ABSTRACT
Critically ill patients in the medical-surgical intensive care unit are at high risk
of both venous thromboembolism (VTE) and bleeding. Although thromboprophylaxis is
of proven effectiveness in other settings, relatively little data exist to inform
“best practice” for the prevention of VTE for these patients. This narrative review
article presents the rate, clinical consequences, and optimal strategies to prevent
VTE in critically ill patients, focusing primarily on medical-surgical intensive care
unit (ICU) patients, but also addressing other specific subgroups of critically ill
patients. Despite the large number of medical-surgical ICU patients, their moderately
high risk of VTE, and the morbidity and mortality likely to be associated with the
development of VTE, relatively little methodologically rigorous data are available
to guide practice. Large, well-designed randomized trials, powered to detect differences
in clinically relevant end points, are required to advance the care of this highly
vulnerable patient population.
KEYWORDS
Venous thrombosis - prevention - critical illness
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Dr. Mark Crowther
Department of Medicine, McMaster University
Hamilton, Ontario, Canada
Email: crowthrm@mcmaster.ca
