Use Of Intermittent Pneumatic Compression Research Articles

Переміжна пневматична компресія у реабілітаційній та спортивній медицині

The purpose of the study was to characterize the clinical value of intermittent pneumatic compression in sports medicine according to the scientific literature. Materials and methods. The English-language publications refereed by the PubMed electronic database, by the keyword “intermittent pneumatic compression”, concerning sports achievements, physiology of athletes, sports rehabilitation and also the treatment of injuries were analyzed. Results and discussion. Hardware for intermittent pneumatic compression develops rapidly in sports rehabilitation, while a significant number of practitioners use intermittent pneumatic compression in combination with other means, which makes it difficult to assess its effectiveness. Traumatic risk is a reality of the professional activity of athletes. In several reviews of the literature, it was shown that the use of intermittent pneumatic compression after injuries can reduce thrombus formation, swelling and duration of preoperative preparation for fractures, reduce swelling and improve joint mobility after fractures, improve wound and fracture healing. During the rehabilitation period, intermittent pneumatic compression allows to reduce limb dysfunction after sprain, increase joint mobility, and enhance the effectiveness of occupational therapy measures. Conclusion. Skeletal muscles are undoubtedly the target organ of intermittent pneumatic compression, but the optimal parameters of exposure need to be clarified. During exercise, intermittent pneumatic compression improves vascular conductivity, and during the recovery period it reduces muscle proteolysis, increases blood flow and tissue oxygenation. Intermittent pneumatic compression does not appear to affect muscle strength and performance recovery. Intermittent pneumatic compression may help reduce delayed muscle pain syndrome, but the optimal conditions for such an effect need to be investigated. In trauma, in particular sprains and fractures, the use of intermittent pneumatic compression can reduce pain and the need for narcotic analgesics, especially in the early stages. The use of intermittent pneumatic compression can reduce swelling and shorten the duration of preoperative preparation for fractures, subsequently improving joint mobility, wound and fracture healing. After surgery or removal of immobilizers, intermittent pneumatic compression reduces swelling, improves limb function, and reduces hospital stay. When using intermittent pneumatic compression in work with athletes, the practitioner must also take into account its reparative, adaptive and other general effects. Intermittent pneumatic compression is a promising sports medicine tool, but the existing data are completely insufficient to make firm recommendations

Pulmonary embolism with bilateral pulmonary infarction after surgical correction of Achilles tendon - a rare complication.

Pulmonary embolism (PE) is a potentially fatal disorder that occurs as a result of a thrombus formed in the deep venous system that detaches and obstructs the pulmonary artery or one of its branches. Herein we report a rare, bilateral PE after surgical correction of the Achilles tendon. To report a bilateral PE after calcaneus tendon repair, and to review the literature on this rare condition. A search of the literature was carried out in electronic databases and a review of medical records. PTE, although rare, is a serious and potentially fatal complication, requiring adequate and early treatment. Pharmacological prophylaxis in these situations is still controversial in the medical literature; however, there is consensus for the use of intermittent pneumatic compression in the postoperative period.

Multidisciplinary Bundle Approach in Venous Thromboembolism Prophylaxis in Patients with Non-Traumatic Subarachnoid Hemorrhage

BackgroundA venous thromboembolism (VTE) bundle was launched in 2016 at the University of Illinois Hospital aiming to reduce the rate of VTE in the neurosurgical ICU. Main elements of the bundle included correct and early use of intermittent pneumatic compression and subcutaneous heparin.MethodsPatients with SAH were retrospectively identified from 2014 until 2018. VTE events were diagnosed using twice weekly lower-extremity venous Duplex ultrasound and chest computerized tomography when appropriate.ResultsA total of 133 patients was included in each group. The incidence of VTE was not significantly different before and after the bundle (15% vs. 12%, p = 0.47). No difference was found regarding new episode of intracranial hemorrhage secondary to SQH (1.5% vs. 2.1%, p = 0.65). Multivariate analysis demonstrated that longer ICU LOS, higher Caprini score, and presence of baseline lung diseases were associated with VTE development.ConclusionsWith a median Caprini score of 9, our patient population was found to be at high risk for developing VTE. The implementation of the VTE bundle did not significantly reduce the rate of VTE in patients with non-traumatic SAH at UIH.

Intermittent Pneumatic Compression and Cold Water Immersion Effects on Physiological and Perceptual Recovery during Multi-Sports International Championship.

