Pulmonary embolism special scenario cancer: Difference between revisions
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Rim Halaby (talk | contribs) (/* Patients With Cancer in the Outpatient Setting (DO NOT EDIT){{cite journal| author=Guyatt GH, Akl EA, Crowther M, Gutterman DD, Schuünemann HJ, American College of Chest Physicians Antithrombotic Therapy and Prevention of Thrombosis Panel| title=Ex...) |
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| colspan="1" style="text-align:center; background:LemonChiffon"| [[ACC AHA guidelines classification scheme#Classification of Recommendations|Class II]] | | colspan="1" style="text-align:center; background:LemonChiffon"| [[ACC AHA guidelines classification scheme#Classification of Recommendations|Class II]] | ||
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|bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''1.''' In outpatients with cancer who have no additional risk factors for VTE, we suggest against routine prophylaxis with LMWH or LDUH. ''([[American College of Chest Physicians#Level of Evidence|Level of Evidence: B]])''<nowiki>"</nowiki> | |bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''1.''' In outpatients with cancer who have no additional risk factors for [[VTE]], we suggest against routine prophylaxis with [[LMWH]] or [[LDUH]]. ''([[American College of Chest Physicians#Level of Evidence|Level of Evidence: B]])''<nowiki>"</nowiki> | ||
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|bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''2.''' In outpatients with solid | |bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''2.''' In outpatients with [[solid tumor]]s who have additional risk factors for [[VTE]] and who are at low risk of [[bleeding]], we suggest prophylactic-dose [[LMWH]] or [[LDUH]] over no prophylaxis. ''([[American College of Chest Physicians#Level of Evidence|Level of Evidence: B]])''<nowiki>"</nowiki> | ||
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|bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''3.''' In outpatients with cancer and indwelling central venous catheters, we suggest against routine prophylaxis with LMWH or LDUH ''([[American College of Chest Physicians#Level of Evidence|Level of Evidence: B]])'' and suggest against the prophylactic use of VKAs ''([[American College of Chest Physicians#Level of Evidence|Level of Evidence: C]])''. <nowiki>"</nowiki> | |bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''3.''' In outpatients with [[cancer]] and indwelling central venous catheters, we suggest against routine prophylaxis with [[LMWH]] or [[LDUH]] ''([[American College of Chest Physicians#Level of Evidence|Level of Evidence: B]])'' and suggest against the prophylactic use of VKAs ''([[American College of Chest Physicians#Level of Evidence|Level of Evidence: C]])''. <nowiki>"</nowiki> | ||
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Revision as of 16:07, 13 July 2014
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Resident Survival Guide |
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Pulmonary Embolism Microchapters |
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Diagnosis |
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Pulmonary Embolism Assessment of Probability of Subsequent VTE and Risk Scores |
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Treatment |
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Follow-Up |
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Special Scenario |
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Trials |
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Case Studies |
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Pulmonary embolism special scenario cancer On the Web |
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Directions to Hospitals Treating Pulmonary embolism special scenario cancer |
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Risk calculators and risk factors for Pulmonary embolism special scenario cancer |
Editor(s)-In-Chief: C. Michael Gibson, M.S., M.D. [1], The APEX Trial Investigators; Associate Editor(s)-in-Chief: Rim Halaby, M.D. [2]
Overview
2012 Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (DO NOT EDIT)[1]
Long-term Treatment of Patients With PE (DO NOT EDIT)[1]
| Class I |
| "1. In patients with PE who are treated with VKA, we recommend a therapeutic INR range of 2.0 to 3.0 (target INR of 2.5) over a lower (INR < 2) or higher (INR 3.0-5.0) range for all treatment durations. (Level of Evidence: B)" |
| "2. In patients with PE and active cancer, if there is a low or moderate bleeding risk, we recommend extended anticoagulant therapy over 3 months of therapy. (Level of Evidence: B)" |
| Class II |
| "1. In patients with PE and active cancer, if there is a high bleeding risk, we suggest extended anticoagulant therapy. (Level of Evidence: B)" |
| "2. In patients with PE and no cancer, we suggest VKA therapy over LMWH for long-term therapy (Level of Evidence: C). For patients with PE and no cancer who are not treated with VKA therapy, we suggest LMWH over dabigatran or rivaroxaban for long-term therapy. (Level of Evidence: C)" |
| "3. In patients with PE and cancer, we suggest LMWH over VKA therapy (Level of Evidence: B). In patients with PE and cancer who are not treated with LMWH, we suggest VKA over dabigatran or rivaroxaban for long-term therapy (Level of Evidence: C). " |
Patients Undergoing General, GI, Urological, Gynecologic, Bariatric, Vascular, Plastic, or Reconstructive Surgery (DO NOT EDIT)[1]
| Class I |
| "1. For high-VTE-risk patients undergoing abdominal or pelvic surgery for cancer who are not otherwise at high risk for major bleeding complications, we recommend extended-duration pharmacologic prophylaxis (4 weeks) with LMWH over limited-duration prophylaxis. (Level of Evidence: B)" |
Patients With Cancer in the Outpatient Setting (DO NOT EDIT)[1]
| Class I |
| "1. In outpatients with cancer who have no additional risk factors for VTE, we recommend against the prophylactic use of VKAs. (Level of Evidence: B)" |
| Class II |
| "1. In outpatients with cancer who have no additional risk factors for VTE, we suggest against routine prophylaxis with LMWH or LDUH. (Level of Evidence: B)" |
| "2. In outpatients with solid tumors who have additional risk factors for VTE and who are at low risk of bleeding, we suggest prophylactic-dose LMWH or LDUH over no prophylaxis. (Level of Evidence: B)" |
| "3. In outpatients with cancer and indwelling central venous catheters, we suggest against routine prophylaxis with LMWH or LDUH (Level of Evidence: B) and suggest against the prophylactic use of VKAs (Level of Evidence: C). " |
References
- ↑ 1.0 1.1 1.2 1.3 Guyatt GH, Akl EA, Crowther M, Gutterman DD, Schuünemann HJ, American College of Chest Physicians Antithrombotic Therapy and Prevention of Thrombosis Panel (2012). "Executive summary: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines". Chest. 141 (2 Suppl): 7S–47S. doi:10.1378/chest.1412S3. PMC 3278060. PMID 22315257.