Prevention

Walking regularly, not to remain still, is the best way to prevent either thrombosis or pulmonary embolism

In every other person with VTE, a thrombosis appears after surgery or after an immobilization process. In these cases the best measure to prevent a thrombosis is to walk as soon as possible.

Thus, after an operation, the surgeon encourages the patient to get up as soon as possible (the next day if possible), and for patients with an infection, bronchitis or heart failure, we recommend them to sit in a chair and not to stay in bed longer than strictly necessary.

As this is often not enough, and we prescribe anticoagulants (albeit lower doses than the one we usually recommend for VTE).

Since the mid-70s, we, the doctors, have heparin and low weight molecular heparin as allies to prevent the appearance of VTE in surgical patients and in immobilized patients. In these cases, heparin is usually administered a few hours before or after the operation, depending on the case, followed by a daily injection, as long as the risk persists.

The risk of suffering a VTE lasts several weeks after certain operations. For this reason, we currently recommend extending the use of low weight molecular heparin for five weeks after a hip or knee prosthesis surgery, or a hip fracture or even in interventions of malignant tumors in the digestive or genitourinary systems.

Since low weight molecular heparin subcutaneous injections and their derivatives- especially if administered during a month – are very annoying to patients, we have recently found new anticoagulants, that are taken orally and that are already available in pharmacies.
Currently, the public health system does not cover the cost of these drugs.

If anticoagulants are not administered

Drugs with an anticoagulant effect are fundamentally aimed at neutralizing the tendency of excess blood clots in patients being operated on or in immobilized patients.

However, there are people who cannot use drugs that interfere with coagulation because they have diseases or circumstances in which the risk of hemorrhage is high. In these cases, they can use elastic stockings or devices that are applied on the legs, and that through intermittent air blowing, they compress the calf area accelerating the venous blood flow.

For patients with a high risk of suffering a post-operation VTE, you can combine their anticoagulants with physical methods, in order to enhance their effects.

In any case, regardless of the use of these forms of prophylaxis, it is always desirable to mobilize those patients and to make them get up from their beds as soon as possible.

But a person who has already had an episode of VTE should avoid being in bed or sitting too long, he/she must walk as much as possible and avoid drugs that may induce a thrombosis (such as estrogen, for example).

 

 

 

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October 2018

 

 

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