DVT or Deep Vein Thrombosis, is the formation of blood clots (thrombus) within deep veins, mostly in the legs. It occurs because of reduced blood flow mainly due to long-term immobility.
PE or Pulmonary Embolism, is the most dangerous and potentially fatal consequence of DVT. The formed blood clot detaches and travels ov7 to the lungs, blocking an artery.
- DVT is the most common preventable cause of death in hospitals. It is ranked among the top 3 adverse medical outcomes in hospitals worldwide. [1]
- There’s a severe underutilization of DVT prophylaxis (17.4%) in India against globally, (50.2%) [2]
How do DVT sleeves and pumps i.e. Intermittent Pneumatic Compression work?
- The sleeve which has an inflatable chamber is wrapped around the patient’s legs.
- Air is pumped alternately in the left and right leg sleeves. For 12 seconds in one minute.
- When air is pumped in, blood is squeezed out of the limb.
- When air is taken out, blood is allowed to flow back in.
- This provides an active stimulation of the blood flow.
Limitations of Graduated Compression Stockings (GCS):
Static compression is not as effective as the dynamic compression of IPC [3], [4], [7] Accurate size is required: Smaller or larger stockings will result in excessive or ineffective compression, respectively.
Blisters, skin necrosis, and ulcers are some of the undesirable outcomes. [5]
Lower adherence to treatment: Due to the discomfort, there was 39% adherence for
stockings compared to 85% for lPCs. [6]
Limitations of Pharmacological Prophylaxis:
Impaired blood clotting ability due to blood thinning agents.
Renal impairment: kidneys lose the ability to remove waste and balance fluids
Intracranial hemorrhage: pathological accumulation of blood within the cranial vault.
References:
- Venous Thromboembolism is becoming a leading cause of disability and death in India: Dr. Suviraj John
- venous thromboembolism risk & prophylaxis in the acute hospital care are setting (ENDORSE), a multinational cross-sectional study: Results from the Indian subset data Ramakrishna Pinjala on behalf of all ENDORSE India Investigators
- Intermittent Pneumatic Compression or Graduated Compression Stockings for Deep Vein Thrombosis Prophylaxis? A Systematic Review of Direct Clinical Compar Morris, Rhys J. Ph.D.*; Woodcock, John P. DSc
- Do graduated compression stockings and pneumatic boots have an additive effect on the peak velocity of venous blood flow? Keith sLl, McLaughlin DJ, Anderson FA Jr, Cardullo PA, Jones CE, Rohrer MJ, Cutler BS.
- Effectiveness of thigh-Iength graduated compression stockings to reduce the risk of deep vein thrombosis after stroke (CLOTS trial 1): a multicentre, randomized controlled trial. CLOTS Trials Collaboration, Dennis M, Sandercock PA, Reid J, Graham C, Murray G, Venables G, Rudd A, Bowler G.
[E’] Summary of the effectiveness of mechanical and pharmacological Prophylaxis.
[7] Use of intermitted rit pneumatic compression and not graduated compression stockings is associated with lower incident VTE in critically ill patients: a multiple propensity scores adjusted analysis. Arabi YM1, Khedr M, Dara SI, Dhar GS, Bhat SA, Tamim HM, Afesh LY.
Top 3 DVT pumps in India
- Arjohuntleigh Flowtron Excel DVT Pump
- Zimmer Biomet Vasopress DVT Pump
- Devon Cirona 6200 DVT Pump