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deep vein thrombosis prophylaxis

Joseph A Ricci, Kayva Crawford, Olivia A Ho, Bernard T Lee, Ketan M Patel, Matthew L Iorio
BACKGROUND: Venous thromboembolism encompasses a spectrum of disease, ranging from asymptomatic deep vein thrombosis to fatal pulmonary embolism. As microsurgical techniques increase in complexity, the overriding benefit from a microsurgical versus a venous thromboembolism prophylactic regimen remains unclear. This study evaluated the current recommendations and procedure-specific strategies for venous thromboembolism prophylaxis with a focus on the utility of prophylaxis in microsurgical procedures...
November 2016: Plastic and Reconstructive Surgery
Shinji Kuroda, Satoru Kikuchi, Masahiko Nishizaki, Shunsuke Kagawa, Shiro Hinotsu, Toshiyoshi Fujiwara
Although intermittent pneumatic compression (IPC) has become common as perioperative prophylaxis for venous thromboembolism (VTE) consisting of pulmonary thromboembolism (PE) and deep vein thrombosis (DVT), the prophylactic effect against VTE, especially lethal PE, is not yet satisfactory. Therefore, pharmacologic prophylaxis, such as with enoxaparin, is desirable. While the efficacy and safety of enoxaparin have been proven in several clinical trials, concern about bleeding with longterm (at least 7 days) use have potentially decreased its widespread adoption...
October 2016: Acta Medica Okayama
Hamid Rahmatullah Bin Abd Razak, Noorul Faeyza Binte Abd Razak, Hwee-Chye Andrew Tan
BACKGROUND: This retrospective cohort study was designed to establish the prevalence of clinically significant venous thromboembolic events (VTE) in our patients undergoing total knee arthroplasty (TKA) without chemoprophylaxis. METHODS: A single-surgeon cohort of patients who underwent TKA from 2006 to 2014 were included. All patients had a pneumatic tourniquet applied and a drain inserted postoperatively. Tranexamic acid was not used perioperatively. All patients were under a standardized postoperative protocol with routine mechanical prophylaxis against VTE...
September 28, 2016: Journal of Arthroplasty
Fatma Yildirim, Filiz Sadi Aykan
We read the report by Çeltikçi et al in the Turkish Neurosurgery with great interest. In this single-center retrospective study, they analysed 449 intracranial meningioma patients underwent open surgery. They stated that venous thromboembolism (VTE) had been seen in 21 (4.6%) of their patients. This is an important issue because VTE, including deep vein thrombosis (DVT) and pulmonary embolism (PE), is the most common overall complication in meningioma surgery and is fatal in up to one third of patients (2)...
September 26, 2016: Turkish Neurosurgery
Feng-Fei Lin, Chao-Hui Lin, Bin Chen, Ke Zheng
PURPOSE: To evaluate the comparative efficacy and safety of combination pharmacologic and graduated compression stockings (GCS) prophylaxis versus pharmacological prophylaxis alone for preventing deep vein thrombosis (DVT) and pulmonary embolism (PE) in hip surgery. METHODS: Relevant publications indexed in PubMed, Cochrane Library, Embase, Web of Science, Wanfang Data, CNKI and Sinomed (CBM) were identified. Appropriate articles identified from the reference lists of the above searches were also reviewed...
October 8, 2016: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
G I Nazarenko, E B Kleimenova, S A Payushchik, V A Otdelenov, D A Sychev
AIM: To reduce the number of preventable hospital-acquired venous thromboembolic events (HA-VTE) and to improve the quality of VTE prophylaxis at multiprofile hospital. MATERIAL AND METHODS: A comprehensive approach to preventing HA-VTE was developed, which involved the global trigger tool method to assess adverse events, as well as the computerized clinical decision support system (CDSS) to prevent HA-VTE on the basis of relevant clinical practice guidelines, and HA-VTE registry...
2016: Terapevticheskiĭ Arkhiv
S Louw, N P Saragas, P N Ferrao, T F Chirwa, B F Jacobson
BACKGROUND: Low-molecular-weight heparin and vitamin K antagonists such as warfarin are the gold standard for prohylaxis and treatment of venous thromboembolic disease (VTED). Direct oral anticoagulants (DOACs) result in predictable anticoagulation with significantly reduced inter- and intra-patient variability. DOAC absorption is rapid, with a short half-life and relatively few drug interactions. DOACs are effective and safe at fixed doses without activity monitoring. However, specific situations may require assessment of accurate drug activity...
