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Comparison of clinical and physiological efficacies of different intermittent sequential pneumatic compression devices in preventing deep vein thrombosis: a prospective randomized study.

Koo KH, Choi JS, Ahn JH, Kwon JH, Cho KT - Clin Orthop Surg (2014)

Bottom Line: Relative frequencies of unpaired samples were compared using Fisher exact test.However, the degrees of flow and velocity enhancement did not differ significantly between the groups.Both graded sequential compression devices showed similar results both in clinical and physiological efficacies.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopedic Surgery, Dongguk University Ilsan Hospital, Dongguk University College of Medicine, Goyang, Korea.

ABSTRACT

Background: There are few comparative studies about the optimal method of pneumatic compression to prevent deep vein thrombosis (DVT). The aim of this prospective randomized study was to compare venous hemodynamic changes and their clinical influences between two graded sequential compression groups (an alternate sequential compression device [ASCD] vs. a simultaneous sequential compression device [SSCD]).

Methods: In total, 34 patients (68 limbs) undergoing knee and spine operations were prospectively randomized into two device groups (ASCD vs. SSCD groups). Duplex ultrasonography examinations were performed on the 4th and 7th postoperative days for the detection of DVT and the evaluation of venous hemodynamics. Continuous data for the two groups were analyzed using a two-tailed, unpaired t-test. Relative frequencies of unpaired samples were compared using Fisher exact test. Mixed effects models that might be viewed as ANCOVA models were also considered.

Results: DVT developed in 7 patients (20.6%), all of whom were asymptomatic for isolated calf DVTs. Two of these patients were from the ASCD group (11.8%) and the other five were from the SSCD group (29.4%), but there was no significant difference (p = 0.331). Baseline peak velocity, mean velocity, peak volume flow, and total volume flow were enhanced significantly in both device groups (p < 0.001). However, the degrees of flow and velocity enhancement did not differ significantly between the groups. The accumulated expelled volumes for an hour were in favor of the ASCD group.

Conclusions: Both graded sequential compression devices showed similar results both in clinical and physiological efficacies. Further studies are required to investigate the optimal intermittent pneumatic compression method for enhanced hemodynamic efficacy and better thromboprophylaxis.

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Related in: MedlinePlus

Comparison of hemodynamic data. Baseline peak velocity, mean velocity, total volume flow, and peak volume flow were enhanced significantly, which more than doubled in both device groups. Asterisk (*) indicates significant difference between the baseline and the augmented values in the same group (all, p < 0.001).
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Figure 2: Comparison of hemodynamic data. Baseline peak velocity, mean velocity, total volume flow, and peak volume flow were enhanced significantly, which more than doubled in both device groups. Asterisk (*) indicates significant difference between the baseline and the augmented values in the same group (all, p < 0.001).

Mentions: Venous hemodynamic data are shown in Table 3. For the comparison of hemodynamic values in the same group (baseline vs. augmented values), baseline PV, mean velocity, PVF, and TVF were enhanced significantly as much as, or more than 2-fold, in both device groups (all p < 0.001) (Fig. 2). In particular, PVF enhancement in the SSCD group was impressive, reaching as much as a 3.5-fold increase. Comparing the two groups, the hemodynamic values divided by BSA, the value indices were used for the analysis. The baseline and augmented value indices were not significantly different between the groups. Furthermore, the amounts of venous flow and volume enhancements were not different between the devices. The mean value of ETV index (ETV/BSA) was 28.8% higher with the SCD Express (ASCD group; 2,632 mL/hr vs. 1,834 mL/hr; p = 0.072) and EPV index (EPV/BSA) 55.9% higher with the SCD Express (ASCD group; 357 mL/hr vs. 229 mL/hr; p = 0.039), compared with the DVT-3000 (SSCD group).


Comparison of clinical and physiological efficacies of different intermittent sequential pneumatic compression devices in preventing deep vein thrombosis: a prospective randomized study.

Koo KH, Choi JS, Ahn JH, Kwon JH, Cho KT - Clin Orthop Surg (2014)

Comparison of hemodynamic data. Baseline peak velocity, mean velocity, total volume flow, and peak volume flow were enhanced significantly, which more than doubled in both device groups. Asterisk (*) indicates significant difference between the baseline and the augmented values in the same group (all, p < 0.001).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4233228&req=5

Figure 2: Comparison of hemodynamic data. Baseline peak velocity, mean velocity, total volume flow, and peak volume flow were enhanced significantly, which more than doubled in both device groups. Asterisk (*) indicates significant difference between the baseline and the augmented values in the same group (all, p < 0.001).
Mentions: Venous hemodynamic data are shown in Table 3. For the comparison of hemodynamic values in the same group (baseline vs. augmented values), baseline PV, mean velocity, PVF, and TVF were enhanced significantly as much as, or more than 2-fold, in both device groups (all p < 0.001) (Fig. 2). In particular, PVF enhancement in the SSCD group was impressive, reaching as much as a 3.5-fold increase. Comparing the two groups, the hemodynamic values divided by BSA, the value indices were used for the analysis. The baseline and augmented value indices were not significantly different between the groups. Furthermore, the amounts of venous flow and volume enhancements were not different between the devices. The mean value of ETV index (ETV/BSA) was 28.8% higher with the SCD Express (ASCD group; 2,632 mL/hr vs. 1,834 mL/hr; p = 0.072) and EPV index (EPV/BSA) 55.9% higher with the SCD Express (ASCD group; 357 mL/hr vs. 229 mL/hr; p = 0.039), compared with the DVT-3000 (SSCD group).

Bottom Line: Relative frequencies of unpaired samples were compared using Fisher exact test.However, the degrees of flow and velocity enhancement did not differ significantly between the groups.Both graded sequential compression devices showed similar results both in clinical and physiological efficacies.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopedic Surgery, Dongguk University Ilsan Hospital, Dongguk University College of Medicine, Goyang, Korea.

ABSTRACT

Background: There are few comparative studies about the optimal method of pneumatic compression to prevent deep vein thrombosis (DVT). The aim of this prospective randomized study was to compare venous hemodynamic changes and their clinical influences between two graded sequential compression groups (an alternate sequential compression device [ASCD] vs. a simultaneous sequential compression device [SSCD]).

Methods: In total, 34 patients (68 limbs) undergoing knee and spine operations were prospectively randomized into two device groups (ASCD vs. SSCD groups). Duplex ultrasonography examinations were performed on the 4th and 7th postoperative days for the detection of DVT and the evaluation of venous hemodynamics. Continuous data for the two groups were analyzed using a two-tailed, unpaired t-test. Relative frequencies of unpaired samples were compared using Fisher exact test. Mixed effects models that might be viewed as ANCOVA models were also considered.

Results: DVT developed in 7 patients (20.6%), all of whom were asymptomatic for isolated calf DVTs. Two of these patients were from the ASCD group (11.8%) and the other five were from the SSCD group (29.4%), but there was no significant difference (p = 0.331). Baseline peak velocity, mean velocity, peak volume flow, and total volume flow were enhanced significantly in both device groups (p < 0.001). However, the degrees of flow and velocity enhancement did not differ significantly between the groups. The accumulated expelled volumes for an hour were in favor of the ASCD group.

Conclusions: Both graded sequential compression devices showed similar results both in clinical and physiological efficacies. Further studies are required to investigate the optimal intermittent pneumatic compression method for enhanced hemodynamic efficacy and better thromboprophylaxis.

Show MeSH
Related in: MedlinePlus