1. Venous thromboembolism prevention in surgery and obstetrics
- Author
-
Samama, C. M., Albaladejo, P., Benhamou, D., Bertin-Maghit, M., Bruder, N., Doublet, J. D., Laversin, S., Leclerc, S., Marret, E., Mismetti, P., Samain, E., Steib, A., Renseigné, Non, Service d'anesthésie-réanimation [Hôtel-Dieu], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Hôtel-Dieu [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Institut de biologie et chimie des protéines [Lyon] (IBCP), Centre National de la Recherche Scientifique (CNRS)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon, Département d'anesthésie-réanimation, Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE), France Télécom Recherche & Développement (FT R&D), France Télécom, Institut Mondor de recherche biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Groupe de recherche sur la thrombose (GRT (EA 3065)), Université Jean Monnet [Saint-Étienne] (UJM), Hôpital Hôtel-Dieu [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Centre National de la Recherche Scientifique (CNRS), Assistance publique - Hôpitaux de Paris (AP-HP)-Hôpital Hôtel-Dieu [Paris], Institut de biologie et chimie des protéines [Lyon] ( IBCP ), Université Claude Bernard Lyon 1 ( UCBL ), Université de Lyon-Université de Lyon-Centre National de la Recherche Scientifique ( CNRS ), Assistance Publique - Hôpitaux de Marseille ( APHM ) - Hôpital de la Timone [CHU - APHM] ( TIMONE ), France Télécom Recherche & Développement ( FT R&D ), Institut Mondor de recherche biomédicale ( IMRB ), Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Université Paris-Est Créteil Val-de-Marne - Paris 12 ( UPEC UP12 ), Groupe de recherche sur la thrombose ( GRT (EA 3065) ), and Université Jean Monnet [Saint-Étienne] ( UJM )
- Subjects
MESH: Pulmonary Embolism ,medicine.medical_treatment ,MESH: Pregnancy Complications, Hematologic ,030204 cardiovascular system & hematology ,MESH : Anticoagulants ,Postoperative Complications ,MESH: Pregnancy ,0302 clinical medicine ,Pregnancy ,Risk Factors ,MESH: Risk Factors ,MESH: Postoperative Complications ,MESH: Fibrinolytic Agents ,MESH : Female ,MESH: Heparin, Low-Molecular-Weight ,MESH: Puerperal Disorders ,Venous Thrombosis ,Obstetrics ,MESH : Venous Thrombosis ,MESH : Risk Factors ,3. Good health ,Pulmonary embolism ,Venous thrombosis ,030220 oncology & carcinogenesis ,MESH : Pulmonary Embolism ,Ambulatory ,Female ,Neurosurgery ,medicine.medical_specialty ,MESH : Heparin, Low-Molecular-Weight ,Compression stockings ,MESH: Anticoagulants ,03 medical and health sciences ,MESH : Pregnancy Complications, Hematologic ,Fibrinolytic Agents ,medicine ,Humans ,Intensive care medicine ,MESH: Humans ,business.industry ,MESH : Humans ,Pregnancy Complications, Hematologic ,MESH : Puerperal Disorders ,MESH : Fibrinolytic Agents ,[ SDV.SP.PHARMA ] Life Sciences [q-bio]/Pharmaceutical sciences/Pharmacology ,Anticoagulants ,Puerperal Disorders ,Heparin, Low-Molecular-Weight ,Vascular surgery ,medicine.disease ,Surgery ,MESH : Pregnancy ,Critical appraisal ,Anesthesiology and Pain Medicine ,MESH: Venous Thrombosis ,Orthopedic surgery ,[SDV.SP.PHARMA]Life Sciences [q-bio]/Pharmaceutical sciences/Pharmacology ,MESH : Postoperative Complications ,Pulmonary Embolism ,business ,MESH: Female - Abstract
International audience; BACKGROUND AND OBJECTIVE: To produce up-to-date clinical practice guidelines on the prevention of venous thromboembolism in surgery and obstetrics. METHODS: A Steering Committee defined the scope of the topic, the questions to be answered, and the assessment criteria. Eight multidisciplinary working groups (total of 70 experts) performed a critical appraisal of the literature in the following disciplines: pharmacology of antithrombotic agents, orthopaedics; general surgery (gastrointestinal (GI) and varicose vein surgery); urology; gynaecology and obstetrics; thoracic, cardiac and vascular surgery; surgery of the head, neck and spine; and surgery of burns patients. The resultant reports and guidelines were submitted for comment and completion of the Appraisal of Guidelines Research & Evaluation questionnaire to a total of 150 peer reviewers, before producing definite guidelines. RESULTS: The report answers the following questions for each type of surgery: (i) What is the venous thromboembolism incidence according to clinical and/or paraclinical criteria in the absence of prophylaxis? (with stratification of venous thromboembolism risk into low, moderate and high categories); (ii) What is the efficacy and safety of the prophylactic measures used? (iii) When should prophylaxis be introduced and how long should it last? (iv) Does ambulatory surgery affect efficacy and safety of prophylaxis? CONCLUSIONS: Apart from answering the above questions, the guidelines provide a summary table for each discipline. This table stratifies types of surgery into the three risk categories, specifies the recommended prophylaxis for venous thromboembolism (pharmacological and/or mechanical) and grades each recommendation. In addition, whenever appropriate, the recommended prophylaxis is adjusted to low- and high-risk patients.
- Published
- 2006