[Prophylactic strategies for perioperative pulmonary embolism].
BACKGROUND
Incidence of perioperative pulmonary embolism (PE) has increased in Japan probably due to the modernized life style. As the mortality rate of PE is very high, its prophylaxis is important. Therefore, prophylactic strategies for PE were instituted in the entire hospital.


METHODS
Elastic stockings (ES) for preventing perioperative deep vein thrombosis in lower extremities were worn from the morning of the operation until the beginning of ambulation. Intermittent pneumatic compression (IPC) apparatuses were used in combination with ES. IPC apparatus was employed right after induction of anesthesia until leaving postanesthetic care unit (PACU). Seventy percent of patients stayed in PACU until the morning after the operation and the other patients for a few hours after the end of surgery.


RESULTS
We managed 4,200 patients with this method. We experienced one symptomatic deep vein thrombosis but not severe or moderately severe PE. However, it is difficult to evaluate the incidence of mild PE because it is usual that symptom such as chest discomfort is thought as an indefinite complaint and its cause is not investigated further.


CONCLUSIONS
Our preventive strategies seem to be useful to decrease the incidence and severity of perioperative PE.
Kambara
Noriko
N
Department of Anesthesiology and Director of Hospital, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka 537-8511.
Kishi
Yoshihiko
Y
Taniguchi
Hiroshi
H
Nakagawa
Masashi
M
Mammoto
Tadanori
T
Tanigami
Hironobu
H
Sakai
Toshiko
T
Imaoka
Shingi
S
D001458:Bandages / Q000592:standards; D006801:Humans; D011183:Postoperative Complications / Q000517:prevention & control*; D011655:Pulmonary Embolism / Q000517:prevention & control*; D020246:Venous Thrombosis / Q000517:prevention & control*