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Final DVT
Final DVT
Introduction
•Definition
•Risk Factors
•Symptoms
•Investigations
•Treatment
•Prevention
Definition
Hemoptysis +1
Malignancy w/ Rx within 6 mo, or palliative? +1
Stein PD, Hull RD, Patel KC, et al. D-dimer for the exclusion of acute venous thrombosis
and pulmonary embolism: a systematic review. Ann Int Med. 2004;140(8):589-602
Imaging
Roy PM, Colombet I, Durieux R, et al. Systematic review and meta-analysis of strategies
for the diagnosis of suspected pulmonary embolism. BMJ. 2005;331(7511):259
VTE – Other Therapy Issues
• Indications
– CHF or severe respiratory disease
– Bedrest with additional risk factor
• Cancer •Acute neurologic disease
• Prior VTE •Inflammatory bowel disease
– Most ICU patients
• Options
– Low dose unfractionated heparin or LMWH
– Sequential compression devices
– Graduated compression stockings
Prophylaxis
1- Pre-Operative:
- Weight Reduction in obese
patients
- Stop OCP 4 weeks before
surgery
2- During Operation :
Elevate heels on sand bag, Avoid
pressure on calves
Post Operative:
• Physical Measures to reduce
venous stasis:
1- Early Ambulation after
surgery
2- Leg Exercise + Massaging
3- Adequate Hydration
4- Elastic Stocks
Prophylaxis