Perioperative venous thromboembolism prophylaxis - Revision history

Aidan: /* Further Reading */

2020-08-03T11:27:05Z

Aidan at 15:00, 29 July 2020

2020-07-29T15:00:47Z

← Older revision		Revision as of 15:00, 29 July 2020
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	== Management ==		==Management==

	* Non-orthopedic surgery		*Non-orthopedic surgery
	** Can estimate risk using Caprini and Rogers scores		**Can estimate risk using Caprini and Rogers scores
	** If very low risk, no prophylaxis		**If very low risk, no prophylaxis
	** If low risk, intermittent pneumatic compression (IPC)		**If low risk, intermittent pneumatic compression (IPC)
	** If moderate risk, IPC or UFH/LMWH		**If moderate risk, IPC or UFH/LMWH
	** If high risk, UFH/LMWH		**If high risk, UFH/LMWH
	** If cancer, continue prophylaxis for 4 weeks		**If cancer, continue prophylaxis for 4 weeks
	** If significant bleeding risk, consider fondaparinux or aspirin		**If significant bleeding risk, consider fondaparinux or aspirin
	* Orthopedic surgery		*Orthopedic surgery
	** ~~THA/TKA~~: LMWH for 14 to 35 days ± IPC		**Total hip or knee arthroplasty: LMWH for 14 to 35 days ± IPC
	* Start prophylaxis 12 hours post-operatively unless significant bleeding concerns		*Start prophylaxis 12 hours post-operatively unless significant bleeding concerns

	=== Medications ===		===Medications===

	* LMWH: enoxaparin 40 mg daily or 30 mg BID, or dalteparin 5000 u daily		*In general, prefer [[low molecular weight heparin]] (LMWH): [[enoxaparin]] 40 mg daily or 30 mg BID, or [[dalteparin]] 5000 u daily
	* UFH 5000 u BID		*If renal failure, can use [[unfractionated heparin]] (UFH) 5000 u BID
			*Alternatives include:
	* Fondaparinux 2.5 mg daily		**[[Fondaparinux]] 2.5 mg daily
	* DOACs
			**Direct oral anticoagulants
	** Dabigatran 220 mg daily
	** ~~Rivaroxaban 10~~ mg daily		***[[Dabigatran]] 220 mg daily
			***[[Rivaroxaban]] 10 mg daily
	** Apixaban 2.5 mg BID		***[[Apixaban]] 2.5 mg BID
	* Wardarin
			**[[Warfarin]]

	== Further Reading ==		==Further Reading==

			*Perioperative Management of Antithrombotic Therapy. ''CHEST''. 2012(141)2:e326S-e350S. doi: [https://doi.org/10.1378/chest.11-2298 10.1378/chest.11-2298]
	* Chest Guidelines on Antithrombotic Therapy

	[[Category:Perioperative medicine]]		[[Category:Perioperative medicine]]

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2020-07-04T01:17:50Z

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== Management ==

* Non-orthopedic surgery
** Can estimate risk using Caprini and Rogers scores
** If very low risk, no prophylaxis
** If low risk, intermittent pneumatic compression (IPC)
** If moderate risk, IPC or UFH/LMWH
** If high risk, UFH/LMWH
** If cancer, continue prophylaxis for 4 weeks
** If significant bleeding risk, consider fondaparinux or aspirin
* Orthopedic surgery
** THA/TKA: LMWH for 14 to 35 days ± IPC
* Start prophylaxis 12 hours post-operatively unless significant bleeding concerns

=== Medications ===

* LMWH: enoxaparin 40 mg daily or 30 mg BID, or dalteparin 5000 u daily
* UFH 5000 u BID
* Fondaparinux 2.5 mg daily
* DOACs
** Dabigatran 220 mg daily
** Rivaroxaban 10 mg daily
** Apixaban 2.5 mg BID
* Wardarin

== Further Reading ==

* Chest Guidelines on Antithrombotic Therapy

[[Category:Perioperative medicine]]
[[Category:Thrombosis]]

← Older revision		Revision as of 11:27, 3 August 2020
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	==Further Reading==		==Further Reading==

	*Perioperative Management of Antithrombotic Therapy. ''CHEST''. 2012(141)2:e326S-e350S. doi: [https://doi.org/10.1378/chest.11-2298 10.1378/chest.11-2298]		*Perioperative Management of Antithrombotic Therapy. ''CHEST''. 2012;141(2):e326S-e350S. doi: [https://doi.org/10.1378/chest.11-2298 10.1378/chest.11-2298]

	[[Category:Perioperative medicine]]		[[Category:Perioperative medicine]]