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11.2.2. Adjunctive Therapies to Minimize Tissue Loss in ALI
COR LOE
Recommendations
1 C-EO
1. Patients with ALI should be monitored and treated
for compartment syndrome with fasciotomy after
revascularization (endovascular or surgical, including
catheter-directed thrombolysis) to prevent the sequelae of
reperfusion injury and need for amputation.
2a B-NR
2. In patients with ALI with a threatened but salvageable limb
(ie, category IIa or IIb), prophylactic fasciotomy is reasonable
based on the clinical findings.
2a C-EO
3. In patients with ALI and prolonged ischemia in whom
revascularization (endovascular or surgical, including
catheter-directed thrombolysis) is performed, concurrent and
early amputation can be beneficial to avoid the morbidity of
reperfusion.
11.3. Diagnostic Evaluation for the Cause of ALI
COR LOE
Recommendations
1 C-EO
1. In patients with ALI, a comprehensive medical history and
physical examination should be performed to determine the
cause of thrombosis or embolization.
2a C-LD
2. In patients with ALI, testing for a cardiovascular cause of
thromboembolism can be useful.
11.2.3. Anticoagulation for ALI
COR LOE
Recommendation
1 C-EO
1. In patients with ALI, regardless of cause or anatomic level of
occlusion, systemic anticoagulation with unfractionated heparin
should be administered on diagnosis unless contraindicated.
