2025 Multiprofessional Critical Care Review: Adult Online-10: Venous Thromboembolism

Video Transcription

Video Summary

Steve Pastoris from Memorial Sloan Kettering Cancer Center discusses venous thromboembolism (VTE), covering venous thrombosis, pulmonary embolism (PE), and their treatments. VTE, being the third most frequent cardiovascular syndrome, affects 370,000 in the U.S. annually, leading to 60,000-100,000 deaths and incurring $7-$10 billion in healthcare costs. Risk factors include cancer, surgery, trauma, immobilization, and others like pregnancy and genetic mutations. Diagnostic techniques like venous duplex ultrasound and blood analysis (D-dimer) are emphasized. PE classifications range from low to high risk, with distinct treatments like anticoagulation, thrombolysis, and catheter-directed therapies. High-risk PE often requires reperfusion therapy while intermediate-risk PE patients are closely monitored. While thrombolytics may rapidly stabilize PE, they entail bleeding risks; catheter-directed approaches offer alternative treatments. Prospective anticoagulation duration for PE is three months with extensions based on risk. IVC filters are reserved for cases where anticoagulation is contraindicated. Thromboprophylaxis is critical in ICU settings, as corroborated by trials like PREVENT. Pulmonary embolism response teams (PERT) enhance treatment outcomes by tailoring expert interventions.

Keywords

venous thromboembolism

pulmonary embolism

anticoagulation

thrombolysis

diagnostic techniques

risk factors

thromboprophylaxis

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