September 8, 2016: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
Hervé Hourlier, Peter Fennema
BACKGROUND: The effect of tranexamic acid has not been examined in patients who are regular users of antithrombotics before undergoing total knee arthroplasty. The aim of this study was to determine the impact of tranexamic acid on bleeding and the risk of transfusion and thrombosis in patients taking an antithrombotic treatment before primary unilateral total knee arthroplasty. MATERIAL AND METHODS: A prospective observational study was conducted in a series of 385 consecutive primary total knee arthroplasties performed with and without the administration of tranexamic acid...
October 4, 2016: Blood Transfusion, Trasfusione del Sangue
Stacy A Voils, Stephen J Lemon, Janeen Jordan, Paul Riley, Reginald Frye
: Incidence of venous thromboembolism (VTE) in adult trauma patients is high despite mechanical and pharmacologic prophylaxis. We hypothesized that thrombin formation capacity as measured by calibrated automated thrombogram (CAT) is increased early in hospitalization and is associated with the development of VTE. METHODS: We conducted a prospective study in adult, critically ill trauma patients. Plasma was generated from whole blood samples collected within the first 3days of hospital admission...
September 20, 2016: Thrombosis Research
Katie Ann Pivarnik, Fred Schiffman, James Sullivan, Arkadiy Finn
Low-molecular-weight heparins including enoxaparin are commonly used for anticoagulation as prophylaxis and treatment for deep vein thrombosis (DVT). Prescribers of enoxaparin monitor for common side effects, such as bleeding and thrombocytopenia, but hepatotoxicity, a less common and under-reported adverse effect, may be overlooked. This report describes a case of enoxaparin-induced hepatotoxicity in a 57-year-old man who was started on the drug for a DVT. Within 3 days of taking enoxaparin, elevated transaminases were noted, and the drug was discontinued after 6 days...
2016: BMJ Case Reports
John C O'Horo, Haitao Lan, Charat Thongprayoon, Louis Schenck, Adil Ahmed, Mikhail Dziadzko
OBJECTIVE Ventilator-associated events (VAEs) are nosocomial events correlated with length of stay, costs, and mortality. Current ventilator bundle practices target the older definition of ventilator-associated pneumonia and have not been systematically evaluated for their impact on VAEs. DESIGN Retrospective cohort study. SETTING Tertiary medical center between January 2012 and August 2014. PARTICIPANTS All adult patients ventilated for at least 24 hours at our institution. INTERVENTIONS We conducted univariate analyses for compliance with each element; we focused on VAEs occurring within a 2-day window of failure to meet any ventilator bundle element...
September 19, 2016: Infection Control and Hospital Epidemiology
Rajeev B Ahuja, Priya Bansal, Gaurav S Pradhan, Manju Subberwal
INTRODUCTION: The high prevalence of deep vein thrombosis (DVT) reported in prospective studies and the unreliability of clinical diagnosis mandates prospective screening for DVT in burn patients. Our study seeks to compare D-dimer and Doppler ultrasound (DUS) in search for a practical, inexpensive and a reliable screening tool. METHODS: One hundred burn patients (inclusion criteria: 30-60% TBSA burn, >18 years of age, admitted within 48h of burn) were computer randomized into two equal groups...
September 14, 2016: Burns: Journal of the International Society for Burn Injuries
Rajeev B Ahuja, Priya Bansal, Gaurav S Pradhan, Manju Subberwal
INTRODUCTION: Morbidity and mortality from venous thrombo-embolism (VTE) remains a significant problem for trauma and medical patients and there are established guidelines for prophylaxis in these patients. However, the efficacy and safety of VTE prophylaxis in thermally injured patients continue to be elusive as it has never been studied in a prospective, randomized fashion. Selective use of VTE prophylaxis, for high risk patients, is practiced by some burn units even if objective evidence is lacking for majority of risk factors enunciated in burn patients...
September 12, 2016: Burns: Journal of the International Society for Burn Injuries
Maria Boddi, Adriano Peris
Venous thromboembolism (VTE) which includes deep vein thrombosis (DVT) and pulmonary embolism (PE) is a severe complication in critically ill patients generally affected by multiorgan disfunction associated with immobilization also prolonged.Nowadays, VTE prophylaxis is included in the requirements of hospital accreditation and evaluation of the maintenance of standards of quality of care. ICU patients are characterized by a dynamic day-to-day variation both of thromboembolic that bleeding risk and DVT incidence in presence of thromboprophylaxis ranges between 5 and 15 %...
