DVT complete diagnostic approach resident survival guide: Difference between revisions
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==Complete Diagnostic Approach== | |||
{{ | A complete diagnostic approach should be carried out after a focused initial rapid evaluation is conducted and following initiation of any urgent intervention.<ref name="pmid22315267">{{cite journal| author=Bates SM, Jaeschke R, Stevens SM, Goodacre S, Wells PS, Stevenson MD et al.| title=Diagnosis of DVT: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. | journal=Chest | year= 2012 | volume= 141 | issue= 2 Suppl | pages= e351S-418S | pmid=22315267 | doi=10.1378/chest.11-2299 | pmc=PMC3278048 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22315267 }} </ref> | ||
{{familytree | | | | | <span style="font-size:85%"> </span> | ||
{{familytree | {{Family tree/start}} | ||
{{familytree | | | | | {{familytree | | | | | | | A01 | | A01=<div style="float: left; text-align: left; width: 35em; padding:1em;"> '''Characterize the symptoms in the involved extremity:''' <br> | ||
{ | ❑ [[Swelling]] <br> | ||
❑ [[Pain]] <br> | |||
❑ [[Erythema]] <br> | |||
❑ | ❑ Warmth<br></div>}} | ||
{{familytree | | | | | | | |!| | |}} | |||
{{familytree | | | | | | | A02 | | A02=<div style="float: left; text-align: left; width: 35em; padding:1em;"> '''Identify if symptoms of pulmonary embolism (PE) are present:''' <br> | |||
| | ❑ [[Dyspnea]] (78–81%)<ref name="pmid24182642">{{cite journal| author=Cohen AT, Dobromirski M, Gurwith MM| title=Managing pulmonary embolism from presentation to extended treatment. | journal=Thromb Res | year= 2014 | volume= 133 | issue= 2 | pages= 139-48 | pmid=24182642 | doi=10.1016/j.thromres.2013.09.040 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24182642 }} </ref> <br> | ||
❑ | ❑ [[Pleuritic chest pain]] (39–56%)<ref name="pmid24182642">{{cite journal| author=Cohen AT, Dobromirski M, Gurwith MM| title=Managing pulmonary embolism from presentation to extended treatment. | journal=Thromb Res | year= 2014 | volume= 133 | issue= 2 | pages= 139-48 | pmid=24182642 | doi=10.1016/j.thromres.2013.09.040 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24182642 }} </ref> <br> | ||
❑ [[Fainting]] (22–26%)<ref name="pmid24182642">{{cite journal| author=Cohen AT, Dobromirski M, Gurwith MM| title=Managing pulmonary embolism from presentation to extended treatment. | journal=Thromb Res | year= 2014 | volume= 133 | issue= 2 | pages= 139-48 | pmid=24182642 | doi=10.1016/j.thromres.2013.09.040 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24182642 }} </ref> <br> | |||
❑ [[Cough]] (20%)<ref name="pmid18757870">{{cite journal| author=Torbicki A, Perrier A, Konstantinides S, Agnelli G, Galiè N, Pruszczyk P et al.| title=Guidelines on the diagnosis and management of acute pulmonary embolism: the Task Force for the Diagnosis and Management of Acute Pulmonary Embolism of the European Society of Cardiology (ESC). | journal=Eur Heart J | year= 2008 | volume= 29 | issue= 18 | pages= 2276-315 | pmid=18757870 | doi=10.1093/eurheartj/ehn310 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18757870 }} </ref><br> | |||
