Fatores de risco adquiridos e profilaxia da trombose venosa profunda em unidade de terapia intensiva / Acquired risk factors and prophylaxis for deep-vein thrombosis at the intensive therapy unit

RESUMO

O estudo caracterizou os fatores de risco adquiridos da trombose venosa profunda de acordo com aspectosgerais, clínicos, cirúrgicos e medicamentosos; estratificou o risco pela Sociedade Brasileira de Angiologia eCirurgia Vascular e verificou as medidas profiláticas mediante prescrições médicas e de enfermagem. Utilizousemétodo transversal e prospectivo, por meio da análise dos prontuários de 112 pacientes de uma UTI. Evidenciou-se elevada prevalência de fatores de risco em pacientes clínicos e cirúrgicos considerados de Alto Risco. Nos clínicos predominou a infecção e nos cirúrgicos a anestesia geral e o tempo cirúrgico maior de duas horas. Verificou-se que a profilaxia medicamentosa utilizada foi a Heparina não fracionada enquantoas medidas mecânicas como movimentação, deambulação precoce e elevação de membros inferiores, namaioria dos prontuários, não foram identificadas nas prescrições médicas e de enfermagem. Conclui-se que a profilaxia farmacológica e mecânica deve ser realizada em pacientes de UTI, sendo importante a estratificação do risco para que o tratamento seja o mais adequado possível.

ABSTRACT

This study has characterized the acquired risk factors for deep-vein thrombosis according to general, clinical,surgical, and drug aspects. These data were used to establish the risk of stratification in agreement with theclassification recommended by the Brazilian Society of Angiology and Vascular Surgery (BSAVS). Prophylacticmeasures were also verified through medical and nursing prescriptions. This prospective cross-sectional study was accomplished through the analysis of 112 medical records of intensive care unit patients. Risk factors prevailed and became evident regarding high-risk clinical and surgical patients. Among clinical patients, the infection has predominated. However, in relation to surgical patients, general anesthesia andsurgical time longer than 2 hours were prevailing. It was verified that the prophylactic drug used was unfractionated Heparin, while mechanical measures against thrombosis, such as movement, early ambulation, and elevation of the legs could not be identified in most of the medical and nursing prescriptions found onmedical records. It has been concluded that the pharmacological and mechanical prophylaxis should beperformed in ICU patients. The bottom line is that the risk stratification for the treatment is the most suitable as possible.