Preventive and therapeutic approach to venous thromboembolic disease and pulmonary embolism--can death from pulmonary embolism be prevented?
نویسندگان
چکیده
Venous thromboembolism produces chronic sequelae in the legs and occasional immediate mortality due to pulmonary embolism. Because it occurs in certain high risk situations (for example, after surgery) its prevention is a practical proposition. This has been attempted using many different approaches. Administration of low dose heparin with or without dihydroergotamine to enhance venous return has been one of the most widely tested regimens. There is little doubt that this can prevent, in many patient groups, postoperative deep venous thrombosis and fatal pulmonary embolism, with a low incidence of adverse reactions. Some particularly high risk postoperative patient groups (for example, those undergoing hip surgery) warrant more aggressive measures to prevent thrombosis. Surveys have shown that increasing use is being made of this approach, and it is hoped that all surgeons will adopt a policy that will reduce postoperative venous thrombosis and pulmonary embolism. A reduction in the incidence of venous thromboembolism in large acute myocardial infarction is achieved by low dose heparin, although early mobilization is important. In addition, many of the patients at risk merit full dose anticoagulation to prevent intracardiac thromboembolism. Established venous thrombosis is treated effectively by intravenous heparin, followed by warfarin to keep the prothrombin time at 1.2 to 1.5 times control, as assessed using rabbit thromboplastin; most patients need three months of treatment. Anticoagulation is warranted for pulmonary embolism, with fibrinolytic therapy reserved for patients with massive embolism and hemodynamic compromise. Embolectomy is a heroic measure, which may occasionally be lifesaving.
منابع مشابه
Diagnosis of thromboembolic disease: Combined ventilation perfusion lung scan and compression ultrasonography
The clinical management of pulmonary embolism and deep venous thrombosis of the legs are similar and requires prolonged anticoagulation therapy. The standard diagnostic approach in patients suspected of pulmonary embolism is ventilation-perfusion (V/Q) lung scan and compression ultrasonography to detect deep venous thrombosis. This retrospective study analyzed the role of V/Q lung scan an...
متن کاملEvaluation of Guidelines and Risk Factors for Venous Thrombosis and Pulmonary Embolism in Hospitalized Children: A Cross-Sectional Study
Background: Thromboembolism (TE) in pediatric population is rare but may be a fatal situation. There is a lack of clinical guidelines to help decision making for the use of prophylactic measures in pediatrics. This study was designed to evaluate current guidelines and risk factors for the prevention of venous thrombosis and pulmonary embolism (DVT/PE) in children. Materials and Methods: Th...
متن کاملPeriodontal Pockets as a Potential Source of Infection: a Case of Possible Odontogenic Septic Pulmonary Embolism
Although dental foci can be sources of bacteremia and bacterial endocarditis, hematogenous spread of infection presented with septic pulmonary embolism apparently is rare. The occurrence of septic pulmonary embolism in patients with periodontal disease without suppurative thrombophlebitis of the great vessels of the neck is well documented but to our knowledge, there is no report on septic pulm...
متن کاملEvaluation of the Frequency of Risk Factors in Venous Thromboembolic Patients Admitted to Ekbatan and Farshchian Hospitals in Hamadan from 2012 to 2017
Background and Objective: Venous thromboembolism is one of the major causes of mortality worldwide. Various environmental and genetic factors are known as risk factors for this disease. Therefore, this study aimed to investigate the frequency of risk factors in patients with venous thromboembolism admitted to Ekbatan and Farshchian hospitals in Hamadan from 2012 to 2017. Materials and Methods:...
متن کاملA Report on Emergent Pulmonary Embolectomy
Introduction: Pulmonary embolism is one of the leading causes of mortality in patients.The mortality rate of this disease can be significantly reduced with appropriate treatment. Surgical intervention can be highly effective for the treatment of acute massive pulmonary embolism. This article presents a report on the experience of acute pulmonary embolectomy. Materials and Methods: Demographic d...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید
ثبت ناماگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید
ورودعنوان ژورنال:
- Journal of the American College of Cardiology
دوره 8 6 Suppl B شماره
صفحات -
تاریخ انتشار 1986