TITLE

Rapid-Inflation Intermittent Pneumatic Compression for Prevention of Deep Venous Thrombosis

AUTHOR(S)
Eisele, R.; Kinzl, L.; Koelsch, T.
PUB. DATE
May 2007
SOURCE
Journal of Bone & Joint Surgery, American Volume;May2007, Vol. 89-A Issue 5, p1050
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Background: Current treatment regimens that are designed to prevent deep venous thrombosis in patients undergoing orthopaedic procedures rely predominantly on drug prophylaxis alone. The purpose of this randomized clinical study was to evaluate the effectiveness of a mechanical adjunct to chemoprophylaxis that involves intermittent compression of the legs. Methods: During a twenty-two month period, 1803 patients undergoing a variety of orthopaedic procedures were prospectively randomized to receive either chemoprophylaxis alone or a combination of chemoprophylaxis and mechanical prophylaxis. Nine hundred and two patients were managed with low-molecular-weight heparin alone, and 901 were managed with low-molecular-weight heparin and intermittent pneumatic compression of the calves for varying time periods. Twenty-four percent of the patients underwent total hip or knee joint replacement. Screening for deep venous thrombosis was performed on the day of discharge with duplex-color-coded ultrasound. Results: In the chemoprophylaxis-only group, fifteen patients (1.7%) were diagnosed with a deep venous thrombosis; three thromboses were symptomatic. In the chemoprophylaxis plus intermittent pneumatic compression group, four patients (0.4%) were diagnosed with deep venous thrombosis; one thrombosis was symptomatic. The difference between the groups with regard to the prevalence of deep venous thrombosis was significant (p = 0.007). In the chemoprophylaxis plus intermittent pneumatic compression group, no deep venous thromboses were found in patients who received more than six hours of intermittent pneumatic compression daily. Conclusions: Venous thrombosis prophylaxis with low-molecular-weight heparin augmented with a device that delivers rapid-inflation intermittent pneumatic compression to the calves was found to be significantly more effective for preventing deep venous thrombosis when compared with a treatment regimen that involved low-molecular-weight heparin alone.
ACCESSION #
25019651

 

Related Articles

  • Postoperative Versus Preoperative Initiation of Deep-Vein Thrombosis Prophylaxis with a Low-Molecular-Weight Heparin (Nadroparin) in Elective Hip Replacement. Palareti, Gualtiero; Borghi, Battista; Coccheri, Sergio; Leali, Nicoletta; Golfieri, Rita; Montebugnoli, M.; Inghilleri, Giovanni; Ronzio, Alessandro; Barbui, Tiziano; Pogliani, Enrico Maria; Di Nino, Gianfranco; Spotorno, Lorenzo // Clinical & Applied Thrombosis/Hemostasis;Winter1996, Vol. 2 Issue 1, p18 

    The aim of this multicenter, randomized, double-blind study performed in patients undergoing elective hip surgery was to compare the efficacy and safety of prophylaxis with low-molecular-weight heparin (LMWH) (Nadroparin, 7,500 anti-Xa IC units for the first 3 days and 10,000 from the fourth day...

  • The use of thromboprophylaxis in total hip replacement surgery: are the attitudes of orthopaedic surgeons changing? Owen, T. D.; Coorsh, J. // Journal of the Royal Society of Medicine;Nov1992, Vol. 85 Issue 11, p679 

    We conducted a survey of all 926 active members of the British Orthopaedic Association using a postal questionnaire to find out their current attitude to thromboprophylaxis in total hip replacement surgery. Previous surveys have been performed, and with all the recent literature on the subject...

  • Prevention of deep vein thrombosis after hip replacement: randomised comparison between unfractionated heparin and low molecular weight heparin. Leyvraz, P.F.; Bachmann, F.; Hoek, J.; Buller, H.R.; Postel, M.; Samama, M.; Vandenbroek, M.D. // BMJ: British Medical Journal (International Edition);9/7/91, Vol. 303 Issue 6802, p543 

    Examines the effectiveness of two subcutaneous prophylactic regimens for postoperative deep vein thrombosis in patients undergoing total hip replacement in Europe. Comparison between low molecular wight heparin and unfractioned heparin; Application of prophylactic measures in hip surgery; Use...

  • Prophylaxis, Diagnosis and Therapy of Surgery-Related Complications in Orthopedic and Trauma Surgery. Bauersachs, Rupert M.; Berger, Karin; Hankowitz, Johannes; Langenberg, Kristian; Marzi, Ingo; Neubauer, Günter; Pauschert, Rolf; Ulle, Tanja; Schramm, Wolfgang // European Journal of Trauma;Apr2005, Vol. 31 Issue 2, p158 

    Background and Purpose: Selective factor Xa inhibition by the synthetic pentasaccharide fondaparinux is an efficient way of preventing venous thrombosis. Fondaparinux has been shown to reduce the incidence of venous thromboembolism (VTE) by 50% compared with the low-molecular-weight heparin...

  • Changes of D-dimer after total hip arthroplasty in patients with and without intraoperative heparin. Maezawa, Katsuhiko; Nozawa, Masahiko; Aritomi, Kentaro; Kubota, Mitsuaki; Shitoto, Katsuo; Kurosawa, Hisashi // Archives of Orthopaedic & Trauma Surgery;Jan2008, Vol. 128 Issue 1, p37 

    Marked activation of thrombosis is common in patients undergoing total hip arthroplasty, especially during reaming of the femur and after insertion of the femoral prosthesis. This suggests that management designed to minimize deep vein thrombosis and fatal pulmonary embolism after total hip...

  • Deep vein thrombosis after total hip and knee arthroplasty in Indian patients. Jain, V.; Dhaon, B. K.; Jaiswal, A.; Nigam, V.; Singla, J. // Postgraduate Medical Journal;Dec2004, Vol. 80 Issue 950, p729 

    Background: Deep vein thrombosis (DVT) is one of the most common complications of total hip (THA) and total knee arthroplasty (TKA). Though the reported incidence of DVT is very high, that of proximal DVT is low and that of fatal thromboembolism is very low. Hence the issue of prophylaxis for...

  • Deep vein thrombosis after total hip arthroplasty in Korean patients and D-dimer as a screening tool. Myung-Chul Yoo; Yoon-Je Cho; Ghanem, Elie; Ramteke, Alankar; Kang-Il Kim // Archives of Orthopaedic & Trauma Surgery;Jul2009, Vol. 129 Issue 7, p887 

    This prospective study was designed to confirm risk factors and to assess the incidence of deep vein thrombosis after total hip and surface replacement arthroplasty in Korean patients not receiving anticoagulation prophylaxis and to determine efficacy of plasma D-dimer levels as a screening...

  • Nonadherence in Outpatient Thrombosis Prophylaxis with Low Molecular Weight Heparins after Major Orthopaedic Surgery. Wilke, Thomas; Moock, Jörn; Müller, Sabrina; Pfannkuche, Matthias; Kurth, Andreas // Clinical Orthopaedics & Related Research;Sep2010, Vol. 468 Issue 9, p2437 

    According to some current guidelines, extended thromboprophylaxis after hip and knee arthroplasties is recommended. Outpatient prophylaxis with low molecular weight heparins (LMWH) is an important part of this prophylaxis, although the rates of adherence to these regimens is not known. We...

  • CME quiz.  // Orthopedics;Nov2003, Vol. 26 Issue 11, p1162 

    Presents a quiz concerning the dosing and timing of low-molecular-heparin thromboprophylaxis in total hip arthroplasty.

Share

Read the Article

Courtesy of VIRGINIA BEACH PUBLIC LIBRARY AND SYSTEM

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics