Preventive Measures Of Venous Thromboembolism In The Hospitalized Patient: An Integrative Literature Review

Abstract

Venous thromboembolism (VTE) includes two closely associated clinical conditions: deep vein thrombosis (DTV) and its main acute complication, pulmonary embolism (PE). In the hospital setting, venous thromboembolism is a concern because of its high prevalence rate. It is estimated that one in twenty inpatients is at risk of pulmonary embolism, if adequate preventive measures are not applied.These may or may not be pharmacological. In this context, the objective of this study is to identify the non-pharmacological measures recommended to prevent venous thromboembolism in inpatients. An integrative literature review was performed using the PI[C]OD method by searching the following databases: EBSCO host, PubMed, JBI, PEDro, Elsevier-ClinicalKey, Scielo and Google Academic studies published in the períod 2006-2016. From the research were included five articles that met the inclusion criteria. The results of the review found that effective mechanical methods comprised graduated compression stockings and intermittent pneumatic compression devices while for nursing care early mobilization and ambulation were identified as preventive measures of VTE. The studies suggest several benefits of using non-pharmacological measures to prevent venous thromboembolism. The differentiated intervention of the nurse specialist in rehabilitation integrated in the multidisciplinary team can be an added value in the adequacy of these measures.

Outline of Hospitalization Due to Venous Thromboembolism in Brazil Between 2010 and 2020

“…The profile in relation to gender also corroborates the literature, since women correspond to most hospitalizations. Intrinsic factors may be favorable to this arrangement, such as the use of oral contraceptives, eventual pregnancy, puerperium or gynecological surgery, as well as a greater search for health services by the female population in relation to the male population (Isabel, & Costa, 2017;Heit, Spencer, & White, 2016). Regarding the use of oral contraceptives , although pills currently have a lower concentration of estrogen, especially ethinyl estradiol, their use increases the risk of VTE by up to six times compared to those that do not use hormonally based contraceptives.…”

“…The diagnosis of venous thrombosis is complex, as no sign or clinical manifestation presented by the patient is predictive for confirmation or exclusion of the condition (Albuquerque, et al, 2017). The manifestations in Deep Vein Thrombosis are pain, heat, redness, swelling of the affected limb, cramps and, in some cases, greater predisposition to the formation of ulcers (Albuquerque, et al, 2017;Nazario, Delorenzo, & Maguire, 2002;Volpe, et al, 2010;Albuquerque, et al, 2017;Goldman, & Schafer, 2022). However, certain patients may not have symptoms or only some of them 6 .…”

“…Rates are equally worrying in the United States (USA), for example, it is estimated that the prevalence of PTE is between 300,000 and 600,000 cases and it is responsible for 60,000 to 100,000 deaths annually. In the world, an estimated number of deaths from VTE is 543,000 every year (Isabel, & Costa, 2017). In Brazil, in turn, the numbers that characterize the epidemiology of VTE are also inaccurate, but alarming.…”

“…According to certain references, the incidence of the disease is 100 to 200 episodes per 100,000 inhabitants , while others describe it as 60 per 100,000 inhabitants (Diogo-Filho, et al, 2009). VTE can still cause several long-term complications even in patients who comply with anticoagulant therapy, so about 1/3 (33%) of patients who had DVT/PE will have a new episode in 10 years, which, in most cases it takes a new hospitalization (Isabel, & Costa, 2017).…”

“…However, during the fertile age, this rate is slightly elevated in females, but after 45 years it returns to the previous pattern. Added to this, even in relation to women, the occurrence of PTE is common in all trimesters of pregnancy (Isabel, & Costa, 2017).…”