Background: Congested-fixture championships are common during the selection of the athletes and teams participating in the Olympic Games. Throughout these tournaments, it is fundamental to perform optimally, rest well, and recover between competitions. This study aimed to (a) explore the effectiveness of the use of intermittent pneumatic compression (IPC) and cold water immersion (CWI) to recover muscle mechanical function (MuscleMechFx), hydration status (HydS), pain perception (PainPercep), rate of perceived exertion (RPE), sleep hours, and sleep quality (SleepQual) during a regional multi-sports international championship and (b) compare these results by sex. Methods: A total of 52 basketball and handball players were exposed to a recovery protocol after the competition as follows: IPC, sequential 20 min at 200 mmHg, and CWI, continuous 12 min at 12 °C. Results: MuscleMechFx presented differences by match and sex (p = 0.058) in time of contraction of biceps femoris; SleepQual and sleep hours were different between matches (<0.01). Conclusions: IPC + CWI seems to be effective to maintain some MuscleMechFx, HydS, and recovery and pain perception during a congested multi-sport tournament.

The use of intermittent pneumatic compression of the thigh to affect arterial and venous blood flow proximal to a chronic wound site.

Intermittent pneumatic compression of the lower limbs has been shown to have beneficial effects in patients with chronic ulceration. However, the intermittent compression cuff will normally be applied over the wound, which may produce discomfort or interfere with other treatments. Thigh‐only approaches to intermittent pneumatic compression could solve this problem. This study aimed to demonstrate if such a system would have positive effects on venous and arterial blood flow distal to the compression site, but proximal to wound sites. The distal venous and arterial effects of a prototype thigh‐only 3‐chamber sequential intermittent pneumatic compression system were tested in 20 healthy volunteers, and 13 patients with ulcers of various aetiologies using Doppler ultrasound. The system produced hyperaemic responses in the arterial flow of both test groups. The peak venous velocity on deflation of the first and second chambers of the cuff was also greater in the patients with ulceration than in the healthy volunteers (11.6 cm/s vs 8.3 cm/s, P = .1). This work demonstrates that compression of the thigh alone can produce positive haemodynamic effects in the calves of patients with chronic wounds, and that this approach should be investigated as a therapy to improve blood flow to wound sites.

The use of intermittent pneumatic compression to prevent venous thromboembolism in neurosurgical patients—A systematic review and meta-analysis

ObjectiveThe incidence of venous thromboembolism (VTE) remains high despite the use of low-molecular weight heparin (LMWH) and compression stocking (CS). We aimed to evaluate the use of IPC as VTE prophylaxis in neurosurgical patients. Patients and methodsWe conducted meta-analysis to assess the use of IPC as VTE prophylaxis in neurosurgical patients from several databases. ResultsThere was a total of 7.515 subjects from 5 studies. Reduction in VTE incidence was demonstrated by the IPC group (OR 0.40 [0.31, 0.52], p < 0.001; I2: 44 %). IPC was shown to reduce the incidence of deep venous thrombosis (DVT) (OR 0.43 [0.32, 0.57], p < 0.001; I2: 0 %) compared to the control group. Incidence of pulmonary embolism (PE) was lower (OR 0.42 [0.25, 0.70], p < 0.001; I2: 80 %) in IPC. Upon sensitivity analysis, PE was significantly lower in IPC (OR 0.24 [0.13, 0.45], p < 0.001; I2: 0 %). Subgroup analysis on patients undergoing neurosurgical intervention (operation) and receiving LMWH + CS shows a markedly reduced incidence of VTE (OR 0.37 [0.28, 0.50], p < 0.001; I2: 3 %), DVT (OR 0.39 [0.28, 0.54], p < 0.001; I2: 0 %), and PE (OR 0.22 [0.11, 0.43], p < 0.001; I2: 0 %) in IPC. ConclusionIntermittent pneumatic compression was associated with less VTE in neurosurgical patients, especially in those who received neurosurgical interventions, however, the certainty of evidence remained inadequate for creating a strong recommendation and further randomized controlled trials are needed before drawing a definite conclusion.

Thromboprophylaxis After Hospitalization for Joint Replacement Surgery.

