• 28Oct

    How to prevent deep vein thrombosis?

    Veins carry blood from limbs, head and other organs back to heart and lungs for oxygenation. Deep vein thrombosis (DVT) is a condition in which there is clotting of blood in the deep veins of the legs. If this clot or coagulum of blood breaks down and a small piece flows back to the heart and lungs, it can cause blockage of the pulmonary artery (artery through which the blood travels from the heart to both lungs) or its branches. This may result in difficulty in breathing due to lack of oxygenation of blood or even sudden death in severe cases. DVT is a multifactorial disease, however immobility remains one of the most important causative factors. Recently the term ‘e-thrombosis’ has been used to describe blood clots occurring in people sitting at their computers for long periods of time. Deep vein thrombosis has also been recognized as a complication that may occur during long distance flights.

     


    Deep vein thrombosis

    DVT common initial symptoms are pain and swelling of the calf. It may be a bilateral occurrence in about 30% of patients. The clot may dislodge resulting in embolism in lungs (blockage of blood vessels supplying the lungs thereby preventing the oxygenation of blood). Lack of oxygen supply to brain may result in sudden death. A low grade fever, difficulty in breathing and cyanosis (bluish discoloration of fingers and toes) may also be observed. The blood investigation reveals raised level of D-dimers. A duplex ultrasound of the limb veins will show lack of compressibility, diminished or absent flow and filling defects. If there is suspicion of pulmonary embolism, a ventilation-perfusion scan of the lungs should be performed.

    Stewardess

    DVT commonly presents with pain and swelling of the calf

    Risk factors

    The patient related risk factors are advanced age, obesity, varicose veins, prolonged immobility, post childbirth, high dose estrogen therapy and previous DVT. The disease or surgery related risk factors include trauma or surgery of pelvis, cancer, heart failure, paralysis of lower limbs, infection and inflammatory bowel disease.

    How to prevent deep vein thrombosis?

    The preventive methods are divided into general, mechanical and pharmacological. The general methods are as follows:

    • Hydration – drink plenty of liquids, especially in cold climate. On the other hand, be aware of coffee / tea in cold environment as drinking them causes diuresis (urination) and dehydration results in concentration of blood and increased risk of DVT
    • Ambulation – frequent walking maintains the circulation of blood from the dependent legs to the heart thereby preventing stagnation. An occasional walk to the toilet during long flights and stretching legs empties the veins to maintain flow of blood from legs to heart. It is also advised method of prevention when you have a sitting job

    The mechanical methods involve the use of graduated elastic compression stockings. When worn, they compress the superficial (surface) veins of calf and divert the blood to deep veins. This increases the blood flow in the deep veins and prevents thrombosis. The external pneumatic compression device works on the same principles and is used during long lasting surgeries. These mechanical measures reduce the incidence of thrombosis.

    Pharmacological methods are based on the use of drugs which prevent the clotting of blood. They are more effective than mechanical methods at reducing the risk of thrombosis, although they carry an increased risk of bleeding. Most patients now start on low molecular weight heparin given subcutaneously by injection, the dose being based on the patient’s body weight. This does not require monitoring and has a reduced risk of complications like thrombocytopenia (low platelet cell count resulting in risk of bleeding). It is given once a day and has a lower risk of bleeding complications. A combination of mechanical and pharmacological treatment can be used in patients at high risk of DVT.

    Deep vein thrombosis is a serious complication of immobility. It is better prevented by maintaining ambulation, consumption of liquids and medication when indicated. If you have a sitting job or even whenever you are planning long distance flight and have any of the risk factors, consult your doctor in advance.

    Anna L.

    It’s all about health!
    I have academic background in drugs related Chemical Technology, as well as extensive professional experience in pharma and medical companies. My main area of interest is everyday life medicine. The goal of my articles is to give people informative answers to the questions that bother them, to dispel doubts and some common misbeliefs and also to inspire everyone to keep healthy lifestyle.

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