[Prevention of thromboembolism in German intensive care units : Results of a nationwide survey]

P Hilbert, P Teumer, R Stuttmann
Der Anaesthesist 2008, 57 (3): 242-50

BACKGROUND: Intensive care unit (ICU) patients have a high risk of developing venous thromboembolism (VTE) and prophylaxis is recommended. Venous thromboembolism confers considerable morbidity and mortality in hospitalized patients, although few studies have focused on critically ill patients.

METHOD AND OBJECTIVE: A systematic prospective mailed self-administered survey of 645 German ICU directors was performed, representing 652 ICUs throughout the country. The objective of this study was to understand current approaches to the prevention of VTE among patients in ICUs.

RESULTS: Of the 652 ICUs approached, 470 (72.3%) participated. Thromboembolism prophylaxis was prescribed in 98% of the ICUs. For mechanical prophylaxis graded elastic stockings were used in 93% and pneumatic compression devices in 24%. For pharmacologic prophylaxis low molecular weight heparin was the predominant prophylactic strategy in 88%, whereas unfractionated heparin was used less often in 45%.

CONCLUSION: The prescribed prophylaxis for thromboembolism in 98% of the German ICUs is surprisingly high compared to that given in the literature. A combination of mechanical and pharmacologic prophylaxis is the predominant prophylactic strategy.

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