Prophylaxis of Venous Thrombosis in Neurocritical Care Patients: An Evidence-Based Guideline: A Statement for Healthcare Professionals from the Neurocritical Care Society

Prophylaxis of Venous Thrombosis in Neurocritical Care Patients: An Evidence-Based Guideline: A Statement for Healthcare Professionals from the Neurocritical Care Society

  • Paul Nyquist  
  • , Cynthia Bautista 
  • , Draga Jichici 
  • , Joseph Burns
  • , Sanjeev Chhangani
  • ,Michele DeFilippis
  • , Fernando D. Goldenberg
  • , Keri Kim
  • , Xi Liu-DeRyke

Abstract

The risk of death from venous thromboembolism (VTE) is high in intensive care unit patients with neurological diagnoses. This is due to an increased risk of venous stasis secondary to paralysis as well as an increased prevalence of underlying pathologies that cause endothelial activation and create an increased risk of embolus formation. In many of these diseases, there is an associated risk from bleeding because of standard VTE prophylaxis. There is a paucity of prospective studies examining different VTE prophylaxis strategies in the neurologically ill. The lack of a solid evidentiary base has posed challenges for the establishment of consistent and evidence-based clinical practice standards. In response to this need for guidance, the Neurocritical Care Society set out to develop and evidence-based guideline using GRADE to safely reduce VTE and its associated complications.

Keywords

Venous thrombus Stroke Subarachnoid hemorrhage Traumatic brain injury Intracranial hemorrhage Pulmonary embolus

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