Skip to main content

Deep venous thrombosis Doppler screening in critically ill patients: is it justified?

Introduction

The purpose of this study was to determine the incidence of asymptomatic deep venous thrombosis (DVT) in long-stay critically ill patients.

Methods

Over an 8-month period, 53 patients were admitted and anticipated to stay in the ICU for >48 hours. DVT prophylaxis was provided using low molecular weight heparin (LMWH) or a sequential leg compression device as medically indicated. Patients had a baseline Duplex Ultrasound Screening (DUS) examination on admission and screening on a weekly basis regardless of clinical or laboratory evidence for DVT. Demographics and ultrasound data were also collected.

Results

We studied 53 patients (42 males, mean age (SEM) 57.6 (2.8) years, illness severity scores APACHE II 21.3 (0.9); SAPS II 53.3 (2.3); SOFA 10.2 (0.2); and ICU stay 35.9 (4.8) days). Eleven (20.8%) of them developed DVT on day 7.4 (1.8), on DUS. Six patients had lower limb DVT, five upper limb DVT. Another one had DVT on admission. In group A (Table 1), six patients (37.5%) developed DVT on day 7.0 (2.4) without receiving LMWH due to underlying disease (hemorrhagic stroke, brain injury), but only pneumatic compression. In group B (Table 1), five patients (13.5%) developed DVT on day 7.7 (2.9) despite timely and appropriate LMWH administration since ICU admission. None of the patients in both groups developed pulmonary embolism. The difference regarding the incidence between the two groups was statistically significant (P = 0.042, RR: 2.847 (CI: 1.050 to 7.721), OR: 4.167 (CI: 0.989 to 17.55)).

Table 1

Conclusions

According to our results the application of DUS screening in ICU patients seems to be justified for early, accurate diagnosis of silent DVT and appropriate therapy.

Author information

Affiliations

Authors

Corresponding author

Correspondence to I Vlachou.

Rights and permissions

This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

Reprints and Permissions

About this article

Cite this article

Vlachou, I., Petrocheilou, G., Evodia, E. et al. Deep venous thrombosis Doppler screening in critically ill patients: is it justified?. Crit Care 15, P15 (2011). https://doi.org/10.1186/cc9435

Download citation

Keywords

  • Pulmonary Embolism
  • Deep Venous Thrombosis
  • Compression Device
  • Ultrasound Data
  • Score Apache