02 Apr Does Intermittent Leg Compression Reduce Blood Clots or Pulmonary Embolism?
MedicalResearch.com Interview with:
Dr. Arabi
Yaseen M. Arabi, M.D
Intensive Care Department
Ministry of National Guard Health Affairs
Riyadh, Saudi Arabia
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Venous thromboembolism, including deep vein thrombosis and pulmonary embolism, is a complication of critical illness. Studies have demonstrated that despite pharmacologic thromboprophylaxis with unfractionated heparin or low-molecular weight heparin, 5-20% of critically ill patients develop deep vein thrombosis (DVT). The PREVENT trial evaluated whether adjunctive intermittent pneumatic compression reduces incident proximal lower limb DVT as detected on twice-weekly lower limb ultrasonography in critically ill patients receiving pharmacologic thromboprophylaxis with unfractionated heparin or low-molecular-weight heparin.
The trial was conducted in 20 sites in Saudi Arabia, Canada, Australia and India and included 2003 patients.
The trial found no difference in the primary end point of proximal leg DVT. The addition of intermittent pneumatic compression to pharmacologic thromboprophylaxis did not result in a lower incidence of pulmonary embolism or a composite outcome of venous thromboembolism or death from any cause at 28 days when compared to pharmacologic thromboprophylaxis alone.
MedicalResearch.com: What should readers take away from your report?
Response: In patients who are able to receive pharmacologic thromboprophylaxis, the addition of pneumatic compression does not add additional protection.
MedicalResearch.com: What recommendations do you have for future research as a result of this work?
Response: It remains unclear whether pneumatic compression would prevent deep-vein thrombosis in coagulopathy patients who cannot receive pharmacologic prophylaxis and the optimal method for thromboprophylaxis in this group needs further study.
Any disclosures?
I would like to acknowledge the study sponsors King Abdulaziz City for Science and Technology and a grant from King Abdullah International Medical Research Center, both in Riyadh, Saudi Arabia.
Citation:
Adjunctive Intermittent Pneumatic Compression for Venous Thromboprophylaxis
Yaseen M. Arabi, M.D, Fahad Al-Hameed, M.D., Karen E.A. Burns, M.D., Sangeeta Mehta, M.D., Sami J. Alsolamy, M.D., M.P.H., Mohammed S. Alshahrani, M.D., Yasser Mandourah, M.D., Ghaleb A. Almekhlafi, M.D., Mohammed Almaani, M.D., Ali Al Bshabshe, M.D., Simon Finfer, M.D., Zia Arshad, M.D., M.B., B.S., et al., for the Saudi Critical Care Trials Group*
February 18, 2019
DOI: 10.1056/NEJMoa1816150
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Last Updated on April 2, 2019 by Marie Benz MD FAAD