Is one Congress on Thrombosis of the most serious complications EMLTD
Venous thromboembolic disease (VTE) Congress on Thrombosis in the form of deep vein thrombosis (DVT) and pulmonary embolism (PE) is one of the most serious complications associated with orthopaedic surgery. According to the data, in the United States alone, nearly one million patients develop VTE each year, of which about one million develop VTE. 300,000. the cases have a fatal effect.
Diagnosis of the disease is sometimes difficult due to the frequent asymptomatic or oligobacterial course. The main mechanism of death in patients with acute pulmonary embolism is right ventricular heart failure. Prevention and anticoagulant treatment is very common in orthopedics and Traumatology of the motor organ. Both Traumatology and orthopedics, led by extensive lower limb surgery, predispose to the development of thrombotic lesions, as all three components of Virchow’s classical triad are disrupted.
Early diagnosis EMLTD of VTE and implementation
Most patients eligible for major lower limb surgery require at least anticoagulant prophylaxis. Therefore, anticoagulant therapy, as knowledge on the border between surgery and internal diseases, should be well known to every orthopedic surgeon. Early diagnosis EMLTD of VTE and implementation of appropriate treatment is key to improving the prognosis of patients and reducing mortality rates among patients.
Venous thromboembolic disease (VTE) is one of the most serious complications associated with orthopaedic surgery. It covers two diseases-deep vein thrombosis (DVT) and pulmonary embolism (PE). According to the data in the United States alone EMLTD, on an annual basis, VTE, in particular IP, is the cause of approx. 300,000. deaths [1, 2]. The most significant risk factors for VTE are surgery (12.5%), hospitalisation (12%) and lower limb injuries (7.8%).
All conditions that impair Virchow triad hemostasis are predisposed to the disease, i.e. release- blood flow, damage to the vessel wall or conditions that increase blood clotting.
Clots occur most often in the venous vessels of the lower extremities and pelvis. According to the data, 95% of the PP-causing embolism material comes from the veins of the lower extremities or pelvis. Clots of other origin, such as the axillary or subclavian artery, are much rarer (1-4%) [5, 6]. However, it should be stressed that the risk of complications EMLTD and severe disease is the same for clots in both the upper and lower extremities.
The most common clinical signs of VTE include pain and swelling of the lower abdomen, tenderness and compression soreness most severe along the course of large venous vessels, positive Homans, increased limb elasticity Congress on Thrombosis and/or superficial venous widening . Symptoms characteristic of PE include shortness of breath and chest pain. In addition, reduced tolerance of exertion, dry cough, haemoptysis, fainting, loss of consciousness, and later shock symptoms may occur . The disease may be asymptomatic or oligobacterial.
A positive result confirms the diagnosis
The starting point for diagnosis and implementation of treatment for PE is the assessment of the likelihood of developing PE on the Wells scale.
- If the probability is assessed as low (< 4 points), the patient meets the exclusion criteria and the D-dimers are low, PE can be excluded. In the case of elevated d-dimers, it is advisable to extend the diagnosis with an angiographic CT scan.
- If the probability of PE is described as moderate (4-5 points), CT angiographic examination is crucial. A positive result confirms the diagnosis. If there is no change in the CT scan, it is advisable to determine the level of D-dimers in addition.
- If the probability of PE is defined as high (> 6 points), the diagnostic procedure is analogous to that of moderate probability, but anticoagulation therapy is required immediately.
General activities EMLTD and Prevention Congress on Thrombosis
Anticoagulant prophylaxis in orthopaedic surgery begins with the implementation of General actions that reduce the risk of compression and impaired venous blood flow and mechanical methods that are often forgotten. Such principles include: anti-clamping of the limbs, use of comfortable pads and rails, avoidance of local pressure, massage of the limbs, early activation and improvement of movement, active and passive rehabilitation of the limbs and exercises using a muscle pump within the leg.
Important mechanical methods include graded compression elastic stockings (PSU) and intermittent pneumatic compression (PUP). These are methods with proven efficacy in reducing the risk of VTE, although less effective than pharmacological methods. The use of combined prophylaxis methods, i.e. mechanical and pharmacological methods, appears to be optimal.
VTE includes Congress on Thrombosis two serious medical conditions
Deep vein thrombosis (DVT), which usually involves the formation of a clot in a vein, most commonly in the leg, that partially or completely blocks blood flow. If part or whole of the blood clot breaks off, it can reach the lungs, causing pulmonary embolism. Symptoms of DVT include pain, swelling, redness of the skin around the affected area and dilation EMLTD of the surface veins. In addition, the skin can be warm to the touch.
Pulmonary embolism Congress on Thrombosis (PE) is a clot that blocks one or more vessels in the lungs. Once it reaches the lungs, the clot fragment can block circulation and lead to sudden death or long-term damage to the lungs and other key organs. About a third (34%) of VTE deaths are those caused by fatal pulmonary embolism. Symptoms of pulmonary embolism include shortness of breath, chest pain and rapid heart rate; some also have haemoptysis.
Who is at risk Congress on Thrombosis of VTE?
Patients at high risk of VTE are m.in. patients undergoing major orthopaedic surgery to reconstruct the hip or knee joint and patients admitted to hospital in an acute condition.
- The risk of symptomatic VTE following major orthopaedic surgery is higher than for the general population for at least two months after surgery
Risk factors and predispositions include hereditary thrombosis, old age, obesity, VTE and advanced varicose veins
- Without prophylactic treatment, the risk of VTE after knee or hip surgery is between 40 and 60%
VTE can be difficult to diagnose because up to 50% of patients have no specific symptoms.
- Consequently, the most economical and effective approach in current clinical practice is to avoid venous clots precisely through prevention.