Intermittent pneumatic compression devices role in DVT prophylaxis is an area that needs to be discovered still more deeply. The design of these machines, pressure exerted on legs and the optimal time to be used still need to be researched.
All are an important confounding factors that need to be addressed by randomized control trials before concluding : Did it work, or not?
We use IPC in all our patients who undergo pneumonectomy for five days postoperatively, combined with enoxoparin for six weeks. The rationale is to prevent (mostly fatal) embolic events in the unique remaining lung. This procedure is now in place for six years and we had no such events in this timeframe. (it is of course an event that is rare, but before we used ICP, major embolic events were seen in about 1% of pneumonectomy patients; we do 40+ pneumonectomies a year, so calculating the odds it seems an improvement).
For the use: the first three days the IPC is running 24/24, when the patient is fully mobilized the IPC is only used during the night. Most patients complain, not of discomfort wearing them, but from the noise the pumps make.
This is of course a totally different population from stroke patients, but we feel it works
Seems that surgical patients always have promising results in every thing even for graduated compression stocking as well, There is a shortage in research targeting stroke patients and mechanical methods issue. A recent Cochrane review 2013 revealed that only 2 RCTs for the effect of IPC on stroke patients (CLOT 3 trial one of them). I think that research should focus more on quality improvement initiatives as looking to improving the design of these heavy machines (portable or baterey powered) as well as the convenient issue you talked about.
I think that Coviden company had made progress in providing more comfortable sleeves " Comfort Sleeve" , we used them in practice and found that there is a huge difference than the traditional sleeves. Comfort sleeves had smoother texture similar to silk as well as evaporation holes for sweat besides more flexibility when dealing with.
-
- Badges
- Science topic
- Similar topics
- Geoscience
- Atmospheric Sciences
- Climate Science
- Climate Change