Venous thromboembolism in critical care:
Gespeichert in:
| Format: | Buch |
|---|---|
| Sprache: | English |
| Veröffentlicht: |
Philadelphia, Pa. [u.a.]
Saunders
2011
|
| Schriftenreihe: | Critical care clinics
27,4 |
| Schlagworte: | |
| Online-Zugang: | Inhaltsverzeichnis |
| Beschreibung: | IX S., S. 766 - 980 Ill., graph. Darst. |
| ISBN: | 9781455710935 |
Internformat
MARC
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| 245 | 1 | 0 | |a Venous thromboembolism in critical care |c guest ed.: Kenneth E. Wood |
| 264 | 1 | |a Philadelphia, Pa. [u.a.] |b Saunders |c 2011 | |
| 300 | |a IX S., S. 766 - 980 |b Ill., graph. Darst. | ||
| 336 | |b txt |2 rdacontent | ||
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Datensatz im Suchindex
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| adam_text | Venous Thromboembolism in Critical Care
Contents
Preface: Venous Thromboembolism in Critical Care
xi
Kenneth E. Wood
Venous Thromboembolism Prophylaxis in Critically III Patients
765
Anne G. McLeod and William Geerts
Venous thromboembolism (VTE)
¡s a
frequent but often silent compli¬
cation of critical illness that has a negative impact on patient outcomes.
The prevention of VTE is an essential component of patient care in the
intensive care unit (ICU) setting, and is the focus of this article. The use
of anticoagulant thromboprophylaxis significantly decreases the risk of
VTE in ICU patients and is discussed at length.
Vena Cava
Interruption
781
Lindsay M. Fairfax and Ronald F. Sing
Anticoagulation
has been proven to be effective in preventing and
treating deep vein thrombosis and pulmonary embolus. However, many
critically ill patients are unable to receive
anticoagulation
or suffer
recurrent venous thromboembolism despite adequate treatment. This
article examines the use of
vena cava
filters in the critically ill. Indica¬
tions for, techniques, and complications of
vena cava
filter insertion are
reviewed. The importance of
vena cava
filters with the option to be
retrieved and bedside insertion in the intensive care unit is emphasized.
Heparin-lnduced Thrombocytopenia in Critically III Patients
805
Theodore E. Warkentin
Critically ill patients commonly evince thrombocytopenia, either evident
on admission to the intensive care unit (ICU) or that develops during
their stay. Heparin-induced thrombocytopenia (HIT) explains thrombo¬
cytopenia in only approximately
1/100
critically ill patients; also, only
1
or
2
in
10
ICU patients with a positive PFA-dependent enzyme immu-
noassay has true HIT. Thus, there is major potential for overdiagnosis
of HIT in the ICU. A recent study showing that dalteparin is associated
with a reduced frequency of HIT indicates that critically ill patients too
can benefit from the HIT-reducing potential of this low molecular weight
heparin preparation.
Contents
Treatment of Pulmonary Embolism:
Anticoagulation, Thrombolytic
Therapy,
and Complications of Therapy
825
Victor F.
Tapson
During the last two decades, considerable progress in technology and
clinical research methods have led to advances in the approach to the
diagnosis, prevention, and treatment of acute venous thromboembo-
lism (VTE. Despite this, however, the diagnosis is often delayed and
preventive methods are often ignored. Thus, the morbidity and mortality
associated with VTE remain high. The therapeutic approach to acute
VTE is discussed in this article, with a particular focus on the intensive
care unit setting.
Diagnostic Approach to Deep Venous Thrombosis and Pulmonary Embolism
in the Critical Care Setting
841
Marisa Magaña,
Robert Bercovitch, and Peter Fedullo
Considerable progress has been made during the last
30
years in the
prevention, diagnosis, and therapy of venous thromboembolism. This
article discusses the epidemiology, pathophysiology, and clinical pre¬
sentation of the disease as well as the diagnostic uncertainty that exists
in the critical care setting. Diagnostic approaches for deep venous
thrombosis and pulmonary embolism are considered, including clinical
prediction rules, D-dimer, contrast venography, duplex ultrasonogra-
phy, computed tomographic angiography and venography, magnetic
resonance imaging,
ventilation-perfusion
scanning, chest radiograph,
arterial blood gases, electrocardiography, and echocardiography.
Natural History of Venous Thromboembolism
869
Timothy A. Morris
Venous thromboembolism (VTE originates in systemic venous throm¬
bosis and has different etiological mechanisms and natural history from
arterial thrombosis. VTE typically originates as deep venous thrombosis
in a lower extremity, where it may give rise to acute symptoms
upstream from the obstructed vein, result in pulmonary embolism,
and/or cause chronic venous obstruction. Pulmonary embolism may
result in acute respiratory symptoms, cardiovascular collapse and,
uncommonly, may also cause chronic disease.
