Some thought about DVT prophylaxis in ICU.
Part of my presentation on the same topic.

Question 1: What is the incidence of DVT and PE in current era of widespread thrombo-prophylaxis?
#FOAMed

Question 2: How do you diagnose DVT in ICU?
▶️I think, the best evidence is available for CUS with limited scope for Venography.
And no role of D-Dimer.
#FOAMed

Question 3: Is there any evidence supporting Heparin thrombo-prophylaxis in ICU?
#FOAMed

Yes.
1⃣Number needed to prophylax to prevent 1 DVT - 20
2⃣Number needed to prophylax to prevent 1 PE - 52
3⃣Overall no major bleeding. But bleeding risk need to be individualised.

Question 4: Is there any evidence of LMWH over UFH in VTE Prophylaxis?
#FOAMeYes.
1⃣LMWH decreases DVT. But no difference in Proximal DVT.
2⃣No difference in PE.
3⃣No difference in major bleeding.
4⃣Lower incidence of HIT in LMWH (PROTECT Trial).
5⃣Overall advantage LMWH.

Question 5: Is there any role of Mechanical Thromboprophylaxis?
#FOAMed