{{ | ❑ [[Substernal chest pain]] (12%)<ref name="pmid18757870">{{cite journal| author=Torbicki A, Perrier A, Konstantinides S, Agnelli G, Galiè N, Pruszczyk P et al.| title=Guidelines on the diagnosis and management of acute pulmonary embolism: the Task Force for the Diagnosis and Management of Acute Pulmonary Embolism of the European Society of Cardiology (ESC). | journal=Eur Heart J | year= 2008 | volume= 29 | issue= 18 | pages= 2276-315 | pmid=18757870 | doi=10.1093/eurheartj/ehn310 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18757870 }} </ref><br> | ||
❑ [[Hemoptysis]] (11%)<ref name="pmid18757870">{{cite journal| author=Torbicki A, Perrier A, Konstantinides S, Agnelli G, Galiè N, Pruszczyk P et al.| title=Guidelines on the diagnosis and management of acute pulmonary embolism: the Task Force for the Diagnosis and Management of Acute Pulmonary Embolism of the European Society of Cardiology (ESC). | journal=Eur Heart J | year= 2008 | volume= 29 | issue= 18 | pages= 2276-315 | pmid=18757870 | doi=10.1093/eurheartj/ehn310 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18757870 }} </ref><br> | |||
❑ [[Wheezing]] <br> | |||
❑ [[Cyanosis]] (11%)<ref name="pmid24182642">{{cite journal| author=Cohen AT, Dobromirski M, Gurwith MM| title=Managing pulmonary embolism from presentation to extended treatment. | journal=Thromb Res | year= 2014 | volume= 133 | issue= 2 | pages= 139-48 | pmid=24182642 | doi=10.1016/j.thromres.2013.09.040 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24182642 }} </ref> <br> | |||
❑ [[Fever]] (7%)<ref name="pmid24182642">{{cite journal| author=Cohen AT, Dobromirski M, Gurwith MM| title=Managing pulmonary embolism from presentation to extended treatment. | journal=Thromb Res | year= 2014 | volume= 133 | issue= 2 | pages= 139-48 | pmid=24182642 | doi=10.1016/j.thromres.2013.09.040 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24182642 }} </ref> <br> | |||
❑ Symptoms suggestive of [[shock]] (in case of massive PE) | |||
:❑ [[Altered mental status]] | |||
: | :❑ [[Cold extremities]] | ||
:❑ [[Cyanosis]] | |||
:❑ | :❑ [[Oliguria]] | ||
:❑ | </div>}} | ||
:❑ | {{familytree | | | | | | | |!| | |}} | ||
:❑ | {{familytree | | | | | | | B01 | | B01= | ||
<div style="float: left; text-align: left; width: 35em; padding:1em;"> | |||
| | '''Identify possible precipitating factors:'''<br> | ||
❑ | ❑ Recent [[surgery]] <br> | ||
❑ | ❑ [[Hospitalization]] <br> | ||
❑ | ❑ [[Trauma]] <br> | ||
❑ | ❑ [[Pregnancy]] <br> | ||
❑ | ❑ [[Postpartum]] <br> | ||
❑ | ❑ [[Heart failure]] <br> | ||
❑ | ❑ Immobility<br> | ||
❑ Recent bed rest <br> | |||
❑ [[ | ❑ Recent cast of lower extremities <br> | ||
❑ | ❑ [[Obesity]]<br> | ||
❑ | ❑ Active [[malignancy]]<br> | ||
❑ | ❑ Treatment for [[malignancy]] within the last 6 months<br> | ||
❑ | ❑ [[Stroke]] <br> | ||
❑ | ❑ Paralysis <br> | ||
❑ | ❑ Paresis <br> | ||
❑ [[Oral contraceptive]] or [[hormone replacement therapy]] | |||
: | |||
---- | |||
'''Elicit a detailed history:'''<br><br> | |||
