Adjunctive Intermittent Pneumatic Compression for Venous Thromboprophylaxis

Arabi, Yaseen M.; Al-Hameed, Fahad; Burns, Karen E. A.; Mehta, Shamir B.; Alsolamy, Sami J; Alshahrani, Mohammed

doi:10.1016/j.jvsv.2019.06.003

Cited by 45 publications

(70 citation statements)

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“…For the patients who do not receive pharmacologic prophylaxis, mechanical prophylaxis and/or aspirin are low cost and low morbidity options, although their benefit is uncertain given the low VTE rate. 13 – 16 …”

Section: Algorithmmentioning

confidence: 99%

Updated guidelines to reduce venous thromboembolism in trauma patients: A Western Trauma Association critical decisions algorithm

Ley

Brown

Moore³

et al. 2020

J Trauma Acute Care Surg

145

260

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Section: Algorithmmentioning

confidence: 99%

Updated guidelines to reduce venous thromboembolism in trauma patients: A Western Trauma Association critical decisions algorithm

Ley

Brown

Moore³

et al. 2020

J Trauma Acute Care Surg

145

260

View full text Add to dashboard Cite

“…These rates are very high when compared to a recent RCT conducted on ICU (no COVID) patients that reported the incidence of VTE to be 9.4% [78]. It has been observed that in COVID-19 patients, during the development of dyspnoea and chest imaging changes from light to severe, the D-dimer increased from mild to signi cant, along with prolonged prothrombin time and gradual decrease of brinogen and platelet [77].…”

Section: Discussionmentioning

confidence: 79%

The management of surgical patients in emergency setting during COVID-19 pandemic. The WSES position paper

Simone

Chouillard

Sartelli

et al. 2020

Preprint

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BackgroundSince the COVID-19 pandemic has occurred, nations showed their unpreparedness to deal with a mass casualty incident of this proportion and severity. The World Society of Emergency Surgery (WSES) conceived this position paper with the purpose of providing recommendations for the management of surgical, infected and non-infected, patients in emergency setting under COVID-19 pandemic in the safety of the patient and health care workers based on available evidences and experienced surgeons’opinion.MethodA systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Review and Meta-analysis Protocols (PRISMA-P)through the MEDLINE (PubMed), Embase and SCOPUS databases. Synthesis of evidence, statements and recommendations were developed in accordance with the GRADE methodology.ResultsGiven the limitation of the evidence, the current document represents an effort to provide a guide for emergency surgeons to perform safely surgery during this pandemic on the basis of evidence medicine and principles of mass casualty incident management to limit the diffusion of the infection among patients and health care workers. ConclusionsWe recommend screening for COVID-19 infection at emergency department, all surgical patients with clinical and epidemiologic features suspect for COVID-19 disease who are waiting for hospital admission and urgent surgery. The screening provides performing a RT-PCR naso-pharyngeal swab test and a baseline (non-contrast) chest CT or chest X-ray or lungs US, depending on skills and availability.The management of COVID-19 surgical patient is multidiplinary.If an immediate surgical procedure is mandatory, whether laparoscopic or via open approach, we recommend doing every efforts to protect the operating room staff, in the safety of the patient . We recommend not being present during the intubation and extubation maneuvers (1A).To perform a safe surgical procedure, we recommend:-having a trained staff, wearing the necessary personal protective equipments, and an established protocol for the preoperative, peri-operative and postoperative management of the COVID-19 surgical patient;-being careful in the establishment and management of the artificial pneumoperitoneum, in the control of the hemostasis and of incisions to prevent any loss of biological fluids and contamination of the surgical staff;-using of all available devices to remove smoke and aerosol during the operation and a closed suction system for artificial pneumoperitoneum, especially if there is a risk of conversion to laparotomy.If it is not possible to perform surgery in a safe and protected environment, we recommend do not underestimating the highest risk of contamination and infection for health care workers and dissemination of the virus in the hospital and to consider transferring the patient in a COVID HUB hospital for the appropriate management.The administration of prophylactic anticoagulation with LMWH is recommended as soon as possible in COVID-19 patients to reduce thromboembolic risk related to the virus and sepsis, decreasing the mortality rate. We recommend to carefully administrating antibiotics in COVID-19 surgical patients for the high risk of selecting resistant bacteria, especially in patients admitted in ICU for mechanical ventilation. Early empirical antibiotic treatment should be targeted to results from cultures, with de-escalation of treatment as soon as possible. We recommend against empirical antifungal treatment in all surgical COVID-19 patients but to consider it in critically ill patients.

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“…40 In contradistinction, a recent study by Arabi et al randomly assigned patients within 48 hours after admission to an intensive care unit (ICU) to receive either IPC for at least 18 hours each day in addition to pharmacologic thromboprophylaxis with unfractionated heparin or LMHW or pharmacologic thromboprophylaxis alone. 41 Proximal DVT occurred in 3.9% of patients in the IPC group and in 4.2% of patients in the control group (difference not significant). The rates of VTE (PE or DVT) did not differ either.…”

Section: Mechanical Prophylaxismentioning

confidence: 80%

Postoperative Venous Thromboembolism Prophylaxis: Changes in the Daily Clinical Practice, Modified Guidelines

Samama

2019

Semin Thromb Hemost

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With current clinical practice, postoperative venous thromboembolism (VTE) risk is not only well controlled, but it is steadily decreasing, especially in orthopaedic surgery, thanks to fast-track and day case procedures, new surgical techniques, and potent antithrombotic agents. Thromboprophylaxis is becoming increasingly adapted to these patients. Aspirin is also extensively prescribed in total hip replacement and total knee replacement procedures in the United States and Australia. Mechanical prophylaxis is sometimes applied alone but most often combined with anticoagulant agents. However, large evidence-based studies are still needed to confirm these optimistic tendencies. In the meantime, physicians have to keep strong control over the VTE risk to prevent the reappearance of pulmonary embolism after admission to the surgical wards.

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Adjunctive Intermittent Pneumatic Compression for Venous Thromboprophylaxis

Cited by 45 publications

References 0 publications

Updated guidelines to reduce venous thromboembolism in trauma patients: A Western Trauma Association critical decisions algorithm

Updated guidelines to reduce venous thromboembolism in trauma patients: A Western Trauma Association critical decisions algorithm

The management of surgical patients in emergency setting during COVID-19 pandemic. The WSES position paper

Postoperative Venous Thromboembolism Prophylaxis: Changes in the Daily Clinical Practice, Modified Guidelines

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