Effectiveness of Intermittent Pneumatic Leg Compression for Preventing Deep Vein Thrombosis After Total Hip Replacement

Hull, Russell D.; Raskob, Gary E.; Gent, Michael; McLoughlin, D.; Julian, Denise H.; Smith, Frank C.; Dale, N I; Reed-Davis, R; Lofthouse, Robert A.; Anderson, Christine

doi:10.1001/jama.1990.03440170035032

Cited by 193 publications

(58 citation statements)

References 46 publications

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“…Historically the rate of DVT or PE after major orthopedic surgery was estimated to be 40% to 84% in patients undergoing total knee arthroplasty (TKA) [13,14] and in 45% to 57% of those undergoing total hip arthroplasty (THA) in the absence of thromboprophylaxis. Proximal DVT in the absence of thromboprophylaxis has been reported to occur in 9% to 20% of TKA patients and in 23% to 36% of THA patients [12,15,16] . Currently with modern techniques and post-operative care, the estimated risk of developing a symptomatic VTE without prophylaxis is approximately 4.3% [1] .…”

Section: Discussionmentioning

confidence: 99%

“…Surprisingly we have read the recommendations of ACCP also on the use of aspirin in the thromboembolism prophylaxis after THA and TKA. It worth noting, however, that it was intended that the use of aspirin is to be considered better than nothing so that it is not certainly the drug of choice in that orthopedic setting [1] ; (2) the difficulty in the peri-operative management of AVK; and (3) the similar efficacy of the new oral anticoagulants (NOAC) in comparison to LMWH, their longer half-life and the lack of post-marketing studSoohoo et al [11] Hull et al [12] A abilities and restore functions, decrease pain and joint inflammation and increase ROM and strength. The early mobilization is the primary objective for the physician in order to assess the duration of prophylaxis Anti-thrombotic prophylaxis should be last at least 5 wk as recommended by the ACCP but in RA patients a longer period of anti-thrombotic prophylaxis should be considered depending on recovery of mobility.…”

Section: Is There a Most Effective Methods Of Vte Prophylaxis After Mamentioning

confidence: 99%

“…After a detailed full-paper review, another 52 were excluded. A total of 8 articles [5][6][7][8][9][10][11][12] satisfied most of the inclusion criteria for data extraction after full review ( Figure 1): Seven observational cohort studies, and 1 randomized clinical trial. Of the 8 studies, 7 were retrospective, 1 was prospective.…”

Section: Study Identification and Selectionmentioning

confidence: 99%

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Thromboembolic disease in patients with rheumatoid arthritis undergoing joint arthroplasty: Update on prophylaxes

Mameli¹

2014

WJO

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The risk of venous thromboembolism (VTE) in rheumatoid arthritis (RA) and the higher incidence of RA patients undergoing major orthopedic surgery is well recognized. The objective of the present study is to describe the incidence of VTE and discuss the correct prophylaxis in RA patients undergoing knee or hip replacement. A systematic review of studies on thromboprophylaxis in RA patients undergoing major orthopedic surgery was performed. Detailed information was extracted to calculate the rate of VTE in RA orthopedic patients and analyze the thromboprophylaxis performed and bleeding complications. Eight articles were eligible for full review. No difference in the overall rate of VTE was observed between RA patients and controls. No significant differences were found in RA patients in terms of bleeding complications. The data on the optimal prophylaxis to be used in RA patients were insufficient to recommend any of the several options available. In the absence of dedicated guidelines for the care of RA patients undergoing orthopedic surgery, management must be individualized to obtain favorable patient outcome, weighing up all the factors that might put the patient at risk for higher bleeding and thrombotic events.