| | ❑ '''Risk factors'''<ref name="pmid12814980">{{cite journal| author=Anderson FA, Spencer FA| title=Risk factors for venous thromboembolism. | journal=Circulation | year= 2003 | volume= 107 | issue= 23 Suppl 1 | pages= I9-16 | pmid=12814980 | doi=10.1161/01.CIR.0000078469.07362.E6 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12814980 }} </ref><ref name="pmid18757870">{{cite journal| author=Torbicki A, Perrier A, Konstantinides S, Agnelli G, Galiè N, Pruszczyk P et al.| title=Guidelines on the diagnosis and management of acute pulmonary embolism: the Task Force for the Diagnosis and Management of Acute Pulmonary Embolism of the European Society of Cardiology (ESC). | journal=Eur Heart J | year= 2008 | volume= 29 | issue= 18 | pages= 2276-315 | pmid=18757870 | doi=10.1093/eurheartj/ehn310 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18757870 }} </ref> | ||
:❑ [[Chemotherapy]]<br> | |||
:❑ [[Chronic heart failure]]<br> | |||
:❑ [[Respiratory failure]]<br> | |||
:❑ [[Hormone replacement therapy]]<br> | |||
:❑ [[Cancer]]<br> | |||
| | :❑ [[Oral contraceptive pills]] <br> | ||
:❑ [[Stroke]] <br> | |||
:❑ [[Pregnancy]] <br> | |||
:❑ [[Postpartum]] <br> | |||
:❑ Prior history of [[VTE]] <br> | |||
:❑ [[Thrombophilia]] <br> | |||
❑ | :❑ Advanced [[age]] <br> | ||
❑ | :❑ [[Laparoscopic surgery]] <br> | ||
❑ | :❑ Prepartum <br> | ||
:❑ [[Obesity]] <br> | |||
❑ | :❑ [[Varicose veins]] | ||
❑ [[ | ❑ '''Triggers'''<ref name="pmid12814980">{{cite journal| author=Anderson FA, Spencer FA| title=Risk factors for venous thromboembolism. | journal=Circulation | year= 2003 | volume= 107 | issue= 23 Suppl 1 | pages= I9-16 | pmid=12814980 | doi=10.1161/01.CIR.0000078469.07362.E6 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12814980 }} </ref><ref name="pmid18757870">{{cite journal| author=Torbicki A, Perrier A, Konstantinides S, Agnelli G, Galiè N, Pruszczyk P et al.| title=Guidelines on the diagnosis and management of acute pulmonary embolism: the Task Force for the Diagnosis and Management of Acute Pulmonary Embolism of the European Society of Cardiology (ESC). | journal=Eur Heart J | year= 2008 | volume= 29 | issue= 18 | pages= 2276-315 | pmid=18757870 | doi=10.1093/eurheartj/ehn310 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18757870 }} </ref> | ||
❑ | :❑ [[Bone fracture]] ([[hip]] or [[leg]]) <br> | ||
❑ | :❑ [[Hip replacement surgery]]<br> | ||
❑ | :❑ Knee replacement surgery<br> | ||
❑ | :❑ [[General surgery|Major general surgery]]<br> | ||
:❑ [[Trauma|Significant trauma]]<br> | |||
:❑ [[Spinal cord injury]]<br> | |||
:❑ Athroscopic knee surgery<br> | |||
:❑ [[Central venous line]]s<br> | |||
:❑ [[Chemotherapy]]<br> | |||
:❑ Bed rest for more than 3 days <br> | |||
:❑ Prolonged car or air travel <br> | |||
:❑ [[Laparoscopic surgery]] <br> | |||
:❑ Prepartum <br> | |||
❑ '''Previous episode of [[VTE]]''' | |||
:❑ Age | |||
:❑ Location | |||
❑ '''Past medical history of diseases associated with hyperviscosity''' | |||
:❑ [[Atherosclerosis]] | |||
:❑ [[Collagen vascular disease]] | |||
:❑ [[Heart failure]] | |||
:❑ [[Myeloproliferative disease]] | |||
:❑ [[Nephrotic syndrome]] | |||
:❑ [[Autoimmune diseases]] | |||
:❑[[Polycythemia vera]] | |||
:❑ [[Hyperhomocysteinemia]] | |||
:❑ [[Paroxysmal nocturnal hemoglobinuria]] | |||
:❑ [[Waldenstrom macroglobulinemia]] | |||
:❑ [[Multiple myeloma]] | |||
❑ '''History of [[thrombophilia]]''' | |||
:❑ [[Factor V Leiden mutation]] | |||
:❑ [[Prothrombin gene mutation G20210A]] | |||
:❑ [[Protein C]] or [[Protein S]] deficiency | |||
