Different types of intermittent pneumatic compression devices for preventing venous thromboembolism in patients after total hip replacement

Zhao, Jinmin; He, Mao Lin; Xiao, Zeng; Li, Ting Song; Wu, Hao; Jiang, Hua

doi:10.1002/14651858.cd009543.pub3

Cited by 29 publications

(26 citation statements)

References 29 publications

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“…Reviews on the use of systemic medications during ATI have been published. 65 , 69 No single systemic agent has yet been definitively identified as the best to aid ATI, although dexmedetomidine has been established as an effective sedative for the purpose. 66 , 69 Airway managers’ preferences and familiarity with the various drugs are important factors to help guide their choice of agent.…”

Section: Implementation Of the Planned Strategy When Difficult Tracheal Intubation Is Predictedmentioning

confidence: 99%

Canadian Airway Focus Group updated consensus-based recommendations for management of the difficult airway: part 2. Planning and implementing safe management of the patient with an anticipated difficult airway

Law

Duggan

Asselin

et al. 2021

Can J Anesth/J Can Anesth

101

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Purpose Since the last Canadian Airway Focus Group (CAFG) guidelines were published in 2013, the published airway management literature has expanded substantially. The CAFG therefore re-convened to examine this literature and update practice recommendations. This second of two articles addresses airway evaluation, decision-making, and safe implementation of an airway management strategy when difficulty is anticipated. Source Canadian Airway Focus Group members, including anesthesia, emergency medicine, and critical care physicians were assigned topics to search. Searches were run in the Medline, EMBASE, Cochrane Central Register of Controlled Trials, and CINAHL databases. Results were presented to the group and discussed during video conferences every two weeks from April 2018 to July 2020. These CAFG recommendations are based on the best available published evidence. Where high-quality evidence is lacking, statements are based on group consensus. Findings and key recommendations Prior to airway management, a documented strategy should be formulated for every patient, based on airway evaluation. Bedside examination should seek predictors of difficulty with face-mask ventilation (FMV), tracheal intubation using video- or direct laryngoscopy (VL or DL), supraglottic airway use, as well as emergency front of neck airway access. Patient physiology and contextual issues should also be assessed. Predicted difficulty should prompt careful decision-making on how most safely to proceed with airway management. Awake tracheal intubation may provide an extra margin of safety when impossible VL or DL is predicted, when difficulty is predicted with more than one mode of airway management (e.g., tracheal intubation and FMV), or when predicted difficulty coincides with significant physiologic or contextual issues. If managing the patient after the induction of general anesthesia despite predicted difficulty, team briefing should include triggers for moving from one technique to the next, expert assistance should be sourced, and required equipment should be present. Unanticipated difficulty with airway management can always occur, so the airway manager should have a strategy for difficulty occurring in every patient, and the institution must make difficult airway equipment readily available. Tracheal extubation of the at-risk patient must also be carefully planned, including assessment of the patient’s tolerance for withdrawal of airway support and whether re-intubation might be difficult.

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Section: Implementation Of the Planned Strategy When Difficult Tracheal Intubation Is Predictedmentioning

confidence: 99%

Canadian Airway Focus Group updated consensus-based recommendations for management of the difficult airway: part 2. Planning and implementing safe management of the patient with an anticipated difficult airway

Law

Duggan

Asselin

et al. 2021

Can J Anesth/J Can Anesth

101

View full text Add to dashboard Cite

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“…Another limitation is that we could not reflect the potential heterogeneity of treatments, both within a trial and across trials. There are two general types of sequential compression devices: the simultaneous sequential compression device and the alternate sequential compression device (Zhao et al, 2012). In pharmacologic prophylaxis, there are many more types of options, with different effects.…”

Section: Strengths and Limitationsmentioning

confidence: 99%

Adjunctive Intermittent Pneumatic Compression in Hospitalized Patients Receiving Pharmacologic Prophylaxis for Venous Thromboprophylaxis: A Systematic Review and Meta‐Analysis

