Key messages

• 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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