ABSTRACTVenous thromboembolism (VTE) is a leading cause of mortality during the perioperative period, with individuals who have undergone hip and knee arthroplasty at the highest risk for VTE. The American College of Chest Physicians recommends 35 days of postoperative thromboprophylaxis and the use of intermittent pneumatic compression (IPC) therapy for mechanical compression after major orthopedic surgery. However, little research has described adherence to these recommendations during recovery at home. The purpose of this cross-sectional descriptive study was to describe thromboprophylaxis prescription, use, and education among patients discharged home after major orthopedic surgery. We surveyed patients within 2 years of major orthopedic surgery. A total of 388 subjects completed the survey. More than three-quarters of respondents reported a thromboprophylaxis duration <35 days. Most (93.8%) respondents were prescribed a pharmacologic agent, while 55.9% were prescribed mechanical compression therapy. Of the respondents who were prescribed mechanical compression therapy, 13.4% were prescribed IPC. Adherence to mechanical compression therapy was moderate, with 63% of respondents wearing mechanical compression therapy ≥75% of the time. The results of this study suggest a need for increased duration of thromboprophylaxis and increased use of IPC in the outpatient setting. Additional research describing prescribers' perceptions of thromboprophylaxis is also needed.

Adjunctive Intermittent Pneumatic Compression for Venous Thromboprophylaxis

In critically ill patients who were already receiving pharmacologic thromboprophylaxis, the use of intermittent pneumatic compression (IPC) did not significantly lower the incidence of deep venous thrombosis (DVT).

A pilot study of venous flow augmentation using a novel mechanical graded intermittent sequential compression device for venous insufficiency

BackgroundGuidelines as well as multiple RTCs support the use of intermittent pneumatic compression (IPC) for the treatment of venous leg ulcers when conservative measures fail. Unfortunately, the clinical usefulness of IPC is significantly limited by the physical limitations of pneumatic motors, which leads to bulky devices with slow inflation cycles, uncomfortable sleeves, lack of patient mobility, and ultimately poor patient compliance with therapy. A novel mechanical device for lower leg graded intermittent sequential compression was designed to address these limitations of IPC therapy for venous leg ulcer treatment by providing rapid compression cycles in a truly wearable device that offers the additional benefit of monitoring compression dose and patient compliance. The wearable intermittent compression (WIC) device was hypothesized to provide improved augmentation of venous flow compared with both baseline and standard IPC therapy. MethodsTen patients with Clinical, Etiologic, Anatomic and Pathophysiologic class 3 to 6 venous insufficiency were recruited under institutional review board approval. The primary end point for the study was augmentation of venous blood flow as measured by peak venous velocity. Patients underwent measurement of peak venous velocity in centimeters per second at the popliteal and femoral veins for the following conditions: (1) baseline, (2) WIC device on a low setting, and (3) WIC device on a high setting. In five patients, an additional measurement of peak venous velocity in centimeters per second at the popliteal and femoral veins was completed while wearing a commercially available IPC device. ResultsBoth low and high settings of the WIC device resulted in higher average peak venous velocities when compared with both baseline and the IPC device (P < .05). No patients reported discomfort with either the WIC device or the IPC device during therapy. ConclusionsThe WIC device significantly increases the augmentation of venous flow as measured by peak venous velocity in both the popliteal and femoral veins in patients with Clinical, Etiologic, Anatomic and Pathophysiologic class 3 to 6 venous insufficiency. In addition, the WIC device was found to be easy to use and comfortable during therapy. Future studies are planned to determine if the WIC improvements in venous flow augmentation and patient compliance will lead to higher rates of venous ulcer healing.

Invited commentary

We thoroughly enjoyed reading this study by Dr Labropolous and colleagues, in which they clearly demonstrate that the use of intermittent pneumatic compression (IPC) devices is fraught with difficulties, even after implementation of strategies to improve compliance. The physiologic effects of IPC can be grouped into hemodynamic, hematologic, flow-induced alterations of the endothelium of the veins and an increase in lymphatic drainage. IPC devices prevent venous thromboembolism (VTE) by reducing venous stasis and increasing endogenous fibrinolytic potential. It remains unknown which of these effects is most important for the prevention of VTE. Nonetheless, for the hemodynamic effects, correct calf application of IPC and continuous use are required to be effective. Several large meta-analyses have demonstrated that IPC use alone can reduce the incidence of deep venous thrombosis (DVT) by >60%, with even greater reduction by the combination of pharmacologic and mechanical prophylaxis. 1 Delos Reyes A.P. Partsch H. Mosti G. Obi A. Lurie F. Report from the 2013 meeting of the International Compression Club on advances and challenges of compression therapy. J Vasc Surg Venous Lymphat Disord. 2014; 2: 469-476 Abstract Full Text Full Text PDF PubMed Scopus (6) Google Scholar A recent Cochrane review concluded that on the basis of moderate-quality evidence, combining IPC with pharmacologic prophylaxis, compared with IPC or pharmacologic prophylaxis alone, decreased DVT compared with compression and decreased pulmonary embolism compared with anticoagulation. The addition of pharmacologic prophylaxis to IPC increased the risk of bleeding compared with IPC alone, but not the other way around. 2 Kakkos S.K. Caprini J.A. Geroulakos G. Nicolaides A.N. Stansby G.P. Reddy D.J. et al. Combined intermittent pneumatic leg compression and pharmacological prophylaxis for prevention of venous thromboembolism. Cochrane Database Syst Rev. 2016; 9: CD005258 PubMed Google Scholar The proper use of IPC is unequivocally an important preventive strategy. The staff and patient perspectives on compliance with mechanical prophylaxis for venous thromboembolismJournal of Vascular Surgery: Venous and Lymphatic DisordersVol. 6Issue 4PreviewThis study evaluated the accuracy of assessment and compliance with proper use of intermittent pneumatic compression (IPC) devices before and after implementation of education, accountability, and oversight measures for health care providers. Full-Text PDF

