tromboprophylaksia

Tromboprophylaksia, also known as thromboprophylaxis, refers to measures taken to prevent the formation of blood clots in individuals at risk of venous thromboembolism, including deep vein thrombosis and pulmonary embolism. It encompasses both pharmacological and mechanical strategies and is commonly integrated into perioperative, critical care, and medical management to reduce morbidity and mortality from thrombotic events.

Pharmacological prophylaxis uses anticoagulants to reduce clot formation. Common agents include unfractionated heparin, low-molecular-weight heparins (such as enoxaparin and dalteparin), and fondaparinux. In certain settings, direct oral anticoagulants may be used after surgery or in medically high-risk patients. Dosing and choice of agent depend on the surgical procedure, patient weight, renal function, pregnancy status, and bleeding risk. Pharmacologic prophylaxis carries a risk of bleeding and, with heparins, a potential for heparin-induced thrombocytopenia.

Mechanical methods provide protection when pharmacologic prophylaxis is unsuitable or as an adjunct to pharmacologic therapy. These include graduated compression stockings and intermittent pneumatic compression devices, which promote venous return and reduce stasis. Early mobilization, adequate hydration, and, in some cases, neuraxial anesthesia considerations play supportive roles.

Indications for tromboprophylaksia are determined by individual risk assessment. Risk factors include major surgery (especially orthopedic and abdominal), cancer, prolonged immobilization, trauma, pregnancy, and critical illness. Tools such as risk scoring systems help tailor prophylaxis to balance thrombotic risk against bleeding risk. Regular monitoring for adverse effects, including bleeding and, when applicable, thrombocytopenia, is essential.