2025 Multiprofessional Critical Care Review: Adult Online-Venous Thromboembolism

Video Transcription

Video Summary

The talk focuses on venous thromboembolism (VTE), specifically deep vein thrombosis (DVT) and pulmonary embolism (PE). Key risk factors include Virchow’s triad elements—venous stasis, hypercoagulability, and endothelial injury—as well as hereditary conditions like factor V Leiden. Diagnosis relies on imaging: venous Doppler for DVT and CT pulmonary angiography (CTPA) for PE, with echocardiography used to assess right heart strain. Risk stratification categorizes PE into low, intermediate, and high risk, guiding management strategies. Anticoagulation remains the cornerstone of treatment, predominantly with direct oral anticoagulants in stable patients, while unstable or ICU patients often receive unfractionated heparin. Thrombolytics are reserved for high-risk, hypotensive PE cases. Use of IVC filters is limited to contraindications to anticoagulation. Catheter-directed thrombolysis and surgical options are emerging for select severe cases. Prophylaxis with low-molecular-weight heparin is preferred, especially in ICU settings. The talk emphasizes weighing benefits versus bleeding risks in therapy decisions and highlights clinical guidelines and recent studies to inform practice.

Keywords

venous thromboembolism

deep vein thrombosis

pulmonary embolism

Virchow's triad

anticoagulation therapy

risk stratification

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