• Diagnosis of venous thromboembolism in the intensive care unit requires a high index of clinical suspicion.
• Anticoagulate initially with closely monitored intravenous heparin by continuous infusion.
• Monitor the platelet count of patients receiving any form of heparin for early evidence of heparin-induced thrombocytopenia.
• Consider thrombolysis and caval filters.
• Consider underlying medical and hematological causes of thromboembolic disease (including rare disorders).
• Treat thrombotic thrombocytopenic purpura early with intensive plasma exchange and fresh frozen plasma replacement.
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