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Sepsis, pneumonia, transverse colon, DVT in legs. On lovenox, hemodialysis. Can blood thinners be given and is it safe to do dialysis?

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17 year old male admitted to ICU with sepsis, pnuemonia and perforated transverse colon. The colon operated on and removed. Should blood thinners have been started immediately? Patient was overweight. After 3 days a large DVT developed in the left leg. Patient given lovenox and was then put on continuous hemodialysis to remove water. Kidney function was impaired; however, not high enough for standard dialysis. With respect to a pulmonary embolism happening, would it be safe to do the dialysis with the DVT, or should the clot be removed, or monitored more thoroughly? Thank you.
Posted Sun, 29 Apr 2012 in Kidney Conditions
Answered by Dr. Avinash Ignatius 13 hours later

Thanks for the query.

1.     If needed Dialysis should be continued irrespective of whether DVT is present or not. I don’t think presence of DVT will effect in any way the decision of your doctors to use dialysis if it has to be used during the course of treatment.

2.      The need for blood thinners is decided based on the nature of surgery and other reports at that time. As blood thinners are also associated with increased risk of bleeding, it is always used with caution. Hence the decision to use for XXXXXXX vein prophylaxis can be taken only by the operating surgeon.

3.     If needed the clot removal can be decided by a vascular surgeon depending on the size and location of the clot.

Hope I have answered all your queries. Please accept my answer if you do not have any further queries.

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