Journal of Korean Academy of Fundamentals of Nursing (기본간호학회지)

Korean Academy of Fundamentals of Nursing (기본간호학회)
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Prevention Effects of Graduated Compression Stockings and Intermittent Pneumatic Compression on Deep Vein Thrombosis in SICU Patients: Pilot Study

항혈전스타킹과 간헐적공기압박기 적용이 중환자의 심부정맥혈전 발생 예방에 미치는 효과: 예비조사

  • Received : 2015.05.16
  • Accepted : 2015.08.05
  • Published : 2015.08.31
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Abstract

Purpose: The purpose of this pilot study was to investigate the effects of mechanical interventions for deep vein thrombosis (DVT) prophylaxis in surgical intensive care unit (SICU) patients. Methods: The participants were assigned to the intermittent pneumatic compression (IPC) and graduated compression stocking (GCS) intervention. Patients who met the criteria were selected for comparison from our previous study. Data for 140 patients were included in the final analysis. Results: The mean age was 57.5 (${\pm}15.7$) and 61.4 % were men. About forty-seven percent of the participants were 61 years or over. In the second duplex scan, 3, 2 and 1 critically ill patients developed deep vein thrombosis in the control, GCS, and IPC groups, respectively. Incidences of DVT were 6.0%, 5.0%, and 2.0% for the control, GCS, and IPC groups, respectively. This difference was not significant. Relative risks of no intervention were 3.0 and 1.2 compared with IPC and GCS application. There were no significantly different variables among the three groups before the intervention except for diagnosis on admission. Conclusion: Although it may difficult to conclude that mechanical prophylaxis effectively prevents DVT among SICU patients because there was no statistical significance in this study, but incidence rates among the three groups differed greatly. The findings reveal that further study should be conducted with larger samples and randomized controlled trial for SICU patients.

