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Deep venous thrombosis prophylaxis are treatments designed to prevent deep vein thrombi from occurring, since blood clots in the deep veins that may result in pulmonary emboli can seriously risk mortality. These treatments are usually undertaken in hospitals for patients who have undergone orthopedic surgeries to the hips, legs or spine, are pregnant and on bed rest, have had extensive surgeries and can only move in limited fashion, or have suffered a recent stroke or myocardial infarction. They may continue after a person has been released from a hospital if they’re warranted. The methods available are split into pharmacological (drug-based) or mechanical means, and they may be used separately or together, depending on patient status.
Pharmacological deep venous thrombosis prophylaxis includes many drugs that either thin the blood or interfere with blood clotting. Medicines like aspirin, warfarin (Coumadin®) and a variety of types of heparin are most common. Typically, these would be given in oral forms, though heparin is injected. The purpose of administering these drugs is to prevent thrombi in the deep veins of the legs from occurring so that pulmonary emboli are also prevented.
Some of these medications aren’t suitable if a person has just had significant surgery because they can cause extra bleeding. Drugs like warfarin have the disadvantage of requiring constant blood-level monitoring to make certain their dose falls in the adequate but not too high range. While such monitoring can easily be accomplished in a hospital, it gets more difficult once patients are released. Still, pharmacological deep venous thrombosis prophylaxis is favored more than mechanical prophylaxis, in some cases, especially if risk is considered as moderate to high.
The mechanical types of deep venous thrombosis prophylaxis vary. The simplest methods involve use of things like compression stockings, which may prevent blood from pooling and clotting in the deep veins. Pneumatic compression devices are sheaths fitting over the legs that inflate and deflate with room air. These help take the place of activities like walking.
When medications aren’t recommended, pneumatic compression devices are often employed, until a patient is able to spend significant time walking. Occasionally, recovering patients have to bring a pneumatic compression device home because they still won’t be able to spend enough time on their feet. Such devices may feel strange at times, similar to a whole leg blood pressure cuff, but patients are usually able to simply ignore them after a few days of use. As patients become more ambulatory, they’re usually able to discontinue use of these devices.
With extreme risk for pulmonary embolism, as exists when patients are over 60 and have had a major surgery that immobilizes the legs, physicians may employ deep venous thrombosis prophylaxis of both types. A pneumatic compression device and a medication could be concurrently used to reduce risk. This aggressive approach is generally warranted because of the fatality risk associated with pulmonary emboli; they may occur suddenly and cause death before treatment can be received, even in a hospital setting.