Fan

Fang

et al. 2020

J of Nursing Scholarship

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Objectives This study assessed the effect of adjunctive intermittent pneumatic compression (IPC) on venous thromboembolism incidence in hospitalized patients receiving pharmacologic thromboprophylaxis. Methods We searched Medline, Embase, and the Cochrane Central Register with no language restrictions from inception until May 15, 2019, for randomized clinical trials comparing adjunctive IPC in pharmacologic thromboprophylaxis and pharmacologic thromboprophylaxis for venous thromboembolism. Two researchers extracted data from published reports independently. A meta‐analysis was conducted to calculate the risk ratio (RR) using random‐effects models. Primary outcomes were deep venous thrombosis (DVT) and pulmonary embolism (PE). Results Eight trials with a total of 7,354 participants were eligible for analysis. Addition of IPC to pharmacologic prophylaxis compared to pharmacologic prophylaxis alone reduced the risk of DVT by 43% (RR 0.57, 95% confidence interval [CI] 0.35–0.93; I2 = 0%), with benefit only seen in surgical patients (RR 0.30, 95% CI 0.15–0.59; I2 = 0%) and not in medical patients (RR 0.80, 95% CI 0.60–1.07; I2 = 0%; p for interaction = .008). Addition of IPC reduced the risk for PE by 54% (RR 0.46, 95% CI 0.30–0.72; I2 = 0%), with benefit only seen in surgical patients (RR 0.40, 95% CI 0.24–0.65; I2 = 0%) and not in medical patients (RR 0.82, 95% CI 0.32–2.26; I2 = 0%; p for interaction = .18) Conclusions Addition of IPC to pharmacologic prophylaxis confers moderate benefit on venous thromboembolism, with benefit confined to surgical patients. For medical patients, there was a trend toward reduced DVT with adjunctive IPC, which warrants further investigation. Clinical Relevance Venous thromboembolism is not unusual among hospitalized patients despite pharmacologic thromboprophylaxis. Nursing personnel should use adjunctive IPC in surgical patients receiving pharmacologic thromboprophylaxis to prevent venous thromboembolism.

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“…Although IPC has a reasonably strong evidence base in reducing DVT and PE in a variety of hospitalised patients−either alone or in combination with anticoagulant prophylaxis−especially for patients at high risk of VTE, 15,16,37,38 there is no high-level RCT evidence to suggest that a sequential compressions IPC device is more efficacious than a single-compartment device in reducing DVT/PE. 39 Because StO 2 in the lower limbs had previously been demonstrated to correlate positively with regional blood flow measured by an ultrasound Doppler, 34 our results provide some rationale to support testing the hypothesis that a sequential compressions mode IPC is better than a single-compartment mode IPC in improving venous leg ulcers healing in patients with chronic leg ulcers 40 and reducing lower limb DVT.…”

Section: Discussionmentioning

confidence: 56%

A comparison of different modes of pneumatic compression on muscle tissue oxygenation: An intraparticipant, randomised, controlled volunteer study

Nandwana

2019

Anaesth Intensive Care

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Intermittent pneumatic compression (IPC) to the lower limbs is widely used as a mechanical means to prevent deep vein thrombosis in hospitalised patients. Due to a theoretical concern about impairing blood flow, thromboembolicdeterrent stockings and IPC are considered contraindicated for patients with peripheral vascular diseases by some clinicians. This study assessed whether IPC would alter peripheral limb muscle tissue oxygenation (StO 2 ), and whether such changes were different during 10 minutes of sequential and single-compartment compressions. Twenty volunteers were randomised to have their left or right arm treated with a sequential or single-compartment IPC for 10 minutes, using the contralateral arm without compression as an intraparticipant control. After a five-minute wash-out period, the procedure was repeated on the same arm using the alternative mode of IPC. Both hands' thenar muscles StO 2 was monitored every two minutes for 10 minutes using the same near-infrared spectroscopy StO 2 monitor. Both sequential (3.5%, 95% confidence intervals (CI) 2.7-4.2; p < 0.001) and single-compartment IPC (1.6%, 95% CI 0.4-2.8; p ¼ 0.039) significantly increased muscle StO 2 within 10 minutes compared to no compression; and the increments were higher during sequential compressions compared to during single-compartment compressions (2.1%, 95% CI 0.7-3.5; p ¼ 0.023). This mechanistic study showed that both modes of IPC increased upper limb muscle StO 2 compared to no compression, but the StO 2 increments were higher with the multiple-chamber sequential compressions mode. Contrary to the theoretical concern that IPC may impair peripheral limb tissue oxygenation, our results showed that IPC actually increases oxygenation of the peripheral limb muscles, especially during the sequential compressions mode.

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Different types of intermittent pneumatic compression devices for preventing venous thromboembolism in patients after total hip replacement

Abstract: types of intermittent pneumatic compression devices for preventing venous thromboembolism in patients a er total hip replacement.

Cited by 29 publications

References 29 publications

Canadian Airway Focus Group updated consensus-based recommendations for management of the difficult airway: part 2. Planning and implementing safe management of the patient with an anticipated difficult airway

Canadian Airway Focus Group updated consensus-based recommendations for management of the difficult airway: part 2. Planning and implementing safe management of the patient with an anticipated difficult airway

Adjunctive Intermittent Pneumatic Compression in Hospitalized Patients Receiving Pharmacologic Prophylaxis for Venous Thromboprophylaxis: A Systematic Review and Meta‐Analysis

A comparison of different modes of pneumatic compression on muscle tissue oxygenation: An intraparticipant, randomised, controlled volunteer study

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