:❑ [[Antithrombin]] (AT) deficiency | |||
:❑ [[Antiphospholipid syndrome]] (APS) | |||
❑ '''Abortion''' | |||
:❑ [[Abortion]] at second or third trimester of [[pregnancy]] (suggestive of an inherited [[thrombophilia]] or APS) | |||
❑ '''Drugs that may increase the risk of VTE''' | |||
:❑ [[Hydralazine]] | |||
:❑ [[Phenothiazine]] | |||
:❑ [[Procainamide]] | |||
:❑ [[Tamoxifen]] | |||
:❑ [[Bevacizumab]] | |||
:❑ [[Glucocorticoids]] | |||
❑ '''Family history (suggestive of [[inherited thrombophilia]])''' | |||
:❑ [[Deep vein thrombosis]] | |||
:❑ [[Pulmonary embolism]] | |||
:❑ Recurrent [[miscarriage]] | |||
❑ '''Social history''' | |||
:❑ Heavy [[cigarette smoking]] (>25 cigarettes per day) | |||
:❑ [[Intravenous drug use]] (if injected directly in [[femoral vein]]) | |||
:❑ [[Alcohol]] | |||
</div>}} | |||
{{familytree | | | | | | | |!| | | }} | |||
{{familytree | | | | | | | C01 | | C01=❑ <div style="float: left; text-align: left; width: 35em; padding:1em;">'''Examine the patient:''' <br> | |||
'''Vitals''' <br> | |||
❑ Temperature, [[blood pressure]], [[heart rate]] and [[respiratory rate]] may all be within normal range in [[DVT]].<br> | |||
❑ Among patients with [[DVT]] complicated by [[PE]], the following might be present: | |||
:❑ [[Blood pressure]] lower than baseline, suggestive of [[cardiogenic shock]] (associated with [[tachycardia]] and end organ hypoperfusion) | |||
:❑ [[Tachycardia]] (26%)<ref name="pmid18757870">{{cite journal| author=Torbicki A, Perrier A, Konstantinides S, Agnelli G, Galiè N, Pruszczyk P et al.| title=Guidelines on the diagnosis and management of acute pulmonary embolism: the Task Force for the Diagnosis and Management of Acute Pulmonary Embolism of the European Society of Cardiology (ESC). | journal=Eur Heart J | year= 2008 | volume= 29 | issue= 18 | pages= 2276-315 | pmid=18757870 | doi=10.1093/eurheartj/ehn310 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18757870 }} </ref> | |||
:❑ [[Tachypnea]] (70%)<ref name="pmid18757870">{{cite journal| author=Torbicki A, Perrier A, Konstantinides S, Agnelli G, Galiè N, Pruszczyk P et al.| title=Guidelines on the diagnosis and management of acute pulmonary embolism: the Task Force for the Diagnosis and Management of Acute Pulmonary Embolism of the European Society of Cardiology (ESC). | journal=Eur Heart J | year= 2008 | volume= 29 | issue= 18 | pages= 2276-315 | pmid=18757870 | doi=10.1093/eurheartj/ehn310 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18757870 }} </ref> | |||
:❑ [[Low grade fever]]<br> | |||
'''Extremities''' <br> | |||
❑ Unilateral calf or thigh tenderness <br> | |||
❑ Unilateral calf or thigh [[pitting edema]] <br> | |||
❑ Unilateral calf or thigh [[swelling]] <br> | |||
❑ Difference in calf diameters > 3 cm (the calf circumference is measured 10 cm below the tibial tuberosity) <br> | |||
❑ Difference in thigh diameters (the thigh circumference is measured 10-15 cm above the patella)<br> | |||
❑ Unilateral calf or thigh warmth <br> | |||
❑ Unilateral calf or thigh [[erythema]] <br> | |||
❑ Palpable cord (a thickened palpable vein suggestive of thrombosed vein) <br> | |||
❑ Dilatation of unilateral collateral superficial [[veins]] <br> | |||
❑ Localized tenderness upon palpation of the deep veins | |||
:❑ Posterior calf | |||
:❑ Popliteal fossa | |||
:❑ Inner anterior thigh | |||
❑ [[Homan's sign]]: tenderness upon dorsiflexion of the foot (not reliable)<br> | |||
'''Skin'''<br> | |||
❑ Generalized [[edema]] (suggestive of [[right heart failure]], or [[nephrotic syndrome]])<br> | |||
❑ [[Cyanosis|Cyanotic]] and cold skin, lips, nail bed (suggestive of [[cardiogenic shock]])<br> | |||
'''Abdomen'''<br> | |||
❑ [[Ascites]] (suggestive of [[Budd Chiari syndrome]], that is [[hepatic vein thrombosis]])<br> | |||
❑ [[Hepatomegaly]] (suggestive of [[Budd Chiari syndrome]], that is hepatic vein thrombosis)<br> | |||
'''Heart'''<br> | |||
Among patients with [[DVT]] complicated by [[PE]], the following might be present:<br> | |||
❑ [[Cardiac murmur]] | |||
:❑ [[Graham-Steell murmur]] (suggestive of [[pulmonary regurgitation]]) | |||
❑ [[Accentuated P2]]<br> | |||
❑ [[S3]] or [[S4]] gallop (suggestive of [[RV dysfunction]])<br> | |||
❑ [[Jugular venous distention]] (suggestive of [[right heart failure]])<br> | |||
'''Lungs'''<br> | |||
Among patients with [[DVT]] complicated by [[PE]], the following might be present:<br> | |||
❑ [[Rales]]<br> | |||
❑ [[Crackles]]<br> | |||
❑ [[Pleural friction rub]]</div>}} | |||
{{familytree | | | | | | | |!| | | }} | |||
{{familytree | | | | | | | D01 | | D01= <div style="float: left; text-align: left; width: 35em; padding:1em;">'''[[Deep vein thrombosis resident survival guide#Assessment of the Pre-Test Probability of DVT|Assess the pretest probability of DVT]]'''<br> ([[Deep vein thrombosis resident survival guide#Assessment of the Pre-Test Probability of DVT|Wells score shown below]])</div>}} | |||
{{familytree | | | | | | | |!| | | }} | |||
{{familytree | | | | | | | E01 | | E01= | |||
<div style="float: left; text-align: left; width: 35em; padding:1em;">'''Consider alternative diagnoses:''' <br> | |||
❑ [[Muscle strain]] or [[muscle tear]] <br> | |||
❑ [[Immobilization]] that led to leg swelling <br> | |||
❑ [[Lymphedema]] <br> | |||
❑ [[Lymphangitis]] <br> | |||
❑ [[Chronic venous insufficiency]] <br> | |||
❑ Venous obstruction | |||
❑ [[Baker's cyst]] <br> | |||
❑ [[Cellulitis]] <br> | |||
❑ [[Superficial thrombophlebitis]]<br> | |||
❑ [[Hypoproteinemia]] | |||
:❑ [[Nephrotic syndrome]] | |||
:❑ [[Cirrhosis]] | |||
</div>}} | |||
{{familytree | | | | | | | |!| | | }} | |||
{{familytree | | | | | | | F01 | | F01= | |||
<div style="float: left; text-align: left; width: 35em; padding:1em;">'''Order tests:''' <br> | |||
❑ [[CBC-D]] <br> | |||
❑ [[PT]] and [[aPTT]]<br> | |||
❑ [[Creatinine]] <br> | |||
❑ [[Liver function test]] </div> }} | |||
{{familytree | | | | | | | |!| | | }} | |||
{{familytree | | | | | | | K01 | | | | | | K01= Is the suspected DVT a first or a recurrent episode?}} | |||
{{familytree | | | | | |,|-|^|-|.| | | | | }} | |||
{{familytree | | | | | L01 | | L02 | | |L01= First suspected episode| L02= Suspected recurrent episode}} | |||
{{familytree | | | | | |!| | | |!| | | | | }} | |||
{{familytree | | | | | M01 | | M02 | | | | M01= <div style="float: left; text-align: left; width: 35em; padding:1em;">'''[[Deep vein thrombosis resident survival guide#Assessment of the Pre-Test Probability of DVT|Assess the pretest probability of DVT]]'''<br> ([[Deep vein thrombosis resident survival guide#Assessment of the Pre-Test Probability of DVT|Wells score shown below]])</div>| M02=<div style="float: left; text-align: left; width: 35em; padding:1em;"> ([[Deep vein thrombosis resident survival guide#Complete Diagnostic Approach for Suspected Recurrent Lower Extremity DVT|Click here for the diagnostic approach]])</div>}} | |||
{{familytree | |,|-|-|-|+|-|-|-|.| | | | | }} | |||
{{familytree | N01 | | N02 | | N03 | | | | N01= Low pretest probability<br>([[Deep vein thrombosis resident survival guide#Low Pretest Probability|Click here for the diagnostic approach]])| N02= Moderate pretest probability<br>([[Deep vein thrombosis resident survival guide#ModeratePretest Probability|Click here for the diagnostic approach]])| N03= High pretest probability<br>([[Deep vein thrombosis resident survival guide#High Pretest Probability|Click here for the diagnostic approach]])}} | |||
{{Family tree/end}} | |||
===Initial Anticoagulation Choices (DVT)=== | |||
❑ SC [[low molecular weight heparin]] (1st line) | |||
:❑ Enoxaparin 1.0 mg/kg every 12 hours OR 1.5 mg/kg once daily | |||
:❑ Tinzaparin 175 U/kg once daily | |||
❑ SC [[fondaparinux]] (1st line) | |||
:❑ 5 mg once daily (if body weight <50 kg) | |||
:❑ 7.5 mg once daily (if body weight <50-100 kg) | |||
:❑ 10 mg once daily (if body weight >100 kg) | |||
❑ IV [[unfractionated heparin]] | |||
:❑ 80 U/kg as bolus, followed by 18 U/kg/h, OR | |||
:❑ 70 U/kg as bolus, followed by 15 U/kg/h for stroke or cardiac patients<ref name="pmid22315259">{{cite journal| author=Holbrook A, Schulman S, Witt DM, Vandvik PO, Fish J, Kovacs MJ et al.| title=Evidence-based management of anticoagulant therapy: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. | journal=Chest | year= 2012 | volume= 141 | issue= 2 Suppl | pages= e152S-84S | pmid=22315259 | doi=10.1378/chest.11-2295 | pmc=PMC3278055 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22315259 }} </ref> | |||
:❑ Adjust the dosages according to the [[aPTT]] | |||
❑ SC [[unfractionated heparin]] | |||
:❑ 333 U/kg as bolus, followed by 250 U/kg<ref name="pmid22315259">{{cite journal| author=Holbrook A, Schulman S, Witt DM, Vandvik PO, Fish J, Kovacs MJ et al.| title=Evidence-based management of anticoagulant therapy: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. | journal=Chest | year= 2012 | volume= 141 | issue= 2 Suppl | pages= e152S-84S | pmid=22315259 | doi=10.1378/chest.11-2295 | pmc=PMC3278055 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22315259 }}</ref> | |||
== Anticoagulation for VTE== | |||
===Warfarin=== | |||
* Begin with 10 mg warfarin for 2 days followed by dosing based on the INR | |||
* Start at the 1st or 2nd day of the initial parenteral therapy | |||
* Target INR is 2-3 | |||
* Monitor INR: | |||
** If stable, repeat INR every 12 weeks | |||
** If stable but one value 0.5 below or above the target range, continue the same dose and repeat INR within 1-2 weeks | |||
* Avoid NSAIDs, COX2 selective NSAIDs and some antibiotics<ref name="pmid22315259">{{cite journal| author=Holbrook A, Schulman S, Witt DM, Vandvik PO, Fish J, Kovacs MJ et al.| title=Evidence-based management of anticoagulant therapy: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. | journal=Chest | year= 2012 | volume= 141 | issue= 2 Suppl | pages= e152S-84S | pmid=22315259 | doi=10.1378/chest.11-2295 | pmc=PMC3278055 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22315259 }} </ref> | |||
