Literature Review on Prophylaxis of Deep Venous Thrombosis and Pulmonary Embolism

Ibrahim Bin Abdullah , Mohamed Ahmed , Doaa Ali Alhalal , Sufana Amer AlOtaibi , Mohammed Alanazi , Israa Zaki Alawami , Osama Abdullah Barnawi , Mohammed Mubark Haqash , Saeed Saad Alqahtani , Kawthar Abdullrahim Bokari , Bayan Mansour Alnefaie

Abstract

Background: Deep Venous Thrombosis (DVT) and subsequent Pulmonary Embolism (PE) are one of the most eminent causes of preventable deaths in nosocomial settings. The prevalence is increasing and they have variable clinical presentations encountered in community settings as well as hospitalized patients requiring timely and obligatory prophylaxis. Objective: This study aims to review prophylactic measures for deep venous thrombosis/pulmonary embolism highlighting implemented pharmacologic and mechanical interventions, newer and yet investigational techniques such as neuromuscular electrical stimulation towards reducing prevalence of venous thromboembolism. Materials and Methods: A review of relevant articles published between the years of 2000 to 2019 in English language was done using the databases of PubMed Pico, Google Scholar and Google, using the predetermined keywords. Conclusion: Venous thromboembolism prevalence is increasing and among the various available methods for thromboprophylaxis, pharmacologic approach is the most superior which involves making use of either unfractioned or low molecular weight heparin although the most efficacious is low molecular weight heparin as evidenced by several meta-analyses. Anticoagulants have numerous side effects leading to limitations of their use and in such situations, mechanical methods such as intermittent pneumatic compression (most effective), graduated compression stockings, and venous foot pump scan can be used. In circumstances where both medicines and mechanical approach become impractical, neuromuscular electrical stimulation can be implemented even though additional research is required to further elucidate its efficacy and implications.