Editorial for the collection: therapies approaches in venous thromboembolism management and coagulation

Carmine Siniscalchi^1*Pierpaolo Di Micco^2*

• ¹Department of Medicine and Surgery, University of Parma, Parma, Italy
• ²Ospedale Santa Maria delle Grazie, Pozzuoli, Italy

Alsuhebany et al reported an intriguing experience on different type of thromboprophylaxis of inpatients in neurological intensive care unit affected by haematological\oncological malignancy. The difficult to choose the best practice in patients with simultaneous risk to develop thrombosis because bedridden and with malignancy associated to frequent thrombocytopenia or platelets' dysfunctions for oncological treatments is still matter of discussion [1,2]. Frequently, this clinical scenario may benefit of nursing surveillance because the instability of clinical conditions of patients with VTE or VTE risk. The nursing system as in other aspects of clinical daily management of patients that cross from acute treatments for VTE to prolonged anticoagulation is acquiring a fundamental role in last years. [3] In the oncological management, in fact, the nursing support is present with strong support day by day. Particular interests, in fact are reserved to particular cancers at high risk of VTE as different types of lung as reported by Xie et al., Chen et al. and Liu et al [4][5][6], the surveillance is high both for patients coming from surgery or addressed to chemotherapy. Clinical characteristics of patients with lung cancer that develop VTE may differ also for oncological characteristics besides to the presence of other thrombotic risk factors. [7] Specific characteristics of patients with VTE represent a cross from evidence based medicine to tailored medicine and among relevant aspects that may induce different prognosis of patients with VTE PaCo2 levels of pulmonal thrombus location may select subgroup of patients with poor prognosis [8]; moreover, inherited predisposition seems to play a specific role also in this frail patients as reported with experienced data found with TMEM132A. [4] Yet, also patients with major trauma prompt to major orthopedic surgery may be addressed to tailored treatments: prophylaxis of post traumatic hemorrhage with tranexamic acid administered before hospitalization [9] represent a constant challenge to decrease mortality of this critical clinical setting but it could increase the risk of forthcoming VTE in major orthopedic surgery. This clinical setting, is, in fact historically associated to the best increase of thrombotic complication also for hip and knee prosthesis as reported by Ren et al [10].Yet, as a part of constant risk of prolonged management of anticoagulant treatments, the best anticoagulation during hospitalization and during the weeks following an acute VTE is still matter of clinical debates [11][12][13][14]. The authors declare no conflict of interest