Department of Medicine, McMaster University, Hamilton, Ontario, Canada.
Crit Care Med. 2010 Feb;38(2 Suppl):S76-82. doi: 10.1097/CCM.0b013e3181c9e344.
Critically ill patients in the medical-surgical intensive care unit are at high risk for deep venous thrombosis and pulmonary embolism, which comprise venous thromboembolism. Herein, we describe the prevalence, incidence, risk factors, clinical consequences, prophylaxis against venous thromboembolism in critically ill patients, and compliance with thromboprophylaxis. We focus primarily on medical-surgical intensive care unit patients, who represent the largest subgroup of critically ill patients. Despite the large and growing number of critically ill patients in our aging society, their high risk for venous thromboembolism, and the morbidity and mortality associated with this complication of critical illness, relatively few rigorous studies are available. Large, well-designed, randomized trials of thromboprophylaxis, powered to detect differences in patient-important outcomes, are required to advance our understanding and care of these vulnerable patients. Furthermore, because thromboprophylaxis is a common error of omission in hospitalized patients, redoubled efforts are needed to ensure that it is used in practice.
重症医学外科监护病房的危重症患者存在发生深静脉血栓和肺栓塞的高风险，而深静脉血栓和肺栓塞属于静脉血栓栓塞症。在此，我们将描述危重症患者静脉血栓栓塞症的流行率、发生率、危险因素、临床后果、预防措施和对血栓预防措施的依从性。我们主要关注重症医学外科监护病房的患者，他们是危重症患者中最大的亚组。尽管我们老龄化社会中的危重症患者数量庞大且不断增加，他们存在静脉血栓栓塞症的高风险，且这种危重症并发症与发病率和死亡率相关，但相关的严格研究相对较少。需要进行大型、精心设计的、针对血栓预防的随机试验，以检测患者重要结局的差异，从而提高我们对这些脆弱患者的认识和护理水平。此外，由于血栓预防是住院患者中常见的遗漏错误，因此需要加倍努力以确保在实践中使用。
