Pulmonary Embolism / DVT / VTE Archives - Page 2 of 3 - PulmCCM
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Pulmonary Embolism / DVT / VTE Articles

Jun 112012
 
Prevention and Treatment of DVT/PE in Pregnant Women (Guideline)

The content previously here was removed at the request of the American College of Chest Physicians. For the ACCP 9th edition clinical practice guidelines for prevention and treatment of venous thromboembolism (VTE), please visit the ACCP website. PulmCCM is not affiliated with ACCP or Chest.

May 212012
 
Diagnosis of Lower-Extremity DVT (Guideline)

The content previously here was removed at the request of the American College of Chest Physicians. For the ACCP 9th edition clinical practice guidelines for prevention and treatment of venous thromboembolism (VTE), please visit the ACCP website. PulmCCM is not affiliated with ACCP or Chest.

Apr 282012
 
Inferior vena cava filters for acute PE and DVT (ACCP Guidelines)

The content here previously has been removed at the request of the American College of Chest Physicians. For the ACCP’s Guidelines for Diagnosis and Management of DVT/PE/VTE, 9th edition, please visit the ACCP’s web site. PulmCCM is not affiliated with the ACCP.

Apr 232012
 
Thrombolytics for acute pulmonary embolism (Guidelines)

The content previously here was removed at the request of the American College of Chest Physicians. For the ACCP 9th edition clinical practice guidelines for prevention and treatment of venous thromboembolism (VTE), please visit the ACCP website. PulmCCM is not affiliated with ACCP or Chest.

Mar 112012
 

The content previously here was removed at the request of the American College of Chest Physicians. For the ACCP 9th edition clinical practice guidelines for prevention and treatment of venous thromboembolism (VTE), please visit the ACCP website. PulmCCM is not affiliated with ACCP or Chest.

Feb 282012
 

For unclear reasons, people receiving chemotherapy for solid tumors are at particularly increased risk for deep venous thrombosis and pulmonary embolism (DVT/PE). Semuloparin is an ultra-low-molecular weight heparin with a long half life of 16-20 hours that (like enoxaparin) is renally excreted. Sanofi, makers of Lovenox, report in the February 16 New England Journal of [... read more]

Feb 232012
 
For most, plane flights add no DVT/PE risk (just stretch your legs)

As we were all taught in med school, long-distance flights, or even a long car trip, greatly increase your risk for deep venous thrombosis and pulmonary embolism … right? (I feel like I’ve answered about 8 board questions featuring this scenario.) The CDC even has a whole page of guidelines detailing the travel-DVT-risk-connection and the [... read more]

Feb 062012
 

Januel et al report findings of a systematic review and meta-analysis to estimate the total incidence of acute symptomatic venous thromboembolism (symptomatic DVT or pulmonary embolism) among patients receiving proper thromboprophylaxis after hip or knee replacements. They came up with rates of 1.1% after knee replacements, and 0.5% after hip replacements. The rate of pulmonary [... read more]

Jan 282012
 
Apixaban for thromboprophylaxis post-discharge causes bleeding (ADOPT Trial, NEJM)

For years, Pharma have been itching to prove a benefit of extended chemoprophylaxis against DVT / PE in medically ill patients after hospital discharge. Three weeks or more of enoxaparin after surgical knee or hip replacement is standard care, since it reduces the high risk of serious venous thromboembolism with a relatively low risk of [... read more]

Jan 212012
 
Omitting heparin prophylaxis in first 24 ICU hours associated with higher mortality (CHEST)

As you know, the risk for DVT and PE in the ICU are high. How high? Depends on how you count them. Asymptomatic, ultrasound-surveillance-detected DVTs have an incidence of 5-10% during the ICU stay (from the PROTECT trial and a 2005 series), even when patients receive proper thromboprophylaxis. The incidence is even higher (up to 80%) in trauma [... read more]

Jan 012012
 
ACP advises against universal DVT/PE prophylaxis! "Quality" quagmire thickens (Guideline/Review, Ann Intern Med)

Daunted by the seeming impossibility of measuring and comparing hospitals on real outcomes (given our primitive state of data collection and heterogeneity in patient populations, among many other challenges), well-meaning bureaucrats and non-profiteering safety advocates like the Institute for Healthcare Improvement have created directives based on surrogate measures in an attempt to standardize and improve [... read more]

Dec 262011
 

Using the Nationwide Inpatient Sample and the national Multiple Cause-of-Death files, Wiener et al found that since the inception of CT-angiography in 1998, the number of CT-PE scans have risen 11-fold, and age-adjusted incidence of pulmonary embolism rose from 62 to 112 per 100,000 (an 81% increase). Over the same period, the mortality rate (presence of PE [... read more]

Dec 262011
 

Moores LK et al. Current Approach to the Diagnosis of Acute Nonmassive Pulmonary Embolism. CHEST 2011;140:509-518.  Review. Where is the best area under the curve, or the “overdiagnosis sweet spot?” It seems no approach gets us off the hook as we seek to avoid anticoagulating people without PEs (without missing any, of course): CT-angiography  is more sensitive [... read more]

Dec 182011
 

Dalteparin is a low-molecular weight heparin that, unlike enoxaparin, is safe for people with renal failure. Among 3,746 ICU patients in 6 countries, followed until hospital discharge, there was no difference in the rate of proximal deep venous thrombosis (5.1% vs 5.8%, 1′ endpoint) between once-daily dalteparin and twice-daily UFH, as detected by twice-weekly ultrasounds. [... read more]