The Indian Society of Critical Care Medicine (ISCCM) has expressed concern over the fact that even though the government had issued the Asian VTE (Venous Thromboembolism) guidelines way back in April 2013, very few hospitals in the country actually follow it.  To prevent hospital-acquired VTE, operation theatres and intensive care units need to adhere to the norms strictly.

In the run up to the World Thrombosis Day, observed on October 13 annually, a panel of VTE experts opined that India needs to formulate a specific guidelines.

Thrombosis is the formation of blood clots. However, VTE is life threatening which includes Deep Vein Thrombosis (DVT) and Pulmonary Embolism (PE). DVT is a blood clot in the deep veins of a limb (usually lower limb) and when this clot travels to lungs, it leads to PE. Therefore, it is necessary to work on creating a database from research and documentation, said the panel of experts represented by Dr. Venkatesh HK, Senior Consultant & Chief, Division of Neuroanaesthesia & Neurocritical Care, Apollo Hospitals; Dr. Ajith Kumar AK, President, ISCC, Bangalore Chapter, Senior Consultant, ICU, Manipal Hospitals; and Dr. Vivekanand, HOD & Senior Consultant Vascular Surgeon, JIVAS.
 
In India, VTE is a concern as Bengaluru alone reports an increase of 10-12% of DVT cases in the last one year. There are several fatalities. Even stroke, trauma, immobility, body vessel injury are major risk factors for VTE. Higher cases PE were observed in Bengaluru in the past year. Globally, VTE affects about 10 million and with fatality reported 1 in 4 people. According to 2011-12 Indian data, DVT incidence is between 17-20%.
 
Symptoms of DVT include swelling and pain especially of lower limbs, increase in heart rate and fever. Diagnosis for PE is established using CT Pulmonary Angiogram and Venogram. Timely treatment of DVT is essential to prevent complications.

VTE maybe hospital-acquired, surgery-acquired community or home acquired, pregnancy or travel related. Elaborating on measures for VTE prevention especially in cases of prolonged immobilization, Dr. Venkatesh recommended wearing compression stockings and providing mechanical prophylaxis till they are mobilized. Surgery-related VTE is mostly observed in obese and elderly patients. For prolonged duration of surgery of over 4 to 5 hours, mechanical compression devices is mandatory in OTs.

Highlighting the importance of VTE prevention, Dr. Kumar said the condition is fatal and requires immediate attention. Its treatment management is expensive.

According to Dr. Vivekanand, lifestyles disorders also increases VTE risk. Once a clot is diagnosed, Heparin is administered to dissolve it. Advanced VTE treatment includes a clot busting treatment wherein a small catheter is inserted with drug for Thrombolysis. Drug is released and the clot is dissolved, as it becomes soft and sucked out with the help of an aspirational device preventing further embolism.