Izlaganje sa skupa
INCIDENCE AND PREVENTION OF DEEP VEIN THROMBOSIS IN RESTRAINED PSYCHIATRIC PATIENTS
Alexis Therasse
; Vascular Surgery Unit, Centre Hospitalier Universitaire et Psychiatrique de Mons-Borinage (CHUP-MB), Mons, Belgium
Humberto L. Persano
; Eating Disorders Unit, Hospital Borda, Cuidad Autonoma de Buenos Aires, Argentina
Adrian D. Ventura
; Eating Disorders Unit, Hospital Borda, Cuidad Autonoma de Buenos Aires, Argentina
Juan Martin Tecco
; Department of Psychiatry, Centre Hospitalier Universitaire et Psychiatrique de Mons-Borinage (CHUP-MB), Mons, Belgium
Sažetak
Background: Although physical restraint is still used in psychiatric inpatient settings, it sometimes causes serious side effects,
including deep vein thrombosis (DVT) and resulting pulmonary embolism. The aim of this study was to review the literature
investigating the incidence of the DVT in restrained psychiatric patients, to identify the risk factors of this condition and the
effectiveness of routine prophylaxis.
Subjects and methods: Studies investigating associations between deep vein thrombosis and restrained psychiatric patients were searched in the Pubmed database. More than 700 articles were sorted independently by two of the authors using predefined criteria. Only research articles, reviews and meta-analyses were selected for this review.
Results: 5 articles published between 2010 and 2016 were selected. Although antipsychotics and restrain are known to be
thrombogenenic, in all retrospective studies, with anticoagulant prophylaxis for those restrained for more than 12 or 24 h, incidence of DVT in restrained psychiatric patients was almost not existent. Controversially, in a comparative study by Ishida, although deep sedation and physical comorbidities were associated with the occurrence of DVT, not using of anticoagulants was not associated with any increased incidence of DVT. DVT may be overlooked because psychiatric patients are often unaware of leg symptoms because of their psychiatric disease and induced sedation. Furthermore most DVT, in particular distal DVT are asymptomatic. When screened and assessed with more appropriate methods such as plasma D Dimer and ultrasound scanning the incidence of DVT reaches 11.6%.
Conclusion: The incidence of DVT in restrained psychiatric patients was not low in spite of prophylaxis. These findings
emphasize the importance of regular screening of and thorough assessments of DVT, especially in restrained psychiatric patients.
Ključne riječi
deep vein thrombosis; physically restrained; psychiatric patient
Hrčak ID:
262955
URI
Datum izdavanja:
21.11.2018.
Posjeta: 358 *