Survey of intensive care units concludes that the current approach to preventing deep vein thrombosis is substandard

December 17, 2001

In this month's Critical Care, a survey of 44 intensive care units (ICU) suggests that the care taken to prevent deep vein thrombosis (DVT) and its complications is substandard.

DVT is a condition whereby a blood clot forms within a deep vein, commonly in the thigh or calf. It can be caused by poor circulation because of problems such as heart disease, a recent heart attack or stroke, varicose veins, or from periods of inactivity like those experienced on long haul flights or during prolonged bed rest. Hospital patients are particularly at risk from developing this condition, as they are inactive for long periods of time.

DVT is not usually life threatening itself, however it can result in the movement of a clot to the lungs causing pulmonary embolism. This condition is common in hospitalized patients, with routine autopsies suggesting that 10-25% of all hospital deaths involve clots in the lungs, many of which may be the actual cause of death. The survey, carried out by Deborah Cook and colleagues, suggests that because diagnosis of DVT is so difficult, physicians should focus on prevention strategies.

Twenty-nine intensive care unit directors were questioned in this survey. It was found that many of the strategies known to be useful in preventing the development of DVT were not being used, such as the use of support stockings, pneumatic stockings and treatment with low molecular weight heparin (a drug that helps to stop the blood clotting). 25% of the directors reported that graded elastic stockings were never used in their ICUs to prevent DVT and 37.9% of directors reported that they did not use pneumatic stockings. Furthermore, the survey showed that the supply of intravenous low molecular weight heparin is not being used enough to protect patients from DVT.

Cook and her colleagues suggest that physicians need more education in the latest techniques to reduce the incidence of DVT and that more fundamental research is needed to understand the nature of this condition and how it can be prevented.
This research article is freely available in Critical Care, a journal published by BioMed Central, simply visit:

The research is discussed in a commentary by the eminent anesthesiologist Professor Charles Marc Samama, for access to this article visit:

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