==Heparin== | |||
IV-UFH | |||
* 80 U/kg as bolus, followed by 18 U/kg/h | |||
* 70 U/kg as bolus, followed by 15 U/kg/h for stroke or cardiac patients<ref name="pmid22315259">{{cite journal| author=Holbrook A, Schulman S, Witt DM, Vandvik PO, Fish J, Kovacs MJ et al.| title=Evidence-based management of anticoagulant therapy: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. | journal=Chest | year= 2012 | volume= 141 | issue= 2 Suppl | pages= e152S-84S | pmid=22315259 | doi=10.1378/chest.11-2295 | pmc=PMC3278055 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22315259 }} </ref> | |||
SC-UFH | |||
* 333 U/kg as bolus, followed by 250 U/kg<ref name="pmid22315259">{{cite journal| author=Holbrook A, Schulman S, Witt DM, Vandvik PO, Fish J, Kovacs MJ et al.| title=Evidence-based management of anticoagulant therapy: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. | journal=Chest | year= 2012 | volume= 141 | issue= 2 Suppl | pages= e152S-84S | pmid=22315259 | doi=10.1378/chest.11-2295 | pmc=PMC3278055 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22315259 }} </ref> | |||
LMWH: decrease dose in renal insufficiency (Creatinine clearance < 30 mL/min)<ref name="pmid22315259">{{cite journal| author=Holbrook A, Schulman S, Witt DM, Vandvik PO, Fish J, Kovacs MJ et al.| title=Evidence-based management of anticoagulant therapy: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. | journal=Chest | year= 2012 | volume= 141 | issue= 2 Suppl | pages= e152S-84S | pmid=22315259 | doi=10.1378/chest.11-2295 | pmc=PMC3278055 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22315259 }} </ref> | |||
Fondaparinux | |||
* 7.5 mg daily | |||
* 10 mg daily if weight>100 Kg<ref name="pmid22315259">{{cite journal| author=Holbrook A, Schulman S, Witt DM, Vandvik PO, Fish J, Kovacs MJ et al.| title=Evidence-based management of anticoagulant therapy: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. | journal=Chest | year= 2012 | volume= 141 | issue= 2 Suppl | pages= e152S-84S | pmid=22315259 | doi=10.1378/chest.11-2295 | pmc=PMC3278055 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22315259 }} </ref> |
Latest revision as of 01:16, 24 October 2014
Complete Diagnostic Approach
A complete diagnostic approach should be carried out after a focused initial rapid evaluation is conducted and following initiation of any urgent intervention.[1]
Identify if symptoms of pulmonary embolism (PE) are present: ❑ Dyspnea (78–81%)[2] | |||||||||||||||||||||||||||||
Identify possible precipitating factors: Elicit a detailed history:
❑ Previous episode of VTE
❑ Past medical history of diseases associated with hyperviscosity
❑ History of thrombophilia
❑ Abortion
❑ Drugs that may increase the risk of VTE ❑ Family history (suggestive of inherited thrombophilia)
❑ Social history
| |||||||||||||||||||||||||||||
❑ Examine the patient: Vitals
❑ Homan's sign: tenderness upon dorsiflexion of the foot (not reliable)
