Abstract
AbstractDeep vein thrombosis (DVT) in critically ill patients still represents a clinical challenge. The aim of the study was to investigate whether a systematic ultrasound (US) screening might improve the management of the antithrombotic therapy in intensive care unit (ICU). In this non-randomized diagnostic clinical trial, 100 patients consecutively admitted to ICU of the University Hospital of Perugia were allocated either in the screening group or in the control group. Subjects in the screening group underwent US examination of lower limbs 48 h after admission, and again after 5 days. Subjects in the control group underwent US examination according to the standard of care (SOC) of the enrolling institution. Retrospectively registered at ClinicalTrials.gov (NCT05019092) on 24.08.2021. Lower limb DVT was significantly more frequent in the screening group (p < 0.001), as well as the subsequent extension of a pre-existing DVT (p = 0.027). In the control group, DVT of large veins was more frequent (p = 0.038). Major bleedings were reported in 5 patients, 4 in the non-screening group and in 1 in the screening group. Patients in the screening group started the antithrombotic treatment later (p = 0.038), although the frequency, dose and duration of the treatment were not different between the two groups. The duration of stay in ICU was longer in the screening group (p = 0.007). Active screening for DVT is associated with an increased diagnosis of DVT. The screening could be associated with a reduced incidence of proximal DVT and a reduction in the bleeding risk.
Funder
Università degli Studi di Perugia
Publisher
Springer Science and Business Media LLC
Subject
Emergency Medicine,Internal Medicine
Reference20 articles.
1. Malato A, Dentali F, Siragusa S, Fabbiano F, Kagoma Y, Boddi M et al (2015) The impact of deep vein thrombosis in critically ill patients: a meta-analysis of major clinical outcomes. Blood Transfus 13(4):559–568
2. Boddi M, Peris A (2017) Deep vein thrombosis in intensive care. Adv Exp Med Biol 906:167–181
3. Ibrahim EH, Iregui M, Prentice D, Sherman G, Kollef MH, Shannon W (2002) Deep vein thrombosis during prolonged mechanical ventilation despite prophylaxis. Crit Care Med 30(4):771–774
4. Shorr AF, Williams MD (2009) Venous thromboembolism in critically ill patients. Observations from a randomized trial in sepsis. Thromb Haemost 101:139–144
5. Minet C, Lugosi M, Savoye PY, Menez C, Ruckly S, Bonadona A et al (2012) Pulmonary embolism in mechanically ventilated patients requiring computed tomography: prevalence, risk factors, and outcome. Crit Care Med 40(12):3202–3208
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