Intermittent Pneumatic Compression in Addition to Standard Prophylaxis of Postoperative Venous Thromboembolism in Extremely High-risk Patients (IPC SUPER): A Randomized Controlled Trial

Lobastov, Kirill; Sautina, Ekaterina; Alencheva, Eleanora; Bargandzhiya, Astanda; Schastlivtsev, Ilya; Barinov, Victor; Laberko, Leonid; Родоман, Г. В.; Boyarintsev, V. V.

doi:10.1097/sla.0000000000004556

Cited by 28 publications

(35 citation statements)

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“…Participants received RBI treatment after surgical operation 24 h. The intermittent pneumatic compression (IPC) device (Zosing, Henan, China) was used to make RBI. The IPC device was described in previous studies [7][8][9] (Fig. 1).…”

Section: Interventionsmentioning

confidence: 99%

Repetitive brief ischemia accelerates tibial shaft fracture healing: a 5-years prospective preliminary clinical trial (PCT)

Wang

Liu

et al. 2021

BMC Musculoskelet Disord

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Background This study was to evaluate the effects of repetitive brief ischemia (RBI) on bone healing in patients with tibial shaft fractures. Methods In this prospective clinical trial, patients with tibia shaft fractures were enrolled between January 2016 and January 2021. The intermittent pneumatic compression (IPC) device was used to make RBI on the affected limb after surgical operation 24 h. The inflation pressure was the systolic pressure of patients + 50 mmHg. Patients were received 30 s inflation/30 s deflation 30 times twice a day for 4 weeks. The primary outcome was bone healing time and the secondary outcomes were the rates of delayed union and nonunion, the rates of venous thrombosis of lower limbs, Johner-Wruhs scores, Lysholm knee score, VAS scores, postoperative complications, serum BMP-2, osteocalcin (OC) and bone specific alkaline phosphatase (BS-ALP). Results A total of 32 patients were enrolled finally and all were completed with a 12 months follow-up. All the fractures were healed and the bone healing time was 3(1) months in RBI group. However, the bone healing time of control group was 4(1) and there was statistical difference between the two groups (p < 0.01). No patient with fracture delayed union, nonunion and venous thrombosis of lower limbs in RBI group. 2 patients were delayed union in the control group. In RBI group, the Lysholm knee score was 83(6) at 6 months and 100(8) at 12 months. In the control group, the score was 78(4) and 90.5(17), there was statistical difference between the two groups (p < 0.01, p = 0.014, respectively). VAS scores were postoperative 2 weeks 6(1) in RBI group and 7(0.5) in the control group, there was statistical difference between the two groups (p = 0.016). There were 2 patients with intramuscular venous thrombosis of lower extremity in control group. Besides, RBI treatment increased the serum BMP-2, OC and BS-ALP at postoperative 2 weeks and 1 month. Conclusions RBI is a new method to accelerate bone healing in tibia shaft fracture patients and is a simple and noninvasive method. Trial registration Chinese clinical trial registry, ChiCTR-INR-17014208. Registered 28 December 2017—Retrospectively registered.

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Section: Interventionsmentioning

confidence: 99%

Repetitive brief ischemia accelerates tibial shaft fracture healing: a 5-years prospective preliminary clinical trial (PCT)

Wang

Liu

et al. 2021

BMC Musculoskelet Disord

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“…8 The more recent publication of the IPC SUPER study classified patients who scored >/¼ 11 points on the Caprini tool 'extremely high risk' patients. 9 This is following some work from the same group (Lobastov et al) from 2016 which demonstrated that there is a strong correlation between Caprini score and the incidence of post-operative DVT. 10 They found DVT risk was increased 18.7-fold for patients with Caprini scores of 9 to 11 and 98.4-fold for scores of 12 to 15 compared with patients with scores of 5 to 8.…”

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confidence: 72%

Thromboprophylaxis; what is the future, for high risk surgical patients?

et al. 2021

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“…The trials spanned data collected from 1994 to 2019 with 48 to 2,551 participants ( eTable 1 , http://links.lww.com/CCX/B66 ). Trials were conducted in North America ( 20 , 29 – 31 , 33 , 34 , 37 ), Europe ( 22 , 35 , 36 , 38 , 39 ), and Asia ( 19 – 21 , 32 , 40 , 41 ). Two trials were conducted in multiple countries ( 20 , 34 ).…”

