The intermitting pneumatic compression as a component of complex prophylactic measures to prevent postoperative venous thromboembolytic complications
Purpose: The given systemic literature review was aimed to evaluate the effectiveness of intermitting pneumatic compression (IPC) as a prophylactic measure to prevent postoperative venous thromboembolytic complications (PVTC) (namely, venous thrombosis and thromboembolism of pulmonary artery) in patients with high risk and to define perspectives for improving complex PVTC prophylactics which includes the discussed technique. Material and methods: The authors have analyzed data of observational and randomized clinical trials which were taken from the international database "PubMed". This analysis included trials which had been performed in traditionally high-risk groups: abdominal surgery (marked as "high risk surgery"), oncosurgery, neurosurgery, traumatology and orthopedics, patients from resuscitation and intensive-care units. Results: It has been found out that among neurosurgical patients the venous thrombosis (VT) rate under isolated IPC application was within 1.5-16%, average about 9%. In patients with oncological diseases VT under IPC application developed in 6.3-55% (average 23%). The postoperative VT rate in patients with abdominal surgical pathology varied from 6.4 to 19 %, in average 11.4%. In resuscitation and intensive-care units the postoperative VT rate under a separate ICP application was 19%, while under a combined application of this technique with compression knitwear - 1%. In orthopedic patients who had endoprosthesing of large joints, an isolated ICP application was associated with PVTC in 0-32%, average 8%. Conclusion: Thus, despite a convincing evidence on the effectiveness of IPC application and reliable decrease in PVT-Crate, the average absolute PVTC rate in patients from a high risk group under IPC application is still about 14%. One of the measures to increase this technique effectiveness is its combination with pharmprophylactics, especially in patients from the group of extremely high PVTC risk.