, 2005·Journal of Thrombosis and Haemostasis : JTH·M StainS Eichinger
Mar 1, 2006·Archives of Internal Medicine·Helen K ChewRichard H White
Apr 17, 2007·Seminars in Hematology·Mary Cushman
Feb 22, 2008·Nature·Nigel Mackman
Mar 5, 2008·Critical Care : the Official Journal of the Critical Care Forum·Deborah CookUNKNOWN Canadian Critical Care Trials Group

❮ Previous
Next ❯

Citations

May 2, 2019·European Journal of Orthopaedic Surgery & Traumatology : Orthopédie Traumatologie·Ryan LeeRajeev Pandarinath
Oct 21, 2020·Clinical and Applied Thrombosis/hemostasis : Official Journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis·Indra WijayaIan Huang
Aug 28, 2021·Biomedicines·Philippe Cauchie, Michael Piagnerelli

❮ Previous
Next ❯

Methods Mentioned

BETA
total hip arthroplasty
gastric bypass

Clinical Trials Mentioned

NCT02707263
NCT02970032
NCT02690090
NCT01721928
NCT00740987

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.