Bleeding and venous thromboembolism in the critically ill with emphasis on patients with renal insufficiency.

Full Abstract

PURPOSE OF REVIEW: The purpose of this review is to critique and summarize clinical literature relevant to thromboprophylaxis in critically ill patients with renal insufficiency. The specific objectives are to discuss factors that increase the risks for bleeding and venous thromboembolism in critically ill patients, with a focus on patients with renal insufficiency, and to consider prophylaxis management options and the rationale for their use. RECENT FINDINGS: Herein, we discuss both bleeding and venous thromboembolism in this population, both of which are of concern as complications. Bleeding is common among critically ill patients and has important clinical consequences. Critically ill patients with renal insufficiency require special consideration in regard to thromboprophylaxis. Such patients have a four-fold higher risk for developing venous thromboembolism compared with ICU patients without renal insufficiency. ICU patients have dynamic risks of thrombosis and bleeding. Invasive procedures may require temporary interruption of anticoagulants. Consequently, approaches to thromboprophylaxis require daily reevaluation. SUMMARY: We provide some considerations for practice in the conclusion section.

Author information

Author/s: Cook, Deborah J (DJ); Douketis, James (J); Arnold, Donald (D); Crowther, Mark A (MA);

Affiliation: Department of Medicine, McMaster University, Hamilton, Ontario, Canada. debcook(-atsign-)mcmaster.ca

Journal and publication information

Publication Type: Journal Article; Review

Journal: Current opinion in pulmonary medicine (Curr Opin Pulm Med), published in United States. (Language: eng)

Reference: 2009-Sep; vol 15 (issue 5) : pp 455-62

Dates: Created 2009/07/28; Completed 2009/11/17;

PMID: 19617833, status: MEDLINE (last retrieved date: 11/17/2009)

Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.

External Links for this article
(including full text providers, if available):

Click Electronic Full-text Provider Links to see options for finding the electronic full text links to this article. Note there may be a subscription or fee required for access to the full text. See our FAQ for information on finding FREE full text articles.

This article may also be located in paper journal collections available in many libraries. Use the Journal and Publication Information above to find the full article.