The staff and patient perspectives on compliance with mechanical prophylaxis for venous thromboembolism

BackgroundThis study evaluated the accuracy of assessment and compliance with proper use of intermittent pneumatic compression (IPC) devices before and after implementation of education, accountability, and oversight measures for health care providers. MethodsProspective analysis of randomly selected, emergently hospitalized adult patients was performed (group 1). IPC use was observed by random visual inspections. These patients underwent independent venous thromboembolism (VTE) risk assessments by the admitting service and a VTE consult service. Mechanical prophylaxis orders were subsequently reviewed. Next, strategies to improve compliance were implemented. One year later, prospective analysis of a similar cohort (group 2) was performed, followed by surveys of staff and patients to identify barriers to compliance. ResultsIn group 1, VTE risk assessments were accurate and IPC was appropriately ordered. Of patients who needed IPC, 24 had IPC correctly applied and 72 did not. In group 2, VTE risk assessments were accurate and IPC was appropriately ordered. Of patients who needed IPC, 26 had IPC correctly applied and 74 did not. Surveys revealed that most providers are aware of the indications, order appropriately, and make efforts to ensure application. Most nurses reported that orders were placed and that IPC was applied. Most patients claimed to have knowledge of VTE and IPC use, but half reported that they were not educated and complained of sleep interference. ConclusionsEven with implementation of strategies to improve compliance, most patients do not receive adequate mechanical prophylaxis. Health care providers appropriately order prophylactic measures but do not follow up to ensure application. Discomfort and lack of education of the patient were important barriers to prophylaxis.

Effect of postoperative pneumatic compression after volar plate fixation of distal radial fractures: a randomized controlled trial.

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Reduced risk of venous thromboembolism with the use of intermittent pneumatic compression after craniotomy: a randomized controlled prospective study.

The term "venous thromboembolism" (VTE) subsumes deep venous thrombosis (DVT) and pulmonary embolism. The incidence of DVT after craniotomy was reported to be as high as 50%. Even clinically silent DVT may lead to potentially fatal pulmonary embolism. The risk of VTE is correlated with duration of surgery, and it appears likely that it develops during surgery. The present study aimed to evaluate intraoperative use of intermittent pneumatic compression (IPC) of the lower extremity for prevention of VTE in patients undergoing craniotomy. A total of 108 patients undergoing elective craniotomy for intracranial pathology were included in a single-center controlled randomized prospective study. In the control group, conventional compression stockings were worn during surgery. In the treatment group, IPC of the calves was used in addition. The presence of DVT was evaluated by Doppler sonography pre- and postoperatively. Intraoperative use of IPC led to a significant reduction of VTE (p = 0.029). In logistic regression analysis, the risk of VTE was approximately quartered by the use of IPC. Duration of surgery was confirmed to be correlated with VTE incidence (p < 0.01); every hour of surgery increased the risk by a factor of 1.56. Intraoperative use of IPC significantly lowers the incidence of potentially fatal VTE in patients undergoing craniotomy. The method is easy to use and carries no additional risks.■ CLASSIFICATION OF EVIDENCE Type of question: therapeutic; study design: randomized controlled trial; evidence: class I.Clinical trial registration no.: DRKS00011783 (https://www.drks.de).

Can intermittent pneumatic compression (IPC) reduce time to surgery for malleolar fractures?

