Key result
Prolonged ICU mechanical ventilation is linked to a ~24% incidence of DVT despite prophylaxis.
Why the study?
The prevalence of deep vein thrombosis among patients requiring prolonged mechanical ventilation despite prophylaxis was not well defined.
Cohort (n=110)
No
Deep vein thrombosis is highly prevalent (23.6%) in patients requiring prolonged mechanical ventilation despite universal prophylaxis, highlighting the need for improved preventive and screening strategies.
DVT despite prophylaxis signals elevated PE risk in ventilated patients; leaves open whether enhanced prevention or screening improves outcomes.
Objective To determine the prevalence of deep vein thrombosis (DVT) among patients requiring prolonged mechanical ventilation in the intensive care unit. Design Prospective cohort study. Setting Medical intensive care unit of a university-affiliated urban teaching hospital. Patients Patients requiring mechanical ventilation for >7 days. Interventions All patients admitted to the medical intensive care unit requiring prolonged mechanical ventilation underwent duplex ultrasonography of their lower extremities and upper extremities every 7 days. The main outcome identified was the presence of DVT. Secondary outcomes included hospital mortality, hospital and intensive care unit lengths of stay, and the occurrence of pulmonary embolism. Measurements and main results A total of 110 patients requiring mechanical ventilation for >7 days were enrolled. Prophylaxis against DVT was employed in 110 of the patients (100%). A total of 26 patients (23.6%) developed DVT. Patients with DVT were statistically more likely to have underlying malignancy (30.8% vs. 8.3%; p =.004) and longer durations of central venous catheterization (26.9 +/- 22.2 days vs. 14.5 +/- 12.1 days; p =.024) compared with patients without DVT. There were no statistically significant differences in hospital mortality or lengths of stay in the hospital and intensive care unit for patients with and without DVT. Patients documented to have DVT by using duplex ultrasonography had a statistically greater frequency of subsequent pulmonary embolism during their hospitalization (11.5% vs. 0.0%; p =.012). Conclusion The occurrence of DVT is common among patients requiring prolonged mechanical ventilation in the intensive care unit setting despite the use of prophylaxis measures. These data suggest that alternative strategies for the prevention of DVT should be evaluated. Additionally, early detection methods should be considered to reduce the potential morbidity associated with untreated DVT in this high-risk population.
No takes yet. Share an insight, caveat, or question.
Ibrahim et al. (2002) conducted a cohort in Prolonged mechanical ventilation in the intensive care unit (n=110). Prolonged mechanical ventilation was evaluated on presence of deep vein thrombosis (DVT). Prolonged mechanical ventilation (>7 days) in the intensive care unit resulted in a 23.6% incidence of deep vein thrombosis despite universal prophylaxis.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: