The efficacy of pneumatic compression stockings in the prevention of pulmonary embolism after cardiac surgery.
BACKGROUND
Pneumatic compression stocking (PCS) devices have been introduced to decrease the incidence of postoperative deep venous thrombosis (DVT). However, their role in the prophylaxis against pulmonary embolism (PE) remains unclear. This study was undertaken to compare the prophylactic effectiveness of subcutaneous heparin (SCH) alone vs the combined use of PCS and SCH in the prevention of PE following cardiac surgery.


METHODS
We studied 2,551 consecutive patients who underwent cardiac surgery over a 10-year period. They were randomly allocated to two groups. Group A included 1,196 patients who were treated with 5,000 U of SCH every 12 h and group B included 1,355 patients treated with a combined prophylactic regimen of PCS and SCH.


RESULTS
The diagnosis of PE was established in 69 patients by either high-probability ventilation perfusion scan, pulmonary angiogram, or autopsy. The incidence of PE in group A patients was 4% (48/1,196) and in group B was 1.5% (21/1,355). The concomitant use of bilateral PCS and SCH reduced the frequency of postoperative PE in 62% in comparison to the prophylaxis with SCH alone (p < 0.001).


CONCLUSIONS
These data suggest that the combined prophylactic method of bilateral PCS and SCH is superior to SCH alone in the prevention of PE after cardiac surgery.
Ramos
R
R
Department of Cardiology, St. Luke's Hospital, Chesterfield, Md, USA.
Salem
B I
BI
De Pawlikowski
M P
MP
Coordes
C
C
Eisenberg
S
S
Leidenfrost
R
R
D000368:Aged; D000792:Angiography; D001458:Bandages; D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D003131:Combined Modality Therapy; D001026:Coronary Artery Bypass / Q000009:adverse effects; D005260:Female; D006493:Heparin / Q000008:administration & dosage / Q000627:therapeutic use; D006801:Humans; D015994:Incidence; D007279:Injections, Subcutaneous; D007866:Leg; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000517:prevention & control; D011312:Pressure; D011655:Pulmonary Embolism / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000517:prevention & control*; D013924:Thrombophlebitis / Q000517:prevention & control; D014692:Ventilation-Perfusion Ratio
D006493:Heparin