Venous thromboembolism

Abstract

The term venous thromboembolism (VTE) describes a spectrum of disease that includes both deep venous thrombosis (DVT) and pulmonary embolism (PE), and more precisely reflects a sequential disease process.1 Despite a better understanding of the pathophysiology of VTE, improvements in diagnostic approaches and techniques, extensive clinical research of treatment options, and widespread recognition of the importance of DVT prevention, VTE continues to be a common and life-threatening problem. It has been estimated that acute PE accounts for 5-10% of deaths among hospitalized patients and that up to three million persons die of PE annually in the United States2,3; up to 70% of deaths are not recognized antemortem.4 The prevalence of proximal DVT in patients admitted to an intensive care unit (ICU) has been reported as approximately 10%, and the incidence of proximal DVT during critical illness as being 9-40% in older studies.5-7 More recent studies seem to show a decrease in the prevalence and incidence of VTE in ICUs8; in a large multicenter observational study, Cook et al. reported that among 12,338 ICU patients in Canada, 1-2% developed VTE and that most of these cases resulted from prophylaxis failure rather than failure to provide prophylaxis.9 Nevertheless, VTE prevention, diagnosis, and treatment remain challenging problems in the ICU. © 2010 Springer-Verlag US.