how long for DVT to dissolve?

Specialties MICU

Published

Specializes in Preoperative and PACU; Med/Surg; ED; Home Health.

I have reviewed my nursing books. I understand the heparin protocol and then Lovenox and maintenance with Coumadin.

I encourage folks to get up and walk around versus sitting in front of TV all day long or stop and get out of their car if they're driving more than an hour. (to promote circulation)

I have had several patients/families ask me how long does it take for the clot to dissolve.

We have recently had several patients with positive D dimers. (which the lab tech tells me is read by them and majority are positive "which doesn't mean anything") So I'm confused about D Dimers. We have many COPD exac patients. I know that our doc has really ordering numerous "PE Protocols" and patients have CT of chest with and without contrast. (So I make sure they have an 18 gauge loc) Some have the VQ scan too. My understanding is that the VQ scan is done when their BUN is too high for their kidneys to tolerate the CT dye in order to rule out a PE.

I am really not finding reading material to help me with my research. When I was in nursing school (thru a hospital program that used to offer diploma RN and by the time I went there, it was a BSN program) - anyway... the hospital had a wonderful medical library with journals and it was easy to find journal articles to help explain various situations. But this is in another city and I haven't ventured there to see if an "alumna" can use the library. I no longer work at their hospital since we moved away.

I just feel like I need more info so I can better care for my people. I work in a very small hospital. (We average 5-10 patients with an RN, LPN and CNA on day shift and an RN and LPN for the night shift)

Input?

Thanks!

Specializes in Oncology/Haemetology/HIV.

There is no way to tell how long that it will take a DVT to dissolve. Depends on size, treatment and still varies from person to person. It is not something that can be predicted.

I have reviewed my nursing books. I understand the heparin protocol and then Lovenox and maintenance with Coumadin.

I encourage folks to get up and walk around versus sitting in front of TV all day long or stop and get out of their car if they're driving more than an hour. (to promote circulation)

I have had several patients/families ask me how long does it take for the clot to dissolve.

We have recently had several patients with positive D dimers. (which the lab tech tells me is read by them and majority are positive "which doesn't mean anything") So I'm confused about D Dimers. We have many COPD exac patients. I know that our doc has really ordering numerous "PE Protocols" and patients have CT of chest with and without contrast. (So I make sure they have an 18 gauge loc) Some have the VQ scan too. My understanding is that the VQ scan is done when their BUN is too high for their kidneys to tolerate the CT dye in order to rule out a PE.

I am really not finding reading material to help me with my research. When I was in nursing school (thru a hospital program that used to offer diploma RN and by the time I went there, it was a BSN program) - anyway... the hospital had a wonderful medical library with journals and it was easy to find journal articles to help explain various situations. But this is in another city and I haven't ventured there to see if an "alumna" can use the library. I no longer work at their hospital since we moved away.

I just feel like I need more info so I can better care for my people. I work in a very small hospital. (We average 5-10 patients with an RN, LPN and CNA on day shift and an RN and LPN for the night shift)

Input?

Thanks!

An acute DVT takes aprox 5-7 days to adhere to the vessel wall. After that it is slowly absorbed in the system but may leave a lesion on the vessel wall. It is generally safe for pt to ambulate after the 7 day mark. The rate of absorption is unpredictable.

D-dimer measures the amt of fibrin degradation and is elevated when a fibrin clot is broken down by a thrombolytic.

VQ scans show if there is a mismatch in perfusion to the lungs that would indicate a pulmonary embolus.

"Anticoagulation, by preventing clot propagation, allows endogenous fibrinolytic activity to dissolve existing thromboemboli. The rate at which this process occurs is variable. Although complete clot lysis has been reported after as little as 7 days, resolution typically occurs over several weeks or months; in many patients, however, resolution is incomplete after several months."

http://www.chestjournal.org/cgi/content/full/115/6/1695

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