BackgroundSurgery of malleolar fractures are often delayed due to oedema of the ankle. The use of intermittent pneumatic compression (IPC) is thought to reduce oedema of the fracture site and thereby time to surgery in patients with malleolar fractures. PurposeTo investigate the influence of IPC on the time from admission to surgery in adult patients with internal fixated primary malleolar fractures. MethodsFebruary 1st 2013 IPC was introduced as a standard treatment for all patients admitted with a malleolar fracture. Data was retrieved from the hospital database 2 years prior and after the introduction date. The patients were found using ICD-10 diagnoses codes (DS825-8) in combination with NOMESCO procedure codes (KNHJ40-3, KNHJ60-3, KNHJ70-3, KNHJ80-3). One reviewer examined all the journals and classified the x-ray images by the AO classification. The primary outcome measure was time from diagnosis to surgery. Results74 patients in the IPC cohort and 113 in the non-IPC cohort were included in the study. Time from admission to surgery was 21.9 (10.8–45.0) hours in the control group and 22.1 (8.9–41.2) hours in the IPC group. The difference is not statistically significant (p=0.420).A subgroup analysis divided the patients operated before and after 24h from admission. The median (IQR) time to surgery for patients operated before 24h was 10.9 (6.4–16.9) hours for the control group and 9.9 (5.8–20.1) hours in the IPC group (p=0.989). The median (IQR) time to surgery for patients operated after 24h was 21.5 (4.1–57.0) hours for the control group and 18.4 (7.4–32.3) hours in the IPC group (p=0.353). InterpretationThere was no benefit from IPC on time to surgery in patients with acute primary malleolar fracture in a cohort with a mean surgical delay less than 24h.

Usefulness of intermittent pneumatic compression in medicine

AbstractMany studies exist that document the use of intermittent pneumatic compression in lymphedema, venous ulcers, prophylaxis of deep vein thrombosis and limb ischaemia. This article discusses the basics and usefulness of this therapy on the basis of available studies and recommendations. As the method is characterized by lack of serious side effects, good patient compliance, and high effectiveness, intermittent pneumatic compression should be taken into consideration as an alternative or additional treatment in many conditions.

Intermittent pneumatic compression in combination with low-molecular weight heparin in the prevention of venous thromboembolic events in esophageal cancer surgery.

Aim of this study was to evaluate the use of Intermittent Pneumatic Compression (IPC) in the prevention of symptomatic venous thromboembolic events (VTE) in patients undergoing esophagectomy for cancer. From a prospective database, all patients operated between 2010 and 2014 received IPC in addition to LMWH and were compared to a historical cohort of patients treated LMWH only (2004-2009). Of the 313 included patients, 195 (62%) received IPC. Patients with IPC received neoadjuvant chemoradiation more often (45% vs. 3%, P < 0.001), whereas, neoadjuvant chemotherapy was equally distributed (31% vs. 34%, P = 0.631). There were no differences with regard to surgical approach, operative time, blood loss, and ICU stay. Patients treated without IPC had a longer hospital stay (18 vs. 15 days, P = 0.014). Overall, 12 clinical VTE's occurred in 11 patients, which consisted of two deep venous thromboses and 10 pulmonary embolisms. In the group of patients, who received IPC 1.5% developed a symptomatic VTE compared to 6.8% in patients without IPC (OR = 0.215; 95% CI = 0.06-0.83). Multivariate analysis identified IPC as the only independent prognostic factor correlated with a reduction in postoperative VTE's (OR = 0.225; 95% CI = 0.06-0.88). The addition of IPC in patients undergoing esophagectomy for cancer was associated with a reduction in symptomatic VTE's. J. Surg. Oncol. 2017;115:181-185. © 2017 Wiley Periodicals, Inc.

Nomogram predicting risk of lymphocele in gynecologic cancer patients undergoing pelvic lymph node dissection.