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Section: Discussionmentioning

confidence: 99%

Section: Is There a Most Effective Methods Of Vte Prophylaxis After Mamentioning

confidence: 99%

Section: Study Identification and Selectionmentioning

confidence: 99%

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Thromboembolic disease in patients with rheumatoid arthritis undergoing joint arthroplasty: Update on prophylaxes

Mameli¹

2014

WJO

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“…Device misuse of CCD 2∞ resulting in propagation of DVT is a well described phenomenonen [12][13][14][15] and may account for this single case of PE rather than factors related to short course LMWH therapy. Additionally, current literature quotes an average incidence of 5% for symptomatic DVT, 0.5-1% for fatal PE, 1-3% for non fatal PE and upto 38% for asymptomatic DVT amongst post operative orthopedic patients whom are receiving anticoagulation in accordance with current…”

Section: Discussionmentioning

confidence: 99%

Combined Short Course Low Molecular Weight Heparin and Calf Compression Therapy in Prevention of Deep Vein Thrombosis after Total Knee Replacement: A Randomized Prospective Study

Ramakrishna¹,

Gupta²,

Sarathy³

et al. 2013

J Hematol Thromb Dis

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Background and aims: Anti-coagulation is an important component of post-operative Venous-Thombo-Embolic (VTE) prophylaxis but can be associated with significant complications including hemorrhage. Current guidelines favour anti-coagulation for ≥ 14 days with little evidence evaluating the efficacy of anticoagulation <14 days. Our study hypothesizes that short course Low-Molecular-Weight-Heparin (LMWH for 5-7 days) in combination with Calf Compression Device (CCD) is equally effective as standard therapy LMWH (14 days) in preventing VTE and related events amongst patients undergoing Total-Knee-Replacement (TKR).

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“…[1][2][3][4] In particular, in cases with an additional risk of bleeding, IPC devices are accepted as an effective alternative because thrombolytic or anticoagulant agents could be dangerous. 5,6 Intermittent pneumatic compression using an electromechanical device was introduced in the early 1970s, and several clinical trials have reported its clinical effects since.…”

Section: Introductionmentioning

confidence: 99%

Investigation of Blood Flow During Intermittent Pneumatic Compression and Proposal of a New Compression Protocol

Lee

Seo

Kim

et al. 2016

Clin Appl Thromb Hemost

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Introduction: Intermittent pneumatic compression (IPC) is now a widely used therapy for the prophylaxis of deep vein thrombosis and pulmonary embolism. In general, the IPC sequence is composed of sequential compression and simultaneous deflation. Typically, veins are considered to be squeezed and emptied during the compression phase and to be refilled during the deflation phase. However, because the stop or sudden increase in blood flow can be dangerous, a further investigation is needed with respect to the blood flow. Materials and Methods: We demonstrated a new compression protocol based on the investigation results of venous blood flow during IPC. This new compression protocol involves successive compression without the deflation phase; thus, the expelled blood volume flow during a given period can be maximized. To investigate the blood flow during IPC, sonography movie clips and in-laboratory developed blood flow analysis software was used. Results: The increases in the peak volume flow during IPC were 49% (+24%) and 25% (+29%) with the conventional protocol and the new protocol, respectively, whereas the total volume flow (TVF) was not significantly changed (À1.0% and À13.0%, respectively). With the new protocol, the peak velocity (PV) was 49% lower than that with the conventional protocol. Thus, the new protocol has an effect of maintaining TVF without resulting in a sudden large increase or decrease in PV. Conclusion: The new suggested protocol might improve safety because it can maintain the stability of blood flow by reducing the risk of blood stasis and a rapid change in blood flow.

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Effectiveness of Intermittent Pneumatic Leg Compression for Preventing Deep Vein Thrombosis After Total Hip Replacement

Cited by 193 publications

References 46 publications

Thromboembolic disease in patients with rheumatoid arthritis undergoing joint arthroplasty: Update on prophylaxes

Thromboembolic disease in patients with rheumatoid arthritis undergoing joint arthroplasty: Update on prophylaxes

Combined Short Course Low Molecular Weight Heparin and Calf Compression Therapy in Prevention of Deep Vein Thrombosis after Total Knee Replacement: A Randomized Prospective Study

Investigation of Blood Flow During Intermittent Pneumatic Compression and Proposal of a New Compression Protocol

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