The natural history and outcomes of line-associated upper extremity deep venous thromboses in critically ill patients.

摘要: Abstract Objective Anticoagulation remains the standard of care for line-associated upper extremity deep venous thrombosis (UEDVT). This treatment carries risk hemorrhagic complications, possibly more so in surgical patients. Considering low-risk profile UEDVT—which is associated with fewer, less severe pulmonary emboli than lower thrombosis—current UEDVT guidelines may be overly aggressive. The goal this study was to review outcomes critically ill patients and define efficacy current protocols embolism (PE) prevention while avoiding complications. Methods A retrospective performed 193 consecutive admitted medical intensive unit (ICU) at a tertiary hospital between 2009 2014 diagnosed acute by duplex ultrasound. examined arms included anticoagulation intent reach therapeutic levels, prophylactic or subtherapeutic anticoagulation, no anticoagulation. Primary major hemorrhage (defined as any intracranial resulting transfusion, ICU readmission, death), PE, in-hospital mortality, total length stay (LOS), LOS. Results Of 10,907 patients, 161 (1.48%) were UEDVT, 81 6027 (1.34%) 80 4880 (1.64%), after exclusion 32 concurrent thrombosis. In total, 122 (75.8%) received 23 (14.3%) 16 (9.94%) Major significantly common symptomatic PE all (15.5% vs 4.97%; P  Conclusions complications are raising concern that too These data necessitate further prospective investigation determine optimal protocol cohort.