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Venous thromboembolism prevention in surgery and obstetrics: clinical practice guidelines

Published online by Cambridge University Press:  20 January 2006

C. M. Samama
Affiliation:
Avicenne University Hospital, Department of Anaesthesiology and Intensive Care, Bobigny, France
P. Albaladejo
Affiliation:
Henri-Mondor University Hospital, Department of Anaesthesiology and Intensive Care, Créteil, France
D. Benhamou
Affiliation:
Bicêtre University Hospital, Department of Anaesthesiology and Intensive Care, Le Kremlin Bicêtre, France
M. Bertin-Maghit
Affiliation:
Lyon-Sud Univesity Hospital, Department of Anaesthesiology and Intensive Care, Pierre Bénite, France
N. Bruder
Affiliation:
La Timone University Hospital, Department of Anaesthesiology and Intensive Care, Marseille, France
J. D. Doublet
Affiliation:
Tenon University Hospital, Department of Urology, Paris, France
S. Laversin
Affiliation:
Haute Autorité en Santé, Department of Recommendations and Guidelines, Saint Denis, France
S. Leclerc
Affiliation:
Rangueil University Hospital, Department of Anaesthesiology and Intensive Care, Toulouse, France
E. Marret
Affiliation:
Tenon University Hospital, Department of Anaesthesiology and Intensive Care, Paris, France
P. Mismetti
Affiliation:
St-Etienne University Hospital, Department of Clinical Pharmacology, Saint-Etienne, France
E. Samain
Affiliation:
Jean Minjoz University Hospital, Department of Anaesthesiology and Intensive Care, Besançon, France
A. Steib
Affiliation:
Hôpital Civil, Strasbourg University Hospital, Department of Anaesthesiology and Intensive Care, Strasbourg, France
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Extract

Summary

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.

Type
Guidelines
Copyright
© 2006 European Society of Anaesthesiology

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