This paper discusses venous thromboembolism (VTE) complications in patients with a stroke, including both deep vein thrombosis (DVT) and pulmonary embolism (PE). It explores the risk of a patient suffering from deep vein thrombosis (DVT) just after the onset of a stroke. This complication is increased with dehydration, malignant diseases, clotting disorder, restricted mobility, or a patient’s ailment history. In this case, a patient is diagnosed, and a suitable treatment plan is given (Zhang et al., 2020). It also assesses the treatment plans that prevent deep venous thrombosis and their administration, such as receiving prophylactic to prevent the chance of having DVT—mobilizing patients as soon as they are stable and giving them enough water. Another treatment administered is low-dose unfractionated heparin, which is most preferred and considered for patients with ischemic stroke or if the concerned patient is at risk of having hemorrhage complications (Zhang et al., 2020). However, these Anticoagulant agents are not popular because of concern about the possibility of increased hematoma enlargement. Search methods for identifying the study include searching terms such as stroke, intracerebral hemorrhage, heparin, heparinoids, anticoagulants, randomized controlled trial prevention, pulmonary embolism, and outcome in the electronic database as Google.
Effective Prophylaxis for Deep Venous Thrombosis After Stroke
Deep Venous Thrombosis can be prevented effectively, and because of these. Guidelines for treatment emphasize the significance of prophylactic Measures. This option includes stockings and alternating pressure devices, and the use of antithrombic agents. Every treatment plan has its limitation, and recommendations are brought about from the experience of other patient groups. Many hospitalized stroke patients have deep vein thrombosis, while others have a pulmonary embolism (Khan et al., 2017). The unit aims to treat patients having an ischemic stroke with aspirin from the onset of the stroke within 48hrs because this improves the long-term outcomes; thus, venous thromboembolism risk is reduced. The findings show that early mobilization is recommended for mildly affected patients, seriously ill patients, and patients with severe motor impairments, limiting them from walking. Moreover, doctors can use stockings to treat bedridden patients with intracranial hemorrhage or those who develop complications for antithrombic agents.
A Randomized Controlled Trial and Review of Venous Thromboembolism in Hemorrhagic Stroke Patients
In patients with intracerebral hemorrhage, they used routine therapy instead of medications such as enoxaparin. Patients who used anticoagulants to prevent venous thrombosis were relatively safe, but the overall level of evidence was not adequate due to the number of patients included in the trials. Intermittent pneumatic compression effectively reduced the risk of complications and could improve survival in a wide range of immobile patients who had a stroke (Voicu et al., 2020). Patients accessed for eligibility were bedridden patients and patients who had intracranial hemorrhage while receiving treatment with oral anticoagulants. Those excluded were patients who had intracranial hemorrhage due to vascular malformation, those with severe hepatic failure, pregnancy, and patients who refused to consent (Voicu et al., 2020). Therefore, the findings indicate that administering early anticoagulation to patients with acute hemorrhage stroke is beneficial. It encourages randomized trials to assess the efficiency and recovery of early heparin administration in patients. Low-dose subcutaneous enoxaparin treatment is also safe in patients with ICH and may be considered individually for patients with hemiplegia too.
Strategies And Recommendations To Prevent Deep Venous Thrombosis After Stroke
The diagnosis of deep venous thrombosis is hard to ascertain because reliable clinical signs or symptoms are not present for the doctors to reach a definite diagnosis. Major cases that were detected were asymptomatic, and they used ancillary investigations. Doppler Ultrasound is preferred to diagnose the complication, but venography, MRI of the thrombosis, and fibrinogen scanning could also be used effectively in other cases. Depending on the method used, more patients did not undergo prophylactic therapy to lessen the complication (Voicu et al., 2020). Therefore, the trials suggest that early mobilization after stroke is safe and valuable after patients suffer from acute ischemic stroke. Early mobilization is a recommendation since it reduces the likelihood of having DVT and pressure sores (Voicu et al., 2020). When elastic stockings and intermittent pneumatic compression were used together, asymptomatic DVT was reduced compared to when elastic stockings were used alone.
Having seen that venous thromboembolism is common after having a stroke and increases mortality and morbidity. There have been positive changes in post-stroke care that have reduced the number of patient fatalities. Intermittent pneumatic compression devices have been found to prevent venous thrombosis, and these devices are routinely used for mechanical prophylaxis. The newer anticoagulants in VTE prophylaxis need to be verified more with the user trials. Measures like compression stocking do not significantly reduce the complication, and it causes skin breakdown until it proves equal or superior to anticoagulants. It should be reserved for treating patients with a high bleeding risk associated with anticoagulants. The difference in the manifestation of the complication, the risk factors included, and the outcomes of the patients with stroke vary immensely. Due to this, more data is required for hospitals to develop standard management strategies for DVT. Therefore, it might lead to fewer complications, a better prognosis for the patients, and even fewer occurrences creating a possibility of gain in the years that the patients with venous thrombosis can live.
Khan, T., Ikram, A., Saeed, O., Afridi, T., Sila, C. A., Irshad, K., & Shuaib, A. (2017). Deep vein thrombosis in acute stroke – a systemic review of the literature. Cureus. Web.
Voicu, S., Bonnin, P., Stépanian, A., Chousterman, B. G., Le Gall, A., Malissin, I., Deye, N., Siguret, V., Mebazaa, A., & Mégarbane, B. (2020). High prevalence of deep vein thrombosis in mechanically ventilated COVID-19 patients. Journal of the American College of Cardiology, 76(4), 480–482. Web.
Zhang, L., Feng, X., Zhang, D., Jiang, C., Mei, H., Wang, J., Zhang, C., Li, H., Xia, X., Kong, S., Liao, J., Jia, H., Pang, X., Song, Y., Tian, Y., Wang, B., Wu, C., Yuan, H., Zhang, Y., … Xie, M. (2020). Deep vein thrombosis in hospitalized patients with covid-19 in Wuhan, China. Circulation, 142(2), 114–128. Web.