Thromboembolism (Subscribe)

Links

Anticoagulants May Increase Mortality After Hip and Knee Surgery Medscape

NEW YORK (Reuters Health) Apr 02 - A review of studies looking at anticoagulant prophylaxis after hip and knee arthroplasty reveals that not only do these agents fail to completely prevent pulmonary embolism (PE), their use may actually increase all-cause mortality. The results, which appear in the March issue of Clinical Orthopaedics and Related Research (Clin Orthop Relat Res 2008;466:714-721), show that the risk was most pronounced with so-called potent anticoagulants, such as low-molecular weight heparin, ximelagatran, fondaparinux, and rivaroxaban. Warfarin, a slow-acting oral anticoagulant, raised the risk to a lesser extent.

Review It Rate It Bookmark It

Antithrombotic Therapy

Antithrombotic Therapy. SIGN Guideline. SIGN Publication No. 36 ISBN 1899893 76 8 Published March 1999

Review It Rate It Bookmark It

Ards Fat Embolism And Thromboembolic Disease In The Orthopaedic Trauma Patient

Orthopaedic Trauma Association Core Curriculum Presentation CoursePowerpoint Presentation made by well known authorities in the area and hosted by the OTA. You may use and edit these presentations for educational purposes provided you give credit to the original author and the OTA

Review It Rate It Bookmark It

Deep Vein Thromboprophylaxis in Hip and Knee Surgery

Authors: Peter B. Rauh, FRCS, Matthew C. Solan, FRCS, and Riyaz H. Jinnah, M.D. Orthopaedic patients undergoing lower limb surgery are recognized as a group at especially high risk of DVT/PE. Prevention is therefore of great importance. Treatment of established DVT or PE is beyond the scope of this text. This chapter will consider prophylactic measures only.

Review It Rate It Bookmark It

Deep Vein Thrombosis

Clinical Signs for DVT:
- exam may be unreliable but positive findings should not be ignored;
- calf tenderness, swelling, fever, & increased pulse rate may be present
- suggestive exam features for pulmonary embolism:
- sudden decrease in O2 saturation;
- tachypnea, cyanosis, and hypoxia;
- pulmonary consolidation, pleural effusion, wheeze, and cor pulmonale;
- new onset tachydysrhythmia (usually a. fib);

Review It Rate It Bookmark It

Deep Venous Thrombosis Prophylaxis in Orthopedic Surgery eMedicine Orthopedics

Thrombosis is a naturally occurring physiologic process. Under normal circumstances, a physiologic balance is present between factors that promote and retard coagulation. A disturbance in this equilibrium may result in the coagulation process occurring at an inopportune time or location or in an excessive manor. Alternatively, failure of the normal coagulation mechanisms may lead to hemorrhage.
Synonyms and related keywords: deep vein thrombosis, DVT prophylaxis, pulmonary embolus, pulmonary embolism, PE, venous thromboembolism, VTE, thromboprophylaxis, DVT prevention, PE prevention, VTE prevention, venous stasis, Virchow triad, Virchow's triad, low-dose heparin, LDH, low-molecular weight heparin, LMWH, unfractionated heparin, UFH, intermittent pneumatic compression, IPC, elastic stockings, ES, post-thrombotic syndrome, postthrombotic syndrome, PTS, heparin-induced thrombocytopenia, HIT
Robert S Ennis, MD 2005

Review It Rate It Bookmark It

DVT and PE prophylaxis in THR Wheeless

40-60% of THR patients who do not receive prophylaxis will get a DVT (dependment on imaging method);
in contrast, the study by Fender et al (JBJS 1997) showed that the incidence of fatal PE (as diagnosed by postmortem examination) was 4 / 2111 patients (0.19%);
Wheeless' Textbook of Orthopaedics

Review It Rate It Bookmark It

Heparin, low molecular weight heparin and physical methods for preventing deep vein thrombosis and pulmonary embolism following surgery for hip fractures (Cochrane Review)

Prophylaxis using heparin and low molecular weight heparin
Heparins and some mechanical pumping devices may help prevent blood clots forming in the legs after surgery for hip fracture
Patients with hip fracture may develop blood clots (thrombosis) in their legs. Some of these blood clots may travel to the lungs and cause a blockage (embolism), which can be fatal. Various drugs and physical devices are sometimes used to try and prevent these complications. This review of randomised trials found that both heparins and mechanical pumping devices significantly decrease the incidence of deep vein thrombosis. There was not enough evidence to conclude about the effect on lung (pulmonary) embolism, mortality or possible side effects for either heparin or mechanical methods.
Handoll HHG, Farrar MJ, McBirnie J, Tytherleigh-Strong G, Milne AA, Gillespie WJ

Review It Rate It Bookmark It

Thromboembolism in Hip Fracture Wheeless

See links to:
- DVT Discussion
- Pulmonary Embolism
- References
- Role of Dextran in Hip Frx
- Role of Heparin in Hip Frx
Wheeless' Textbook of Orthopaedics

Review It Rate It Bookmark It

Tromboembolism eMedicine Orthopedics

Thromboembolism encompasses two interrelated conditions that are part of the same spectrum, deep venous thrombosis (DVT) and pulmonary embolism (PE). PE is the obstruction of blood flow to one or more arteries of the lung by a thrombus lodged in a pulmonary vessel (see Image 1). PE and DVT can occur in the setting of disease processes, following hospitalization for serious illness, or following major surgery. In 1856, Virchow demonstrated that 90% of all clinically important PEs result from DVT occurring in the deep veins of the lower extremities, proximal to and including the popliteal veins. However, emboli also can originate from the pelvic veins, the inferior vena cava, and the upper extremities.
Synonyms and related keywords: pulmonary embolism, PE, deep venous thrombosis, deep vein thrombosis, DVT
Vera A De Palo, MD 2005

Review It Rate It Bookmark It