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References

  1. Geerts W, Cook D, Selby R, Etchells E. Venous thromboembolism and its prevention in critical care. Journal of Critical Care. 2002;17(2):95-104. http://dx.doi.org/10.1053/jcrc.2002.33941
  2. Nathens AB, McMurray MK, Cuschieri J, Durr EA, Moore EE, Bankey PE, et al. The practice of venous thromboembolism prophylaxis in the major trauma patient. Journal of Trauma. 2007;62(3):557-562. http://dx.doi.org/10.1097/TA.0b013e318031b5f5
  3. Chua K, Kong KH, Chan SP. Prevalence and risk factors of asymptomatic lower extremity deep venous thrombosis in Asian neurorehabilitation admissions in Singapore. Archives of Physical Medicine and Rehabilitation. 2008;89(12): 2316-2323. http://dx.doi.org/10.1016/j.apmr.2008.05.025
  4. Chua KS, Kong KH, Arul E. Deep venous thrombosis in Asian traumatic brain injury patients during rehabilitation: Prevalence and risk factors. Journal of Head Trauma Rehabilitation. 2009;24(3):178-186. http://dx.doi.org/10.1097/HTR.0b013e3181a0b265
  5. Taniguchi S, Fukuda I, Daitoku K, Minakawa M, Odagiri S, Suzuki Y, et al. Prevalence of venous thromboembolism in neurosurgical patients. Heart and Vessels. 2009;24(6):425-428. http://dx.doi.org/10.1007/s00380-008-1135-9
  6. Wilasrusmee C, Kiranantawat K, Horsirimanont S, Lertsithichai P, Reodecha P, Soonthonkit Y, et al. Deep venous thrombosis in surgical intensive care unit: Prevalence and risk factors. Asian Journal of Surgery. 2009;32(2):85-88. http://dx.doi.org/10.1016/S1015-9584(09)60016-6
  7. Yablon SA, Rock WA Jr, Nick TG, Sherer M, McGrath CM, Goodson KH. Deep vein thrombosis: Prevalence and risk factors in rehabilitation admissions with brain injury. Neurology. 2004;63(3):485-491. http://dx.doi.org/10.1212/01.WNL.0000133009.24727.9F
  8. Hong KC, Kim H, Kim JY, Kwak KS, Cho OM, Cha HY, et al. Risk factors and incidence of deep vein thrombosis in lower extremities among critically ill patients. Journal of Clinical Nursing. 2012;21(13):1840-1846. http://dx.doi.org/10.1111/j.1365-2702.2012.04112.x
  9. Chiasson TC, Manns BJ, Stelfox HT. An economic evaluation of venous thromboembolism prophylaxis strategies in critically ill trauma patients at risk of bleeding. PLoS Medicine. 2009;6(6):e1000098. http://dx.doi.org/10.1371/journal.pmed.1000098
  10. Muscedere JG, Heyland DK, Cook D. Venous thromboembolism in critical illness in a community intensive care unit. Journal of Critical Care. 2007;22(4):285-289. http://dx.doi.org/10.1016/j.jcrc.2007.02.003
  11. Kurtoglu M, Yanar H, Bilsel Y, Guloglu R, Kizilirmak S, Buyukkurt D, et al. Venous thromboembolism prophylaxis after head and spinal trauma: Intermittent pneumatic compression devices versus low molecular weight heparin. World Journal of Surgery. 2004;28(8):807-811. http://dx.doi.org/10.1007/s00268-004-7295-6
  12. Collen JF, Jackson JL, Shorr AF, Moores LK. Prevention of venous thromboembolism in neurosurgery: A metaanalysis. Chest. 2008;134(2):237-249. http://dx.doi.org/10.1378/chest.08-0023
  13. Barillari G, Pasca S. Practical use of intermittent pneumatic compression as thromboprophylaxis in neurosurgery. Journal of Neurosurgical Sciences. 2009;53(2):45-48.
  14. Zubkov AY, Wijdicks EF. Deep venous thrombosis prophylaxis in cerebral hemorrhage. Reviews in Neurological Diseases. 2009;6(1):21-25.
  15. Zhang C, Zeng W, Zhou H, Zheng BX, Cheng JC, Li XY, et al. The efficacy of intermittent pneumatic compression in the prevention of venous thromboembolism in medical critically ill patients. Chinese Critical Care Medicine. 2011; 23(9):563-565.
  16. Morris RJ, Woodcock JP. Intermittent pneumatic compression or graduated compression stockings for deep vein thrombosis prophylaxis?: A systematic review of direct clinical comparisons. Annals of Surgery. 2010;251(3):393-396. http://dx.doi.org/10.1097/SLA.0b013e3181b5d61c
  17. Elpern E, Killeen K, Patel G, Senecal PA. The application of intermittent pneumatic compression devices for thromboprophylaxis: An observational study found frequent errors in the application of these mechanical devices in ICUs. American Journal of Nursing. 2013;113(4):30-37. http://dx.doi.org/10.1097/01.NAJ.00004287736.48428.10
  18. Robertson MS, Nichol AD, Higgins AM, Bailey MJ, Presneill JJ, Cooper DJ, et al. Venous thromboembolism prophylaxis in the critically ill: A point prevalence survey of current practice in Australian and New Zealand intensive care units. Critical Care and Resuscitation. 2010;12(1):9-15.
  19. Epstein NE. Intermittent pneumatic compression stocking prophylaxis against deep venous thrombosis in anterior cervical spinal surgery: A prospective efficacy study in 200 patients and literature review. Spine. 2005;30(22):2538-2543. http://dx.doi.org/10.1097/01.brs.0000186318.80139.40
  20. Cook D, Crowther M, Meade M, Rabbat C, Griffith L, Schiff D, et al. Deep venous thrombosis in medical-surgical critically ill patients: Prevalence, incidence, and risk factors. Critical Care Medicine. 2005;33(7):1565-1571. https://doi.org/10.1097/01.CCM.0000171207.95319.B2
  21. Caprini JA. Thrombosis risk assessment as a guide to quality patient care. Disease-a-Month. 2005;51(2-3):70-78. http://dx.doi.org/10.1016/j.disamonth.2005.02.003
  22. Kalodiki E, Marston R, Volteas N, Leon M, Labropoulos N, Fisher CM, et al. The combination of liquid crystal thermography and duplex scanning in the diagnosis of deep vein thrombosis. European Journal of Vascular Surgery. 1992;6(3):311-316. http://dx.doi.org/10.1016/S0950-821X(05)80325-1
  23. Arabi YM, Khedr M, Dara SI, Dhar GS, Bhat SA, Tamim HM, et al. Use of intermittent pneumatic compression and not graduated compression stockings is associated with lower incident VTE in critically ill patients: A multiple propensity scores adjusted analysis. Chest. 2013;144(1):152-159. http://dx.doi.org/10.1378/chest.12-2028
  24. Urbankova J, Quiroz R, Kucher N, Goldhaber SZ. Intermittent pneumatic compression and deep vein thrombosis prevention: A meta-analysis in postoperative patients. Thrombosis and Haemostasis. 2005;94(6):1181-1185. https://doi.org/10.1160/TH05-06-1181
  25. Marik PE, Andrews L, Maini B. The incidence of deep venous thrombosis in ICU patients. Chest. 1997;111(3):661-664. https://doi.org/10.1378/chest.111.3.661

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