Preventing Venous Thromboembolic Disease in Patients Undergoing Elective Hip and Knee Arthroplasty
| Autor: | William C. Watters, Adolph J. Yates, Courtland G. Lewis, Charles M. Turkelson, Stuart B. Goodman, Joshua J. Jacobs, Kevin J. Bozic, Janet L. Wies, Nilay Patel, Patrick Sluka, Michael A. Mont, Patrick Donnelly, Lisa N. Boggio, Craig J.Delia Valle |
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| Rok vydání: | 2011 |
| Předmět: |
Anesthesia
Epidural medicine.medical_specialty Vena Cava Filters Arthroplasty Replacement Hip medicine.medical_treatment Blood Loss Surgical MEDLINE Comorbidity Hemophilia A Postoperative Complications Venous thromboembolic disease Risk Factors medicine Humans Orthopedics and Sports Medicine In patient Risk factor Arthroplasty Replacement Knee Early Ambulation Intermittent Pneumatic Compression Devices Venous Thrombosis Ultrasonography Doppler Duplex business.industry Venous Thromboembolism Guideline medicine.disease Arthroplasty Surgery Elective Surgical Procedures business Elective Surgical Procedure |
| Zdroj: | American Academy of Orthopaedic Surgeon. 19:768-776 |
| ISSN: | 1067-151X |
| DOI: | 10.5435/00124635-201112000-00007 |
| Popis: | This guideline supersedes a prior one from 2007 on a similar topic. The work group evaluated the available literature concerning various aspects of patient screening, risk factor assessment, and prophylactic treatment against venous thromboembolic disease (VTED), as well as the use of postoperative mobilization, neuraxial agents, and vena cava filters. The group recommended further assessment of patients who have had a previous venous thromboembolism but not for other potential risk factors. Patients should be assessed for known bleeding disorders, such as hemophilia, and for the presence of active liver disease. Patients who are not at elevated risk of VTED or for bleeding should receive pharmacologic prophylaxis and mechanical compressive devices for the prevention of VTED. The group did not recommend specific pharmacologic agents and/or mechanical devices. The work group recommends, by consensus opinion, early mobilization for patients following elective hip and knee arthroplasty. The use of neuraxial anesthesia can help limit blood loss but was not found to affect the occurrence of VTED. No clear evidence was established regarding whether inferior vena cava filters can prevent pulmonary embolism in patients who have a contraindication to chemoprophylaxis and/or known VTED. |
| Databáze: | OpenAIRE |
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