What Padua score indicates high VTE risk requiring pharmacological prophylaxis?

Padua score ≥4 indicates high risk (10.9% vs 0.3% low-risk VTE rate); score includes active malignancy (3), prior VTE (3), reduced mobility (3), known thrombophilia (3), recent trauma/surgery (2), age ≥70 (1), heart/respiratory failure (1), acute MI/stroke (1), obesity (1), ongoing hormonal therapy (1).

When is pharmacological VTE prophylaxis contraindicated?

Absolute: active major hemorrhage, platelet <50,000/mm³, HIT; relative: intracranial hemorrhage <24h, post-neurosurgery, high-risk spinal injury, renal failure CrCl <15 mL/min (reduce dose).

What is the standard enoxaparin prophylaxis dose in ICU?

Medical ICU: enoxaparin 40 mg SC q24h; surgical: 40 mg SC q12h or 30 mg SC q12h (orthopedic); CrCl 15-30: 20-30 mg q24h; renal failure <15 mL/min: UFH 5000 units SC q8-12h preferred.

Is mechanical prophylaxis (pneumatic compression) equivalent to pharmacological?

GCS (graduated compression stockings) and IPC (intermittent pneumatic compression) reduce VTE when pharmacological is contraindicated; combined pharmacological + mechanical is superior to either alone; IPC preferred over GCS in most ICU patients.

Should therapeutic anticoagulation be used in COVID-19 ICU patients?

ACTIV-4a/ATTACC/INSPIRATION trials: therapeutic heparin did not reduce organ support need in ICU COVID-19 patients (possible harm in some high-IL-6 patients); standard prophylaxis doses are recommended for most ICU COVID-19 patients.

ICU VTE Prophylaxis Risk Stratification and Dosing Protocol

Stratifies VTE risk and prophylaxis method in ICU patients using Padua score, contraindications to pharmacological prophylaxis, and enoxaparin/UFH dosing for medical and surgical ICU patients.

Weight

Height

Clinical Guidance

BMI is a screening measure of body size, not a direct measure of body fat. The standard WHO categories are underweight (<18.5), normal (18.5–24.9), overweight (25–29.9), and obese (≥30).

BMI can overestimate body fat in athletes with high muscle mass and underestimate it in older adults with low muscle mass. Interpret it alongside waist circumference and clinical context rather than as a standalone diagnosis.

⚕ Clinical Disclaimer: These calculators are for educational and reference purposes only. Always verify results with qualified clinical judgment and current clinical guidelines. Do not use as a sole basis for medical decisions.

How It Works

Stratifies VTE risk and prophylaxis method in ICU patients using Padua score, contraindications to pharmacological prophylaxis, and enoxaparin/UFH dosing for medical and surgical ICU patients

Each component has a specific meaning:

Contraindications — The contraindications recorded for the patient or scenario being assessed.

Note: Interpret the icu vte prophylaxis result against the clinical thresholds and context described above.

How to Use

Enter the contraindications for the patient or scenario you are assessing. Stratifies VTE risk and prophylaxis method in ICU patients using Padua score, contraindications to pharmacological prophylaxis, and enoxaparin/UFH dosing for medical and surgical ICU patients. Use the icu vte prophylaxis result to inform your clinical assessment.

Related Calculators

Enoxaparin Dosing

Medical Calculators

Heparin Infusion Dosing