Ultrasound screening for asymptomatic deep vein thrombosis in critically ill patients: a pilot trial

Internal and Emergency Medicine - Tập 17 Số 8 - Trang 2269-2277 - 2022
Giordano Tini1, Alessio Moriconi1, Stefano Ministrini1, Valentina Zullo1, Elisa Venanzi1, Giulia Mondovecchio1, Tommaso Campanella1, Ettore Marini1, Maura Bianchi2, Federico Carbone3, Matteo Pirro1, Edoardo De Robertis2, Leonella Pasqualini1
1Internal Medicine, Angiology and Atherosclerosis-Department of Medicine and Surgery, Università Degli Studi Di Perugia, Piazzale Gambuli 1/8, 06124, Perugia, Italy
2Anesthesia, Analgesia and Intensive Care-Department of Medicine and Surgery, Università Degli Studi Di Perugia, Piazzale Gambuli 1/8, 06124, Perugia, Italy
3First Clinic of Internal Medicine, Department of Internal Medicine and Medical Specialties, University of Genoa, 6 Viale Benedetto XV, 16132, Genoa, Italy

Tóm tắt

AbstractDeep vein thrombosis (DVT) in critically ill patients still represents a clinical challenge. The aim of the study was to investigate whether a systematic ultrasound (US) screening might improve the management of the antithrombotic therapy in intensive care unit (ICU). In this non-randomized diagnostic clinical trial, 100 patients consecutively admitted to ICU of the University Hospital of Perugia were allocated either in the screening group or in the control group. Subjects in the screening group underwent US examination of lower limbs 48 h after admission, and again after 5 days. Subjects in the control group underwent US examination according to the standard of care (SOC) of the enrolling institution. Retrospectively registered at ClinicalTrials.gov (NCT05019092) on 24.08.2021. Lower limb DVT was significantly more frequent in the screening group (p < 0.001), as well as the subsequent extension of a pre-existing DVT (p = 0.027). In the control group, DVT of large veins was more frequent (p = 0.038). Major bleedings were reported in 5 patients, 4 in the non-screening group and in 1 in the screening group. Patients in the screening group started the antithrombotic treatment later (p = 0.038), although the frequency, dose and duration of the treatment were not different between the two groups. The duration of stay in ICU was longer in the screening group (p = 0.007). Active screening for DVT is associated with an increased diagnosis of DVT. The screening could be associated with a reduced incidence of proximal DVT and a reduction in the bleeding risk.

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Tài liệu tham khảo

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Internal and Emergency Medicine

Tập 17 Số 8

2269-2277

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