Chest. Feb;(2 Suppl):eS-eS. doi: /chest Development of Antithrombotic Therapy and Prevention of Thrombosis Guidelines. Copyrightby the American College of Chest Physicians, ANTITHROMBOTIC THERAPY AND PREVENTION OF THROMBOSIS, 9TH ED: ACCP GUIDELINES reductions in symptomatic DVT and pulmonary. Allan S. Brett, MD reviewing Guyatt GH et al. Chest Feb. Widely considered the gold standard for thrombosis prevention and therapy.
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Recommendations incorporate perspectives in bleeding disorders, critical care, preventive medicine, methodology, and cost effectiveness. Antithrombotic Therapy for Atrial Fibrillation: For patients at high dft for VTE undergoing abdominal or pelvic surgery for cancer, we recommend extended-duration, postoperative, pharmacologic prophylaxis 4 weeks with LMWH over limited-duration prophylaxis Grade 1B. For patients at moderate to high risk for VTE who are at high risk for major bleeding complications or those in whom the consequences of bleeding are believed to be particularly severe, we suggest use of mechanical prophylaxis, preferably with IPC, over no prophylaxis until the risk of bleeding diminishes and pharmacologic prophylaxis may be initiated Grade 2C.
We developed recommendations for thromboprophylaxis in nonorthopedic surgical patients by using systematic methods as described in Methodology for the Development of Antithrombotic Therapy and Prevention of Thrombosis Guidelines.
Antithrombotic Therapy in Neonates and Children February Recommendations focusing on the monitoring to specific target ranges for both unfractionated and low-molecular-weight heparins in neonates and children. George, MD; Anna R.
VTE is a common cause of preventable death in surgical patients. Prevention of Venous Thromboembolism in Nonsurgical Patients Recommendations regarding the decisions in prophylaxis in nonsurgical patients.
It acknowledges the ongoing need for dedicated clinical trials that demonstrate the differences in the pharmacokinetics, dose responses, and monitoring tests for anticoagulation therapy in children compared with adults.
Antithrombotic and Thrombolytic Therapy for Valves February Recommendations based on the optimal balance of thrombotic and hemorrhagic risk for antithrombotic therapy in valvular disease.
The Perioperative Management of Antithrombotic Therapy Recommendations to simplify patient management and minimize adverse clinical outcomes for perioperative antithrombotic management based on risk assessment for thromboembolism and bleeding. Antithrombotic and Thrombolytic Therapy for Ischemic Stroke February Recommendations for the use of antithrombotic therapy in patients with stroke or transient ischemic attack.
Prevention of Venous Thromboembolism in Nonorthopedic Surgical Patients Recommendations for optimal thromboprophylaxis in nonorthopedic surgical patients. The slides address the risks of venous thromboembolism and bleeding complications, as well as the values and preferences of individual patients.
Antithrombotic Therapy in Atrial Fibrillation February Recommendations regarding atrial fibrillation based on net clinical benefit for patients at varying levels of stroke risk and in a number of common clinical scenarios. For patients in all risk groups, we suggest that an inferior vena cava filter not be used for primary VTE prevention Grade 2C and that surveillance with venous compression ultrasonography should not be performed Grade 2C.
Antithrombotic Therapy in Peripheral Artery Disease February Recommendations regarding antithrombotic drug therapies for primary and secondary prevention of cardiovascular disease as well as for the relief of lower-extremity symptoms and critical ischemia in patients with peripheral arterial disease PAD.
These slides address initiation, maintenance, dosing, drug interactions, bleeding, and organization of care, offering guidance for many common anticoagulation-related management problems.
Guidelines & Resources
The Prpohylaxis and Secondary Prevention of Cardiovascular Disease February Recommendations focusing on long-term administration of antithrombotic drugs designed for primary and secondary prevention of cardiovascular disease, including two new antiplatelet therapies ticagrelor and prasugrel. Prevention of Venous Thromboembolism in Orthopedic Surgery Patients Recommendations for the optimal strategies for thromboprophylaxis after major orthopedic surgery.
We describe several alternatives for stratifying the risk of VTE in general and abdominal-pelvic surgical patients.
Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: Topics covered include pharmacologic and mechanical approaches to reduce patient-important outcomes, such as pulmonary embolism and symptomatic DVT. It discusses the use of antithrombotic agents during pregnancy and the associated challenges because of the potential for both fetal and maternal complications.
Venous Thromboembolism, Thrombophilia, Antithrombotic Therapy, and Pregnancy February Recommendations focusing on the management of venous thromboembolism and thrombophilia. The slide set highlights single antiplatelet therapy for primary and secondary prevention of cardiovascular events in most patients with asymptomatic PAD, symptomatic PAD, and asymptomatic carotid stenosis. Optimal thromboprophylaxis in nonorthopedic surgical patients will consider the risks of VTE and bleeding complications as well as the values and preferences of individual patients.
Pulmonary Vascular | CHEST Guideline Topic Areas – American College of Chest Physicians
This CHEST guideline series presents recommendations for the prevention, diagnosis, and treatment of thrombosis, addressing a comprehensive list of clinical conditions, including medical, surgery, orthopedic surgery, atrial fibrillation, stroke, cardiovascular disease, pregnancy, and neonates and children. Comment in Aesthet Surg J. We developed similar recommendations for other nonorthopedic surgical populations. In these patients, we suggest adding mechanical prophylaxis with elastic stockings or IPC to pharmacologic prophylaxis Grade 2C.
Treatment and Prevention of Heparin-Induced Thrombocytopenia February Recommendations regarding heparin-induced thrombocytopenia and the primary efficacy outcome measures of interest, including new thrombosis, limb amputation, and major bleeding and death due to thrombosis or bleeding.
Evidence-Based Management of Anticoagulant Therapy Recommendations for the general management of anticoagulant therapy. CHEST develops slide sets to incorporate into prophypaxis presentations, for the purposes of disseminating and explaining guideline recommendations.