PMID- 24068866
OWN - NLM
STAT- MEDLINE
DCOM- 20140505
LR  - 20211021
IS  - 1177-8881 (Electronic)
IS  - 1177-8881 (Linking)
VI  - 7
DP  - 2013
TI  - Prevention of venous thromboembolism in hospitalized acutely ill medical 
      patients: focus on the clinical utility of (low-dose) fondaparinux.
PG  - 973-80
LID - 10.2147/DDDT.S38042 [doi]
AB  - Venous thromboembolism (VTE) is a frequent complication among acutely ill medical 
      patients hospitalized for congestive heart failure, acute respiratory 
      insufficiency, rheumatologic disorders, and acute infectious and/or inflammatory 
      diseases. Based on robust data from randomized controlled studies and 
      meta-analyses showing a reduced incidence of VTE by 40% to about 60% with 
      pharmacologic thromboprophylaxis, prevention of VTE with low molecular weight 
      heparin (LMWH), unfractionated heparin (UFH), or fondaparinux is currently 
      recommended in all at-risk hospitalized acutely ill medical patients. In patients 
      who are bleeding or are at high risk for major bleeding, mechanical prophylaxis 
      with graduated compression stockings or intermittent pneumatic compression may be 
      suggested. Thromboprophylaxis is generally continued for 6 to 14 days or for the 
      duration of hospitalization. Selected cases could benefit from extended 
      thromboprophylaxis beyond this period, although the risk of major bleeding 
      remains a concern, and additional studies are needed to identify patients who may 
      benefit from prolonged prophylaxis. For hospitalized acutely ill medical patients 
      with renal insufficiency, a low dose (1.5 mg once daily) of fondaparinux or 
      prophylactic LMWH subcutaneously appears to have a safe profile, although proper 
      evaluation in randomized studies is lacking. The evidence on the use of 
      prophylaxis for VTE in this latter group of patients, as well as in those at 
      higher risk of bleeding complications, such as patients with thrombocytopenia, 
      remains scarce. For critically ill patients hospitalized in intensive care units 
      with no contraindications, LMWH or UFH are recommended, with frequent and careful 
      assessment of the risk of bleeding. In this review, we discuss the evidence for 
      use of thromboprophylaxis for VTE in acutely ill hospitalized medical patients, 
      with a focus on (low-dose) fondaparinux.
FAU - Di Nisio, Marcello
AU  - Di Nisio M
AD  - Department of Medical, Oral and Biotechnological Sciences, University G 
      D'Annunzio of Chieti-Pescara, via dei Vestini 31, Chieti, Italy. 
      mdinisio@unich.it
FAU - Porreca, Ettore
AU  - Porreca E
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20130916
PL  - New Zealand
TA  - Drug Des Devel Ther
JT  - Drug design, development and therapy
JID - 101475745
RN  - 0 (Anticoagulants)
RN  - 0 (Polysaccharides)
RN  - J177FOW5JL (Fondaparinux)
SB  - IM
MH  - Anticoagulants/administration & dosage/adverse effects/*therapeutic use
MH  - Critical Illness
MH  - Dose-Response Relationship, Drug
MH  - Fondaparinux
MH  - Hemorrhage/chemically induced/prevention & control
MH  - Hospitalization
MH  - Humans
MH  - Intensive Care Units
MH  - Polysaccharides/administration & dosage/adverse effects/*therapeutic use
MH  - Randomized Controlled Trials as Topic
MH  - Risk Factors
MH  - Venous Thromboembolism/*prevention & control
PMC - PMC3782407
OTO - NOTNLM
OT  - fondaparinux
OT  - heparin
OT  - hospitalization
OT  - medical patient
OT  - venous thromboembolism
EDAT- 2013/09/27 06:00
MHDA- 2014/05/06 06:00
PMCR- 2013/09/16
CRDT- 2013/09/27 06:00
PHST- 2013/09/27 06:00 [entrez]
PHST- 2013/09/27 06:00 [pubmed]
PHST- 2014/05/06 06:00 [medline]
PHST- 2013/09/16 00:00 [pmc-release]
AID - dddt-7-973 [pii]
AID - 10.2147/DDDT.S38042 [doi]
PST - epublish
SO  - Drug Des Devel Ther. 2013 Sep 16;7:973-80. doi: 10.2147/DDDT.S38042. eCollection 
      2013.