September 15, 2016: Advances in Experimental Medicine and Biology
Mohammed Jeraq, David J Cote, Timothy R Smith
Venous thromboembolism (VTE) is a common medical condition, particularly after surgical interventions. Many studies have shown that development of VTE, including both deep vein thrombosis (DVT) and pulmonary embolism (PE), is more common in surgical patients with cancer than in patients without cancer. This chapter focuses on VTE in brain tumor patients, including their pathogenesis, presentation, diagnosis, and treatment. Topics discussed included a brief overview of VTE followed by an in-depth discussion of the VTE risks brain tumor patients face in the post-operative period...
September 15, 2016: Advances in Experimental Medicine and Biology
John W Eikelboom, Clive Kearon, Gordon Guyatt, Daniel I Sessler, Salim Yusuf, Deborah Cook, James Douketis, Ameen Patel, Andrea Kurz, Rene Allard, Philip M Jones, Rodolfo J Dennis, Thomas W Painter, Sergio D Bergese, Kate Leslie, Duminda N Wijeysundera, Kumar Balasubramanian, Emmanuelle Duceppe, Scott Miller, Johan Diedericks, P J Devereaux
BACKGROUND: The PeriOperative ISchemia Evaluation-2 (POISE-2) trial compared aspirin with placebo after noncardiac surgery. METHODS: The authors randomly assigned 10,010 patients undergoing noncardiac surgery to receive 200 mg aspirin or placebo 2 to 4 h before surgery and then 100 mg aspirin daily or placebo daily for up to 30 days after surgery. Herein, the authors report the effect of aspirin on venous thromboembolism (VTE), including deep vein thrombosis and pulmonary embolism, as well as an updated pooled analysis of randomized trials of antiplatelet therapy for VTE prevention in noncardiac surgery patients...
September 14, 2016: Anesthesiology
Ros Wade, Fiona Paton, Nerys Woolacott
AIM: The aim of this study was to explore patient preference and adherence to thigh and knee length graduated compression stockings for the prevention of deep vein thrombosis in surgical patients. BACKGROUND: Hospitalised patients are at risk of developing deep vein thrombosis. Mechanical methods of prophylaxis include compression stockings, available as knee or thigh length. Patient adherence to correct stocking use is of critical importance to their effectiveness...
September 14, 2016: Journal of Advanced Nursing
Stavros K Kakkos, Joseph A Caprini, George Geroulakos, Andrew N Nicolaides, Gerard Stansby, Daniel J Reddy, Ioannis Ntouvas
BACKGROUND: It is generally assumed by practitioners and guideline authors that combined modalities (methods of treatment) are more effective than single modalities in preventing venous thromboembolism (VTE), defined as deep vein thrombosis (DVT) or pulmonary embolism (PE), or both. This is an update of the review first published in 2008. OBJECTIVES: The aim of this review was to assess the efficacy of combined intermittent pneumatic leg compression (IPC) and pharmacological prophylaxis versus single modalities in preventing venous thromboembolism...
September 7, 2016: Cochrane Database of Systematic Reviews
Sin Hyung Park, Joong Hyeon Ahn, Yong Bok Park, Sun Geun Lee, Soo Jae Yim
PURPOSE: To investigate the incidence of thromboembolic events and complications related to bleeding after total knee arthroplasty (TKA) with a mechanical compression device alone or in combination with low-molecular-weight heparin (LMWH). MATERIALS AND METHODS: A total of 489 TKA patients (776 knees) were retrospectively reviewed for the incidence of thromboembolic events and complications related to bleeding. While 233 patients (354 knees) were treated with a mechanical compressive device without LMWH, 256 patients (422 knees) were treated with the mechanical compressive device along with LMWH...
September 2016: Knee Surgery & related Research
L Loganathan, A Hua, S Patel, C Gibbons, M P Vizcaychipi
Introduction Venous thromboembolism (VTE) is a potentially fatal complication of hip arthroplasty and knee arthroplasty. The National Institute for Health and Care Excellence recommend rivaroxaban for VTE prevention. Amid concerns over bleeding complications, the modified thromboprophylaxis policy of Chelsea and Westminster Hospital (CWH; London, UK) advises enoxaparin given after surgery in the inpatient setting followed by rivaroxaban upon hospital discharge. This retrospective study investigated the efficacy and safety of rivaroxaban in this novel, modified venous-prophylaxis regimen in a surgical orthopaedic cohort at CWH...
September 2016: Annals of the Royal College of Surgeons of England
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