All I want for coagulation
ABSTRACT Evidence-based medicine underpins modern practice of medicine. This paper describes a fictional consultation between Santa Claus and a doctor regarding deep vein thrombosis (DVT) prophylaxis, giving a review of the evidence for DVT prophylaxis in travellers while exposing the difficulty in applying evidence to atypical clinical encounters. Medline and the Cochrane Library were searched, and guidelines reviewed. Keywords used were DVT, thromboembolism, deep vein thrombosis and air travel-related venous thromboembolism. All relevant studies found, have been included in this review, with additional studies identified from the references in these articles. In conclusion, compression stockings, with or without a one-off dose of either aspirin or heparin, are the most evidence-based approaches for prophylaxis in someone with established risk factors for DVT prior to a long-haul flight. Simple exercises should also be encouraged.
SourceAvailable from: Andrew D Blann
Article: Venous thromboembolism.BMJ (online) 02/2006; 332(7535):215-9. DOI:10.1136/bmj.332.7535.215 · 16.38 Impact Factor
The Lancet 10/2001; 358(9284):837-8; author reply 839. DOI:10.1016/S0140-6736(01)05978-5 · 39.21 Impact Factor
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ABSTRACT: The risk of venous thrombosis is thought to be increased by flying. In a study of 20 healthy male volunteers who were suddenly exposed to a hypobaric environment similar to that encountered within aeroplane cabins, markers of activated coagulation transiently Increased by two-fold to eight-fold. We suggest that hypobaric hypoxia, with sedentariness and dehydration, may cause this increased risk of venous thrombosis.The Lancet 12/2000; 356(9242):1657-8. DOI:10.1016/S0140-6736(00)03165-2 · 39.21 Impact Factor