ObjectiveThe purpose of this study is to estimate the risk of postoperative lymphocele development after lymphadenectomy in gynecologic cancer patients through establishing a nomogram.MethodsWe retrospectively reviewed 371 consecutive gynecologic cancer patients undergoing lymphadenectomy between 2009 and 2014. Association of the development of postoperative lymphocele with clinical characteristics was evaluated in univariate and multivariate regression analyses. Nomograms were built based on the data of multivariate analysis using R-software.ResultsMean age at the operation was 50.8±11.1 years. Postoperative lymphocele was found in 70 (18.9%) patients. Of them, 22 (31.4%) had complicated one. Multivariate analysis revealed that hypertension (hazard ratio [HR], 3.0; 95% confidence interval [CI], 1.5 to 6.0; P=0.003), open surgery (HR, 3.2; 95% CI, 1.4 to 7.1; P=0.004), retrieved lymph nodes (LNs) >21 (HR, 1.8; 95% CI, 1.0 to 3.3; P=0.042), and no use of intermittent pneumatic compression (HR, 2.7; 95% CI, 1.0 to 7.2; P=0.047) were independent risk factors for the development of postoperative lymphocele. The nomogram appeared to be accurate and predicted the lymphocele development better than chance (concordance index, 0.754). For complicated lymphoceles, most variables which have shown significant association with general lymphocele lost the statistical significance, except hypertension (P=0.011) and mean number of retrieved LNs (29.5 vs. 21.1; P=0.001). A nomogram for complicated lymphocele showed similar predictive accuracy (concordance index, 0.727).ConclusionWe developed a nomogram to predict the risk of lymphocele in gynecologic cancer patients on the basis of readily obtained clinical variables. External validation of this nomogram in different group of patients is needed.

Identifying risk factors for occult lower extremity lymphedema using computed tomography in patients undergoing lymphadenectomy for gynecologic cancers

ObjectiveTo identify risk factors for lower extremity lymphedema (LEL) using computed tomographic (CT) scan in patients undergoing lymphadenectomy for gynecologic cancers. MethodsWe retrospectively reviewed 511 consecutive gynecologic cancer patients undergoing lymphadenectomy. Mean difference (3.77±3.14mm) of subcutaneous layer thicknesses between preoperative and postoperative 1-year CT scans of 106 patients with clinical LEL was used as an objective criterion for regrouping all the patients into those with mean difference >3.77mm and ≤3.77mm. Risk factors for clinical LEL and significant increase of subcutaneous layer thickness on CT were evaluated using a logistic regression model. ResultsA total of 106 (20.7%) patients were clinically diagnosed with LEL by a physician. Total number of lymph nodes (LNs) retrieved >30 (Odds ratio [OR] 3.2; 95% Confidence interval [CI] 1.94–5.32; p<0.001) and adjuvant pelvic radiotherapy (OR 3.1; 95% CI 1.75–5.52; p<0.001) were risk factors for clinical LEL. One hundred-nineteen (23.3%) had subcutaneous layer thickness increase of >3.77mm. In addition to number of LNs retrieved >30 (OR 2.3; 95% CI 1.40–3.74; p=0.001) and adjuvant pelvic radiotherapy (OR 1.7; 95% CI 1.01–2.74; p=0.046), open surgery (OR 1.8; 95% CI 1.01–3.11; p=0.045), long operation time (OR 1.7; 95% CI 1.05–2.83; p=0.032), and no use of intermittent pneumatic compression (IPC) (OR 2.1; 95% CI 1.06–4.16; p=0.034) were risk factors for thick subcutaneous layer on postoperative CT. ConclusionsIn addition to high LN retrieval and adjuvant pelvic radiotherapy, open surgery, long operation time, and no IPC use could be risk factors for occult LEL after lymphadenectomy in gynecologic cancers.

The Use of Intermittent Pneumatic Compression in Orthopedic and Neurosurgical Postoperative Patients: A Systematic Review and Meta-analysis.

The objective of this systematic review and meta-analysis was to carry out an up-to-date evaluation on the use of compression devices as deep vein thrombosis (DVT) prophylaxis methods in orthopedic and neurological patients. There is an increased risk of DVT with surgery, particularly in patients who are not expected to mobilize soon after their procedures, such as orthopedic and neurosurgical patients. Compression devices are often employed for DVT prophylaxis in these patients. However, the true efficacy of these devices and the standardization of use with these devices are yet to be established. Medline, CINAHL, Embase, Google Scholar, and the Cochrane library electronic databases were searched to identify randomized controlled trials and observational studies reporting on the use of compression devices for DVT prevention. Nine studies were included for review and meta-analysis. Use of an intermittent pneumatic compression device alone is neither superior nor inferior to chemoprophylaxis. In the absence of large randomized multicenter trials comparing the use of intermittent pneumatic compression or chemoprophylaxis alone to a combination of both treatments, the current evidence supports the use of a combined approach in high-risk surgical patients.

脳卒中後片麻痺患者における間欠的空気圧迫療法や弾性ストッキング装着は下肢静脈環流を増加させるか

脳卒中後片麻痺患者における間欠的空気圧迫療法や弾性ストッキング装着は下肢静脈環流を増加させるか