Pulmonary and Critical Care Medicine, Washington Hospital Center, Washington, DC 20010, USA.
Semin Respir Crit Care Med. 2010 Feb;31(1):39-46. doi: 10.1055/s-0029-1246283. Epub 2010 Jan 25.
Critically ill patients are at increased risk of developing venous thromboemboli (VTE). Risk factors that predispose them to acquiring VTE encompass factors that usually afflict the general medical population as well as factors attained in the intensive care unit (ICU) (e.g., sedation, mechanical ventilation). The poor cardiopulmonary reserve of this patient population is intolerant of even small pulmonary emboli (PE), which emphasizes the importance of preventing VTE from ever occurring. Indeed, the complications associated with hospital-acquired VTE increase morbidity, mortality, hospital length of stay, and costs. Without thromboprophylaxis, the incidence of VTE in the ICU ranges from 15 to 60%. Systematic implementation of VTE prophylaxis significantly reduces this rate and as a consequence, morbidity and mortality. In fact, prevention of VTE is so important that the American College of Chest Physicians (ACCP) developed guidelines on the use of routine VTE prophylaxis in critically ill patients. Therefore, upon admission, all ICU patients should be evaluated for and immediately prescribed the appropriate thromboprophylaxis therapy.
危重症患者发生静脉血栓栓塞症（VTE）的风险增加。使他们易患 VTE 的危险因素包括通常影响普通人群的因素以及在重症监护病房（ICU）获得的因素（例如，镇静、机械通气）。该患者人群的心肺储备能力较差，即使是小的肺栓塞（PE）也无法耐受，这强调了预防 VTE 发生的重要性。事实上，与医院获得性 VTE 相关的并发症会增加发病率、死亡率、住院时间和成本。如果没有血栓预防，ICU 中 VTE 的发生率为 15%至 60%。系统实施 VTE 预防可显著降低该比率，从而降低发病率和死亡率。事实上，预防 VTE 非常重要，以至于美国胸科医师学会（ACCP）制定了关于在危重症患者中常规使用 VTE 预防的指南。因此，所有 ICU 患者入院时都应评估并立即开出适当的血栓预防治疗。