Section: Resultsmentioning

confidence: 99%

“…We did not confirm the reduced risk of PE observed in these two reviews. The inclusion in our review of recently published RCTs (19)(20)(21)(22)41), of studies using anticoagulants other than heparin and the exclusion of observational studies could explain these discrepancies.…”

Section: Discussionmentioning

confidence: 99%

Effect of Intermittent Pneumatic Compression in Addition to Pharmacologic Prophylaxis for Thromboprophylaxis in Hospitalized Adult Patients: A Systematic Review and Meta-Analysis

Duval

Sirois

Savoie-White

et al. 2022

Critical Care Explorations

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OBJECTIVES: Venous thromboembolic events (VTE) are frequent complications in hospitalized patients and a leading cause of preventable death in hospital. Pharmacologic prophylaxis is a standard of care to prevent VTE in patients at risk, the additional value of intermittent pneumatic compression (IPC) is uncertain. We aimed to evaluate the efficacy of adding IPC to pharmacologic prophylaxis to prevent VTE in hospitalized adults. DATA SOURCES:We searched the Cochrane Central Register of Controlled Trials, Embase, MEDLINE, Cumulative Index to Nursing and Allied Health Literature, ClinicalTrials.gov, and the International Clinical Trials Registry Platform from inception to July 2022. STUDY SELECTION:We included randomized controlled trials comparing the use of IPC in addition to pharmacological thromboprophylaxis to pharmacological thromboprophylaxis alone in hospitalized adults.DATA EXTRACTION: Meta-analyses were performed to calculate risk ratio (RR) of VTE, deep venous thrombosis (DVT), and pulmonary embolism (PE). We assessed the risk of bias using the Cochrane Risk of Bias Tool for Randomized Trials, Version 2 and the quality of evidence using the Grading of Recommendations Assessment, Development and Evaluation approach. DATA SYNTHESIS:We included 17 trials enrolling 8,796 participants. The IPC was mostly applied up to the thigh and pharmacological thromboprophylaxis was primarily low-molecular-weight heparin. Adjunctive IPC was associated with a decreased risk of VTE (15 trials, RR = 0.53; 95% CI [0.35-0.81]) and DVT (14 trials, RR = 0.52; 95% CI [0.33-0.81]) but not PE (seven trials, RR = 0.73; 95% ). The quality of evidence was graded low, downgraded by risk of bias and inconsistency. Moderate and very low-quality evidence, respectively, suggests that adjunctive IPC is unlikely to change the risk of all-cause mortality or adverse events. Subgroup analyses indicate a more evident apparent benefit in industry-funded trials. CONCLUSIONS:Results indicate low-quality evidence underpinning the additional use of IPC to pharmacological thromboprophylaxis for prevention of VTE and DVT. Further large high-quality randomized trials are warranted to support its use and to identify patient subgroups for whom it could be beneficial. KEY WORDS: intermittent pneumatic compression devices; pulmonary embolism; Venous thromboembolic events; venous thrombosis V nous thromboembolic events (VTE), including deep venous thrombosis (DVT) and pulmonary embolism (PE), are the second most frequent medical complication of hospitalization, the leading cause of preventable

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Intermittent Pneumatic Compression in Addition to Standard Prophylaxis of Postoperative Venous Thromboembolism in Extremely High-risk Patients (IPC SUPER): A Randomized Controlled Trial

Abstract: Supplemental Digital Content is available in the text

Cited by 28 publications

References 30 publications

Repetitive brief ischemia accelerates tibial shaft fracture healing: a 5-years prospective preliminary clinical trial (PCT)

Repetitive brief ischemia accelerates tibial shaft fracture healing: a 5-years prospective preliminary clinical trial (PCT)

Thromboprophylaxis; what is the future, for high risk surgical patients?

Effect of Intermittent Pneumatic Compression in Addition to Pharmacologic Prophylaxis for Thromboprophylaxis in Hospitalized Adult Patients: A Systematic Review and Meta-Analysis

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