Major Pulmonary Embolism
885
Kenneth E. Wood
The scope and spectrum of pulmonary embolism (PE) that are likely
to challenge the
intensivist
are dominantly confined to
2
scenarios;
first, a patient presenting with undifferentiated shock or respiratory
failure and, second, an established intensive care unit (ICU) or hospital
patient who develops hemodynamically unstable PE after admission. In
either scenario, the diagnostic approach and therapeutic options are
Contents
challenging. Differentiating
PE
from other life-threatening cardiopulmo-
nary disorders can be exceedingly difficult. This article will review a
structured pathophysiologic approach to the diagnostic, resuscitative
and management strategies related to PE in the ICU.
Epidemiology and Incidence: The Scope of the Problem and Risk Factors for
Development of Venous Thromboembolism
907
Paul D. Stein and Fadi
Matta
The proportion of hospitalized patients with pulmonary embolism (PE) is
increasing. Whether this represents more admissions with PE or more
diagnoses made in hospitalized patients is uncertain. The proportion of
hospitalized patients with deep venous thrombosis has decreased
precipitously as a result of home treatment. Asians and Native Ameri¬
cans have a lower incidence of PE than whites or African Americans.
The incidence of PE increases exponentially with age, but no age
group, including infants and children, is immune. Several medical
illnesses have now been shown to be associated with a higher risk for
venous thromboembolism.
Epidemiologie data
and new information on
risk factors provide insight into making an informed clinical assessment
and evaluation for antithrombotic prophylaxis.
Hypercoagulable States
933
Julia A.M. Anderson and Jeffrey I. Weitz
Hypercoagulable states can be inherited or acquired. Inherited hyper¬
coagulable states can be caused by a loss of function of natural
anticoagulant pathways or a gain of function in
procoagulant
pathways.
Acquired hypercoagulable risk factors include a prior history of throm¬
bosis, obesity, pregnancy, cancer and its treatment, antiphospholipid
antibody syndrome, heparin-induced thrombocytopenia, and my-
eloproliferative disorders. Inherited hypercoagulable states combine
with acquired risk factors to establish the intrinsic risk of venous
thromboembolism for each individual. Venous thromboembolism oc¬
curs when the risk exceeds a critical threshold. Often a triggering factor,
such as surgery, pregnancy, or estrogen therapy, is required to in¬
crease the risk above this critical threshold.
Mortality Risk Assessment and the Role of Thrombolysis in Pulmonary
Embolism
953
Mareike Lankeit and
Stavros Konstantinides
Acute venous thromboembolism remains a frequent disease, with an
incidence ranging between
23
and
69
cases per
100,000
population per
year. Of these patients, approximately one-third present with clinical
symptoms of acute pulmonary embolism
(PĘ
and two-thirds with deep
venous thrombosis (DVT). Recent registries and cohort studies suggest
that approximately
10%
of all patients with acute PE die during the first
1
to
3
months after diagnosis. Overall,
1 %
of all patients admitted to
viii Contents
hospitals die of acute PE, and
10%
of all hospital deaths are PE-related.
These facts emphasize the need to better implement our knowledge on
the pathophysiology of the disease, recognize the determinants of
death or major adverse events in the early phase of acute PE, and most
importantly, identify those patients who necessitate prompt medical,
surgical, or interventional treatment to restore the patency of the
pulmonary vasculature.
Index
969
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| language | English |
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| spelling | Venous thromboembolism in critical care guest ed.: Kenneth E. Wood Philadelphia, Pa. [u.a.] Saunders 2011 IX S., S. 766 - 980 Ill., graph. Darst. txt rdacontent n rdamedia nc rdacarrier Critical care clinics 27,4 Venenthrombose (DE-588)4187482-1 gnd rswk-swf Intensivmedizin (DE-588)4027263-1 gnd rswk-swf Intensivmedizin (DE-588)4027263-1 s Venenthrombose (DE-588)4187482-1 s DE-604 Wood, Kenneth E. Sonstige oth Critical care clinics 27,4 (DE-604)BV000019838 27,4 Digitalisierung UB Regensburg application/pdf http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=024660660&sequence=000002&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA Inhaltsverzeichnis |
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| title | Venous thromboembolism in critical care |
| title_auth | Venous thromboembolism in critical care |
| title_exact_search | Venous thromboembolism in critical care |
| title_full | Venous thromboembolism in critical care guest ed.: Kenneth E. Wood |
| title_fullStr | Venous thromboembolism in critical care guest ed.: Kenneth E. Wood |
| title_full_unstemmed | Venous thromboembolism in critical care guest ed.: Kenneth E. Wood |
| title_short | Venous thromboembolism in critical care |
| title_sort | venous thromboembolism in critical care |
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