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Indian Society of Critical Care Medicine Consensus Statement for Prevention of Venous Thromboembolism in the Critical Care Unit.
Jagiasi, Bharat G; Chhallani, Akshaykumar A; Dixit, Subhal B; Kumar, Rishi; Pandit, Rahul A; Govil, Deepak; Prayag, Shirish; Zirpe, Kapil G; Mishra, Rajesh C; Chanchalani, Gunjan; Kapadia, Farhad N.
  • Jagiasi BG; Critical Care Department, Reliance Hospital, Navi Mumbai, Maharashtra, India.
  • Chhallani AA; Akshjyot Clinic, Mumbai, Maharashtra, India.
  • Dixit SB; Department of Critical Care, Sanjeevan and MJM Hospital, Pune, Maharashtra, India.
  • Kumar R; Department of Critical Care, PD Hinduja National Hospital and Medical Research Centre, Mumbai, Maharashtra, India.
  • Pandit RA; Critical Care, Fortis Hospital, Mumbai, Maharashtra, India.
  • Govil D; Institute of Critical Care and Anesthesia, Medanta - The Medicity, Gurugram, Haryana, India.
  • Prayag S; Critical Care, Prayag Hospital, Pune, Maharashtra, India.
  • Zirpe KG; Neuro Trauma Unit, Grant Medical Foundation, Pune, Maharashtra, India.
  • Mishra RC; Department of MICU, Shaibya Comprehensive Care Clinic, Ahmedabad, Gujarat, India.
  • Chanchalani G; KJ Somaiya Hospital and Research Centre, Mumbai, Maharashtra, India.
  • Kapadia FN; Hinduja Hospital, Mumbai, Maharashtra, India.
Indian J Crit Care Med ; 26(Suppl 2): S51-S65, 2022 Oct.
Article in English | MEDLINE | ID: covidwho-2144654
ABSTRACT
Deep vein thrombosis (DVT) is a preventable complication of critical illness, and this guideline aims to convey a pragmatic approach to the problem. Guidelines have multiplied over the last decade, and their utility has become increasingly conflicted as the reader interprets all suggestions or recommendations as something that must be followed. The nuances of grade of recommendation vs level of evidence are often ignored, and the difference between a "we suggest" vs a "we recommend" is overlooked. There is a general unease among clinicians that failure to follow the guidelines translates to poor medical practice and legal culpability. We attempt to overcome these limitations by highlighting ambiguity when it occurs and refraining from dogmatic recommendations in the absence of robust evidence. Readers and practitioners may find the lack of specific recommendations unsatisfactory, but we believe that true ambiguity is better than inaccurate certainty. We have attempted to comply with the guidelines on how to create guidelines.1 And to overcome the poor compliance with these guidelines.2 Some observers have expressed concern that DVT prophylaxis guidelines may cause more harm than good.3 We have placed greater emphasis on large randomized controlled trials (RCTs) with clinical end point and de-emphasized RCTs with surrogate end points and also de-emphasized hypothesis generating studies (observational studies, small RCTs, and meta-analysis of these studies). We have de-emphasized RCTs in non-intensive care unit populations like postoperative patients or those with cancer and stroke. We have also considered resource limitation settings and have avoided recommending costly and poorly proven therapeutic options. How to cite this article Jagiasi BG, Chhallani AA, Dixit SB, Kumar R, Pandit RA, Govil D, et al. Indian Society of Critical Care Medicine Consensus Statement for Prevention of Venous Thromboembolism in the Critical Care Unit. Indian J Crit Care Med 2022;26(S2)S51-S65.
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Full text: Available Collection: International databases Database: MEDLINE Type of study: Experimental Studies / Observational study / Prognostic study / Randomized controlled trials / Reviews Language: English Journal: Indian J Crit Care Med Year: 2022 Document Type: Article Affiliation country: Jp-journals-10071-24195

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Experimental Studies / Observational study / Prognostic study / Randomized controlled trials / Reviews Language: English Journal: Indian J Crit Care Med Year: 2022 Document Type: Article Affiliation country: Jp-journals-10071-24195