Deep Vein Thrombosis (Dvt) Propagative
Venous thromboembolism (VTE) is a common disorder that comprises deep vein thrombosis (DVT) and pulmonary embolism (PE). Most clinically important pulmonary embolism arises from proximal deep vein thrombosis i.e. popliteal, femoral or iliac veins in at least 90%.
Signs and symptoms
• Leg pain, tenderness and swelling.
• A palpable cord representing thrombosed vessels.
• Discoloration, venous distention and prominence of superficial veins and cyanosis.
• The clinical diagnosis of DVT is highly nonspecific.
• In most patients the symptoms and signs are nonspecific.
- Long term anticoagulation is required to prevent a frequency of symptomatic extension of thrombosis and/or recurrent venous thromboembolic events.
Warfarin is started with initial heparin or clexane therapy and then overlapped for 4-5days.
• Warfarin 5mg PO for 4–5 days
• Low Molecular weight Heparin 1mg/kg subcutaneous for 4–5days
• Unfractionated Heparin by 75units/kg IV followed by continuous infusion of 18units/kg/hrs.
Adolescents or children:
• Lower loading dose then 15–25 Units /kg/hr by IV infusion or 250units/kg every 12hrs by subcutaneous injection.
• Low Molecular weight Heparin (Clexane) 1mg/kg SC and should be monitored by anti-Xa levels.
Warfarin therapy should be monitor by INR after 5–7 days of treatment. Heparin should be monitored by aPTT before treatment is initiated and monitor aPTT hourly until aPTT is twice of the initial.
14 Novemba 2020 12:52:55
- 1. STG