Modern thromboprophylaxis protocol based on guidelines applied in a respiratory intensive care unit: a single-center prospective cohort study

Thrombosis Journal

Research

Zhao-Hui Tong¹  Xiao Tang¹  Rui Wang¹  Yu Jin¹  Bing Sun¹  Wen-Rui Lyu¹  Xu-Yan Li¹  Ying Li¹  Chun-Yan Zhang¹  Wei Zhao² 

[1] Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine and Beijing Chao-Yang Hospital, Capital Medical University, No. 8 Gongtinan Road, Chaoyang, 100020, Beijing, China;Department of Ultrasonic diagnosis, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China;

关键词: Venous thromboembolism;    Thromboprophylaxis;    Critical illness;    Intensive care unit;    Risk factors;   

DOI  :  10.1186/s12959-022-00439-2

 received in 2022-05-09, accepted in 2022-12-05,  发布年份 2022

来源: Springer

【 摘 要 】

BackgroundCritically ill patients in intensive care units (ICUs) are at high risk of venous thromboembolism (VTE). This study aimed to explore the prophylaxis effect under a guideline-based thromboprophylaxis protocol among critically ill patients in a respiratory ICU.MethodsFor this single-center prospective cohort study, we followed the thromboprophylaxis protocol, which was drawn up based on relevant guidelines and Chinese experts’ advice. Clinical data were entered into an electronic case report form and analyzed. Multivariate logistic regression was conducted to explore independent risk factors of VTE event under this protocol.ResultsFrom August 1, 2014, to December 31, 2020, 884 patients underwent thromboprophylaxis according to this protocol; 10.5% of them received mechanical prophylaxis, 43.8% received pharmacological prophylaxis, and 45.7% received pharmacological combined with mechanical prophylaxis. The proportion of VTE events was 14.3% for patients who received the thromboprophylaxis protocol, of which 0.1% had pulmonary thromboembolism (PTE), 2.0% had proximal deep vein thrombosis (DVT), and 12.1% had isolated distal DVT. There was no significant difference between different thromboprophylaxis measures. Cirrhosis (OR 5.789, 95% CI [1.402, 23.894], P = 0.015), acute asthma exacerbation (OR 39.999, 95% CI [4.704, 340.083], P = 0.001), and extracorporeal membrane oxygenation treatment (OR 22.237, 95%CI [4.824, 102.502], P < 0.001) were independent risk factors for proximal DVT under thromboprophylaxis.ConclusionsThe thromboprophylaxis protocol based on guidelines applied in the ICU was practicable and could help decrease the proportion of PTE and proximal DVT events. The risk factors of VTE events happening under the thromboprophylaxis protocol require more attention.Trial registrationClinicalTrials.gov: NCT02213978.

【 授权许可】

CC BY   
© The Author(s) 2022

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Fig. 1