Esen KIYAN, Halim İSSEVER, Perihan ÖZCAN ERGİN, Gülfer OKUMUŞ, Bahar ÖZÇELİK, Orhan ARSEVEN, Artur SALMASLIOĞLU, Hadi SASAN, Evren ŞENTÜRK

Do appropriate thromboprophylaxis and routine physiotherapy prevent venous thromboembolism in intensive care unit?

Amaç: Bu çalışmada tromboprofilaksi uygulanan yoğunbakım hastalarında venöz tromboembolizm prevalansı veinsidansı araştırıldı.Çalışmaplanı: Medikal-cerrahi yoğun bakım ünitesinekabul edilen ≥18 yaşında ve ≥72 saat yoğun bakımdakalması planlanan 74 ardışık hasta (34 kadın, 40 erkek; (ort.yaş 55.8±19.4 yıl; dağılım 20-86 yıl) çalışmaya dahil edildi.Demografik veriler, Akut Fizyolojik ve Kronik SağlıkDeğerlendirmesi II skoru, başlangıç ve zaman bağımlıderin ven trombozu (DVT) risk faktörleri kaydedildi.İki taraflı alt ekstremite kompresyon ultrasonografihaftada iki kez ve yoğun bakımdan çıktıktan bir haftasonra uygulandı. Yoğun bakım yatışı süresince DVTşüphesi olduğunda, kompresyon ultrasonografi tekrarlandı.Hastaların tümüne düşük molekül ağırlıklı heparin veyamekanik tromboprofilaksi uygulandı. Ayrıca, her günfizyoterapist tarafından tüm hastalara pasif ekstremiteegzersizleri uygulandı.Bul gu lar: Ortalama Akut Fizyolojik ve Kronik SağlıkDeğerlendirmesi II skoru 17±6.1 idi. Yoğun bakımakabulde DVT prevalansı %2.7 (CI %95; 3.3-9.42) idi.Hastaların %89.1ine düşük molekül ağırlıklı heparin,%10.9una mekanik tromboprofilaksi uygulandı. Yoğunbakım yatışı süresince yeni DVT veya pulmoner embolisaptanmadı.Sonuç: Yoğun bakım ünitesinde DVT prevalansı %2.7olmasına rağmen, uygun ve etkili tromboprofilaksi yoğunbakım yatışı süresince yeni DVT gelişimini önledi.

Yoğun bakım ünitesinde uygun tromboprofilaksi ve rutin fizyoterapi venöz tromboemboliyi önler mi?

Background: This study aims to investigate the prevalenceand incidence of venous thromboembolism in intensivecare unit (ICU) patients receiving thromboprophylaxis. Methods: Seventy-four consecutive patients (34 females,40 males; mean age 55.8±19.4 years; range 20-86 years)admitted to the medical-surgical ICU, who were ≥18years old and expected to stay in ICU for ≥72 hours,were included. Demographic data, Acute Physiologyand Chronic Health Evaluation II scores, baseline andtime-dependent deep vein thrombosis (DVT) risk factorswere recorded. Bilateral lower extremity compressionultrasound was performed twice weekly, and one weekafter discharge from ICU. If DVT was suspected atany time during ICU stay, compression ultrasound wasrepeated. All patients were administered low molecularweight heparin or mechanical thromboprophylaxis. Also,passive extremity exercises were applied by physiotherapistto all patients every day. Results: Mean Acute Physiology and Chronic HealthEvaluation II score was 17±6.1. The prevalence of DVTwas 2.7% (CI 95% 3.3-9.42) on ICU admission. Ofthe patients, 89.1% were administered low molecularweight heparin, and 10.9% were administered mechanicalthromboprophylaxis. We did not detect new DVT orpulmonary embolism during the ICU stay. Conclusion: Although DVT prevalence in ICU was 2.7%,appropriate and effective thromboprophylaxis preventedhe development of new DVT during ICU stay.

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