Thromboemboliebehandlung auch in der Palliativmedizin – ein Paradigmenwechsel?

Zusammenfassung

Venöse Thromboembolien (VTE) führen nicht nur in operativen, allgemeininternistischen oder onkologischen Fachbereichen, sondern auch in der Palliativmedizin zu erheblicher Mortalität, Morbidität und Symptomlast. Die thromboemboliespezifischen Belastungen zu verhindern bzw. zu behandeln und dennoch die veränderten therapeutischen Prioritäten vor dem Hintergrund der letzten Lebensphase voranzustellen, stellt eine besondere Herausforderung in der Palliativmedizin dar. Diese Übersicht versucht, relevante Standards der allgemeinen Thromboemboliebehandlung und -prophylaxe und aktuelle hämostaseologische Aspekte onkologischer Grunderkrankungen so darzustellen, dass eine ausgewogene Bewertung in der palliativmedizinischen Therapieentscheidung erleichtert wird.

Abstract

Venous thromboembolism (VTE) leads to substantial mortality, morbidity and symptom burden not only in operative, medical or oncological, but also in palliative care settings. To prevent and treat these symptoms but to keep shifting priorities regarding aspects of end of life care in mind remains a major challenge in palliative care. This review article summarizes relevant standards for VTE treatment and prophylaxis, includes updated haemostaseologic insights in the care of cancer patients, and thereby tries to promote a balanced therapeutic assessment of palliative care decisions.

Schlüsselwörter

Thromboembolie - Primär- / Sekundärprophylaxe - Primärtherapie - Symptome

Key words

thromboembolism - primary / secondary prophylaxis - primary treatment - symptoms

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