By Ellen Welch
ISBN-10: 0470511893
ISBN-13: 9780470511893
ISBN-10: 0470684070
ISBN-13: 9780470684078
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Additional info for Venous Thromboembolism: A Nurse's Guide to Prevention and Management
Example text
Plasma protein fibrinogen binds to the glycoprotein membrane receptors of platelets, 32 Venous Thromboembolism cross-linking them together. The resulting mass of aggregated platelets plugs the breach in the vessel wall and provides an expanse of platelet membrane on which further coagulation reactions can continue. Secondary haemostasis The primary phase described above occurs within minutes of vessel damage, and the platelet plug formed will disintegrate unless it becomes strengthened by an insoluble fibrin net produced by the complex coagulation cascade during secondary haemostasis.
De Stefano V, Martinelli I, Mannuccio P et al. (1999) The risk of recurrent deep venous thrombosis among heterozygous carriers of both factor V Leiden Pathophysiology 37 and the G20210A prothrombin mutation. New England Journal of Medicine 341: 801–806. Diehm C, Allenberg JR, Nimura-Eckert K et al. (2000) Diseases of veins. In Color Atlas of Vascular Diseases, 1st Edition. Springer-Verlag, Milan. Egeberg O (1965) Inherited antithrombin deficiency causing thrombophilia. Thrombosis et Diathesis Haemorrhagica 13: 516.
Autopsy studies have shown a greater incidence of VTE in those patients confined to bedrest for more than a week and in those patients with fractures of the lower limbs immobilized in plaster cast – all factors promoting venous stasis (Gibbs 1957; Hamilton et al. 1970). Blood flow is also thought to be hindered by increased blood viscosity. Blood becomes thicker in a number of disease conditions, such as polycythaemia and the dysproteinaemias, and during periods of dehydration (Mammen 1992). Certain inflammatory diseases can result in patients having increased fibrinogen levels (fibrinogen is a sticky acute phase reactant protein, which promotes thrombosis by causing platelets to clump together in vessels) and it has been found that fibrinogen levels are also increased in patients with spinal cord injury and paralysis (Rossi et al.
Venous Thromboembolism: A Nurse's Guide to Prevention and Management by Ellen Welch
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