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Thromboembolism
4
GENERAL THROMBOPROPHYLAXIS
RECOMMENDATIONS
Level of Risk Estimated DVT Risk Suggested Thromboprophylaxis
Low
Minor surgery in mobile
patients <10% Early and aggressive ambulation
Medical patients who are fully
mobile
Moderate
Medical pts, bed rest or sick LMWH, LDUH BID/TID or
Most general, open gynecologic Fondaparinux
or urologic surgery patients
10%-40%
Moderate VTE + High bleeding Mechanical
risk Thromboprophylaxis
High Risk
Hip or knee arthroplasty,
Major Trauma, SCI LMWH
40% - 80%
High VTE + High Bleeding risk Mechanical Thromboprophylaxis
5
PREVENTION OF VTE IN
NONSURGICAL PATIENTS
6
Stroke with
Advanced age Previous VTE Cancer lower extremity
weakness
Congestive COPD
Sepsis Bed Rest
Heart Failure Exacerbation
Acutely Ill Hospitalized Medical Patients
8
• Aspirin
• Unfractionated
heparin
• Low-molecular weight
heparins
• Vitamin K antagonists
Warfarin,
• Fondaparinux (Factor
Xa inhibitor)
QUESTIONS?
11