Deep venous thrombosis prophylaxis in trauma

Improved compliance with a novel miniaturized pneumatic compression device

Maki Murakami, Tandace L. McDill, Lori Cindrick-Pounds, David B. Loran, Kenneth J. Woodside, William Mileski, Glenn C. Hunter, Lois A. Killewich

Research output: Contribution to journalArticle

38 Citations (Scopus)

Abstract

Objective: Intermittent pneumatic compression (IPC) devices prevent lower-extremity deep venous thrombosis (LEDVT) when used properly, but compliance remains an issue. Devices are frequently discontinued when patients are out of bed, and they are rarely used in emergency departments. Trauma patients are at high risk for LEDVT; however, IPCs are underused in this population because of compliance limitations. The hypothesis of this study was that a new miniaturized, portable, battery-powered pneumatic compression device improves compliance in trauma patients over that provided by a standard device. Methods. This was a prospective trial in which trauma patients (mean age, 46 years; revised trauma score, 11.7) were randomized to DVT prophylaxis with a standard calf-length sequential IPC device (SCD group) or a miniaturized sequential device (continuous enhanced-circulation therapy [CECT] group). The CECT device can be battery-operated for up to 6 hours and worn during ambulation. Timers attached to the devices, which recorded the time each device was applied to the legs and functioning, were used to quantify compliance. For each subject in each location during hospitalization, compliance rates were determined by dividing the number of minutes the device was functioning by the total minutes in that location. Compliance rates for all subjects were averaged in each location: emergency department, operating room, intensive care unit, and nursing ward. Results. Total compliance rate in the CECT group was significantly higher than in the SCD group (77.7% vs. 58.9%, P= .004). Compliance in the emergency department and nursing ward were also significantly greater with the CECT device (P = .002 and P = .008 respectively). Conclusions: Previous studies have demonstrated that reduced compliance with IPC devices results in a higher incidence of LEDVT. Given its ability to improve compliance, the CECT may provide superior DVT prevention compared with that provided by standard devices.

Original languageEnglish (US)
Pages (from-to)923-927
Number of pages5
JournalJournal of Vascular Surgery
Volume38
Issue number5
DOIs
StatePublished - Nov 2003

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Venous Thrombosis
Equipment and Supplies
Wounds and Injuries
Compliance
Intermittent Pneumatic Compression Devices
Hospital Emergency Service
Lower Extremity
Group Psychotherapy
Emergency Nursing
Critical Care Nursing
Aptitude
Operating Rooms
Walking
Intensive Care Units
Leg
Hospitalization
Therapeutics
Incidence

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

Cite this

Deep venous thrombosis prophylaxis in trauma : Improved compliance with a novel miniaturized pneumatic compression device. / Murakami, Maki; McDill, Tandace L.; Cindrick-Pounds, Lori; Loran, David B.; Woodside, Kenneth J.; Mileski, William; Hunter, Glenn C.; Killewich, Lois A.

In: Journal of Vascular Surgery, Vol. 38, No. 5, 11.2003, p. 923-927.

Research output: Contribution to journalArticle

Murakami, M, McDill, TL, Cindrick-Pounds, L, Loran, DB, Woodside, KJ, Mileski, W, Hunter, GC & Killewich, LA 2003, 'Deep venous thrombosis prophylaxis in trauma: Improved compliance with a novel miniaturized pneumatic compression device', Journal of Vascular Surgery, vol. 38, no. 5, pp. 923-927. https://doi.org/10.1016/S0741-5214(03)00792-4
Murakami, Maki ; McDill, Tandace L. ; Cindrick-Pounds, Lori ; Loran, David B. ; Woodside, Kenneth J. ; Mileski, William ; Hunter, Glenn C. ; Killewich, Lois A. / Deep venous thrombosis prophylaxis in trauma : Improved compliance with a novel miniaturized pneumatic compression device. In: Journal of Vascular Surgery. 2003 ; Vol. 38, No. 5. pp. 923-927.
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abstract = "Objective: Intermittent pneumatic compression (IPC) devices prevent lower-extremity deep venous thrombosis (LEDVT) when used properly, but compliance remains an issue. Devices are frequently discontinued when patients are out of bed, and they are rarely used in emergency departments. Trauma patients are at high risk for LEDVT; however, IPCs are underused in this population because of compliance limitations. The hypothesis of this study was that a new miniaturized, portable, battery-powered pneumatic compression device improves compliance in trauma patients over that provided by a standard device. Methods. This was a prospective trial in which trauma patients (mean age, 46 years; revised trauma score, 11.7) were randomized to DVT prophylaxis with a standard calf-length sequential IPC device (SCD group) or a miniaturized sequential device (continuous enhanced-circulation therapy [CECT] group). The CECT device can be battery-operated for up to 6 hours and worn during ambulation. Timers attached to the devices, which recorded the time each device was applied to the legs and functioning, were used to quantify compliance. For each subject in each location during hospitalization, compliance rates were determined by dividing the number of minutes the device was functioning by the total minutes in that location. Compliance rates for all subjects were averaged in each location: emergency department, operating room, intensive care unit, and nursing ward. Results. Total compliance rate in the CECT group was significantly higher than in the SCD group (77.7{\%} vs. 58.9{\%}, P= .004). Compliance in the emergency department and nursing ward were also significantly greater with the CECT device (P = .002 and P = .008 respectively). Conclusions: Previous studies have demonstrated that reduced compliance with IPC devices results in a higher incidence of LEDVT. Given its ability to improve compliance, the CECT may provide superior DVT prevention compared with that provided by standard devices.",
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