Jornal Vascular Brasileiro
https://www.jvascbras.org/article/doi/10.1590/1677-5449.180107
Jornal Vascular Brasileiro
Review Article

Papel da deambulação na prevenção do tromboembolismo venoso em pacientes clínicos: onde estamos?

Role of ambulation to prevent venous thromboembolism in medical patients: where do we stand?

Maria Chiara Chindamo; Marcos Arêas Marques

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Resumo

Resumo: O tromboembolismo venoso (TEV), que compreende o espectro de manifestações de trombose venosa profunda e/ou embolia pulmonar, é uma complicação comum, grave e evitável em pacientes hospitalizados. Embora a perda da mobilidade recente ou continuada represente um dos principais fatores de risco relacionados ao desenvolvimento de TEV, não existem critérios claros e uniformes para a definição do conceito de imobilidade. A diversidade dessas descrições dificulta a interpretação e a comparação dos resultados de estudos clínicos randomizados no que se refere à influência dos diferentes níveis de imobilidade na magnitude do risco de TEV e ao papel da deambulação precoce, de forma isolada, na prevenção de tais eventos. O entendimento dessas limitações é mandatório para a utilização e interpretação adequadas das ferramentas de avaliação de risco de TEV, e para a indicação da melhor estratégia de prevenção de trombose em pacientes clínicos hospitalizados. O objetivo deste estudo é revisar as principais evidências da literatura quanto ao papel da deambulação na prevenção do TEV.

Palavras-chave

trombose venosa profunda, embolia pulmonar, tromboprofilaxia, segurança do paciente, limitação da mobilidade

Abstract

Abstract: Venous thromboembolism (VTE) encompasses the spectrum of manifestations of deep venous thrombosis and/or pulmonary embolism and is a common, serious, and preventable complication in hospitalized patients. Although immobility plays an important role in determining VTE risk in medical patients, no clear and uniform criteria exist to guide clinicians in assessing immobility. The variation in the descriptions that do exist makes it difficult to interpret and compare the results of randomized clinical trials with respect to the influence of different levels of immobility on the magnitude of VTE risk and the role that early ambulation as an isolated factor plays in prevention of such events. Understanding these limitations is a prerequisite for the proper use and interpretation of VTE risk assessment tools and for indicating the best strategy for preventing venous thrombosis in hospitalized medical patients. The objective of this study was to review the main evidence reported in the literature on the role of ambulation in prevention of VTE.
 

Keywords

deep venous thrombosis, pulmonary embolism, thromboprophylaxis, patient safety, mobility limitation

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