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2011, Number 4

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Med Crit 2011; 25 (4)

Clinical practice guidelines for thromboprophylaxis in the Intensive Care Unit

Carrillo-Esper R, Márquez AP, Sosa-García J, Aponte UM, Bobadilla AA, Briones GC, D´Ector LD, Elizondo AS, Gracia LR, Izaguirre AR, Lizárraga LS, López SN, Martínez ZR, Paredes AR, Pizaña DA, Ramírez RF, Ramírez ZL, Sánchez ZM, Vázquez GF, Villagómez OA, Zárate CP, Aldrete-Velasco J, Coronado AS, Jiménez GC, Cárdenas AA, Fonseca SL, Johnson HJ, Luque FD

Language: Spanish
References: 122
Page: 227-254
PDF size: 195.80 Kb.


ABSTRACT

The venous thromboembolic disease (TED) is one of the most frequently occurring complications in hospitalized patients including deep venous thrombosis (DVT) and pulmonary embolism (PE). It has been noted that in adult hospitalized patients are admitted with the risk to develop a venous thromboembolic event of which approximately 40% have one of three risk factors. Evidently patients with acute medical emergencies have greater risk to develop an acute venous thromboembolic event specifically, those patients with acute medical illnesses will have at least one episode of DVT and approximately 30% of patients with medical illnesses may develop DVT or PE. Current clinical studies have demonstrated that patients with medical diagnosis have a greater probability to develop a venous embolic event that those patients admitted under a surgical diagnosis. Furthermore, in the Intensive Care Units, it appears that the absence of application of the thromboprophylaxis protocol may contribute to an incidence of 13 to 31% greater than when protocols to prevent the venous thromboembolic complications are implemented. It is evident that thromboembolism, as a disease, increases significantly the morbidity and the mortality of patients admitted to general hospitals and even more so, when their medical condition indicates admission to critical care units.
Objectives: The proposed Guidelines for Clinical Practice (GPC) have the objective to standardize the evaluation, detection and prevention of the venous thromboembolic phenomenon aimed to improve the quality of care of this population, whether adults or pediatric patients implementing a protocol in all adult patients, potential candidates to develop this complication and in specific indications in underage patients. The protocol may be applied in general, but ought to allow for clinical decisions, according to the specificity of each individual patient.
Participants: This, herein proposed protocol is directed to Intensivists, Internists, Emergency Physician, specialized Pediatricians and Neonatologists, as well as, all medical personnel actively participating in the care of the above noted critically ill patients with the probable risk of a venous thromboembolic event; as noted, in these cases, prevention is by far better than frustrated attempts to treat this patients in more desperate condition.


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