❑ Accentuated P2
| |||||||||||||||||||||||||||||
Consider alternative diagnoses: ❑ Muscle strain or muscle tear | |||||||||||||||||||||||||||||
Is the suspected DVT a first or a recurrent episode? | |||||||||||||||||||||||||||||
First suspected episode | Suspected recurrent episode | ||||||||||||||||||||||||||||
Low pretest probability (Click here for the diagnostic approach) | Moderate pretest probability (Click here for the diagnostic approach) | High pretest probability (Click here for the diagnostic approach) | |||||||||||||||||||||||||||
Initial Anticoagulation Choices (DVT)
❑ SC low molecular weight heparin (1st line)
- ❑ Enoxaparin 1.0 mg/kg every 12 hours OR 1.5 mg/kg once daily
- ❑ Tinzaparin 175 U/kg once daily
❑ SC fondaparinux (1st line)
- ❑ 5 mg once daily (if body weight <50 kg)
- ❑ 7.5 mg once daily (if body weight <50-100 kg)
- ❑ 10 mg once daily (if body weight >100 kg)
- ❑ 80 U/kg as bolus, followed by 18 U/kg/h, OR
- ❑ 70 U/kg as bolus, followed by 15 U/kg/h for stroke or cardiac patients[5]
- ❑ Adjust the dosages according to the aPTT
- ❑ 333 U/kg as bolus, followed by 250 U/kg[5]
Anticoagulation for VTE
Warfarin
- Begin with 10 mg warfarin for 2 days followed by dosing based on the INR
- Start at the 1st or 2nd day of the initial parenteral therapy
- Target INR is 2-3
- Monitor INR:
- If stable, repeat INR every 12 weeks
- If stable but one value 0.5 below or above the target range, continue the same dose and repeat INR within 1-2 weeks
- Avoid NSAIDs, COX2 selective NSAIDs and some antibiotics[5]
Heparin
IV-UFH
- 80 U/kg as bolus, followed by 18 U/kg/h
- 70 U/kg as bolus, followed by 15 U/kg/h for stroke or cardiac patients[5]
SC-UFH
- 333 U/kg as bolus, followed by 250 U/kg[5]
LMWH: decrease dose in renal insufficiency (Creatinine clearance < 30 mL/min)[5]
Fondaparinux
- 7.5 mg daily
- 10 mg daily if weight>100 Kg[5]
- ↑ Bates SM, Jaeschke R, Stevens SM, Goodacre S, Wells PS, Stevenson MD; et al. (2012). "Diagnosis of DVT: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines". Chest. 141 (2 Suppl): e351S–418S. doi:10.1378/chest.11-2299. PMC 3278048. PMID 22315267.
- ↑ 2.0 2.1 2.2 2.3 2.4 Cohen AT, Dobromirski M, Gurwith MM (2014). "Managing pulmonary embolism from presentation to extended treatment". Thromb Res. 133 (2): 139–48. doi:10.1016/j.thromres.2013.09.040. PMID 24182642.
- ↑ 3.0 3.1 3.2 3.3 3.4 3.5 3.6 Torbicki A, Perrier A, Konstantinides S, Agnelli G, Galiè N, Pruszczyk P; et al. (2008). "Guidelines on the diagnosis and management of acute pulmonary embolism: the Task Force for the Diagnosis and Management of Acute Pulmonary Embolism of the European Society of Cardiology (ESC)". Eur Heart J. 29 (18): 2276–315. doi:10.1093/eurheartj/ehn310. PMID 18757870.
- ↑ 4.0 4.1 Anderson FA, Spencer FA (2003). "Risk factors for venous thromboembolism". Circulation. 107 (23 Suppl 1): I9–16. doi:10.1161/01.CIR.0000078469.07362.E6. PMID 12814980.
- ↑ 5.0 5.1 5.2 5.3 5.4 5.5 5.6 Holbrook A, Schulman S, Witt DM, Vandvik PO, Fish J, Kovacs MJ; et al. (2012). "Evidence-based management of anticoagulant therapy: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines". Chest. 141 (2 Suppl): e152S–84S. doi:10.1378/chest.11-2295. PMC 3278055. PMID 22315259.