Thromboprophylaxis
Description General measures Medicine treatment Description See: Venous thrombo-embolism . General Measures All critically ill patients should receive pharmacological (i.e. unfractionated heparin, low-molecular-weight heparin [LMWH]) OR mechanical (intermittent pneumatic compression devices) thromboprophylaxis. Pharmacological thromboprophylaxis is superior to mechanical prophylaxis and should be
Description
See: Venous thrombo-embolism.
General Measures
- All critically ill patients should receive pharmacological (i.e. unfractionated heparin, low-molecular-weight heparin [LMWH]) OR mechanical (intermittent pneumatic compression devices) thromboprophylaxis.
- Pharmacological thromboprophylaxis is superior to mechanical prophylaxis and should be used, unless contraindicated.
- If mechanical thromboprophylaxis is used, it should be provided with intermittent pneumatic compression devices which fit the patient well and cover both legs up to mid-thigh.
Medicine Treatment
- Low-molecular weight heparin (LMWH), e.g.
- Enoxaparin, SC, 40mg daily.
- Reduce dose to 20 mg daily if eGFR <30 ml/min.
If LMWH is unavailable or contraindicated:
- Unfractionated heparin, SC, 5000 IU 12 hourly.
Note:
- Dose of enoxaparin must be adjusted in kidney disease and for patients with increased body mass.
- Avoid pharmacological thromboprophylaxis in patients with active bleeding, significant coagulopathy, or elevated risk for spontaneous or procedural bleeding.
Standard Treatment Guidelines and Essential Medicines List for South Africa Adult Hospital _Chapter 23: Adult Critical Care_NEMLC Medicine Recommendations Review Cycle_ 2020_2023