Do appropriate thromboprophylaxis and routine physiotherapy prevent venous thromboembolism in intensive care unit

OZ Amac: Bu calismada tromboprofilaksi uygulanan yogun bakim hastalarinda venoz tromboembolizm prevalansi ve insidansi arastirildi. Ca­lis­ma­ pla­ni:­ Medikal-cerrahi yogun bakim unitesine kabul edilen ≥18 yasinda ve ≥72 saat yogun bakimda kalmasi planlanan 74 ardisik hasta (34 kadin, 40 erkek; (ort. yas 55.8±19.4 yil; dagilim 20-86 yil) calismaya dahil edildi. Demografik veriler, Akut Fizyolojik ve Kronik Saglik Degerlendirmesi II skoru, baslangic ve zaman bagimli derin ven trombozu (DVT) risk faktorleri kaydedildi. Iki tarafli alt ekstremite kompresyon ultrasonografi haftada iki kez ve yogun bakimdan ciktiktan bir hafta sonra uygulandi. Yogun bakim yatisi suresince DVT suphesi oldugunda, kompresyon ultrasonografi tekrarlandi. Hastalarin tumune dusuk molekul agirlikli heparin veya mekanik tromboprofilaksi uygulandi. Ayrica, her gun fizyoterapist tarafindan tum hastalara pasif ekstremite egzersizleri uygulandi. Bul gu lar: Ortalama Akut Fizyolojik ve Kronik Saglik Degerlendirmesi II skoru 17±6.1 idi. Yogun bakima kabulde DVT prevalansi %2.7 (CI %95; 3.3-9.42) idi. Hastalarin %89.1’ine dusuk molekul agirlikli heparin, %10.9’una mekanik tromboprofilaksi uygulandi. Yogun bakim yatisi suresince yeni DVT veya pulmoner emboli saptanmadi. So­nuc:­ Yogun bakim unitesinde DVT prevalansi %2.7 olmasina ragmen, uygun ve etkili tromboprofilaksi yogun bakim yatisi suresince yeni DVT gelisimini onledi. Anah­tar­soz­cuk­ler: Derin ven trombozu; yogun bakim unitesi; fizyoterapi; pulmoner emboli; tromboprofilaksi. ABSTRACT Background:­This study aims to investigate the prevalence and incidence of venous thromboembolism in intensive care unit (ICU) patients receiving thromboprophylaxis. Methods: Seventy-four consecutive patients (34 females, 40 males; mean age 55.8±19.4 years; range 20-86 years) admitted to the medical-surgical ICU, who were ≥18 years old and expected to stay in ICU for ≥72 hours, were included. Demographic data, Acute Physiology and Chronic Health Evaluation II scores, baseline and time-dependent deep vein thrombosis (DVT) risk factors were recorded. Bilateral lower extremity compression ultrasound was performed twice weekly, and one week after discharge from ICU. If DVT was suspected at any time during ICU stay, compression ultrasound was repeated. All patients were administered low molecular weight heparin or mechanical thromboprophylaxis. Also, passive extremity exercises were applied by physiotherapist to all patients every day. Results:­ Mean Acute Physiology and Chronic Health Evaluation II score was 17±6.1. The prevalence of DVT was 2.7% (CI 95% 3.3-9.42) on ICU admission. Of the patients, 89.1% were administered low molecular weight heparin, and 10.9% were administered mechanical thromboprophylaxis. We did not detect new DVT or pulmonary embolism during the ICU stay. Conclusion:­Although DVT prevalence in ICU was 2.7%, appropriate and effective thromboprophylaxis prevented the development of new DVT during ICU stay.