title: Comparison of Simultaneous and Alternate Bilateral Pneumatic Compression in Hemodynamic Effects and Thromboprophylaxis After Total Knee Arthroplasty.
abstract: In this randomized trial, we compared the hemodynamic effects of 2 different methods of bilateral sequential pneumatic compression (Simultaneous compression with Fixed cycling rate [SF] vs Alternate compression with Adjusted cycling rate [AA]) and investigated whether venous flow augmentation influenced deep vein thrombosis (DVT) development in patients undergoing total knee arthroplasty. Pneumatic compression was started on the operation day and applied to discharge. A total of 108 limbs was evaluated by computed tomographic angiography and duplex ultrasound. Augmented peak volume flow (P = .008), expelled total volume (P < .001), and expelled peak volume (P < .001) were significantly larger in group SF. The DVT developed in 35 (32.4%) limbs, and they were neither symptomatic nor ileofemoral in location. The enhanced hemodynamic parameters did not influence the DVT development. In conclusion, group SF showed superior hemodynamic efficacy, but this superiority may not be a surrogate for better thromboprophylaxis.
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Seoul Metropolitan Government-Seoul National University Boramae Hospital, Seoul, Korea turejsreal@hanmail.net.
authors.forename: Jae-Sung
authors.initials: JS
authors.lastname: Choi
authors.affiliation: Department of Orthopedic Surgery, Seoul Metropolitan Government-Seoul National University Boramae Hospital, Seoul, Korea.
authors.forename: Hyuk-Soo
authors.initials: HS
authors.lastname: Han
authors.affiliation: Department of Radiology, Seoul Metropolitan Government-Seoul National University Boramae Hospital, Seoul, Korea.
authors.forename: Young Ho
authors.initials: YH
authors.lastname: Choi
authors.affiliation: Division of Interventional Radiology, Department of Radiology, Dongguk University Ilsan Hospital, Dongguk University, Gyeonggi-do, Korea.
authors.forename: Jae Hyun
authors.initials: JH
authors.lastname: Kwon
authors.affiliation: Department of Statistics, Dongguk University-Seoul, Seoul, Korea.
authors.forename: Hong-Yup
authors.initials: HY
authors.lastname: Ahn
mesh_terms: D000368:Aged; D019645:Arthroplasty, Replacement, Knee; D005260:Female; D006439:Hemodynamics; D006801:Humans; D048228:Intermittent Pneumatic Compression Devices; D008297:Male; D008875:Middle Aged; D013927:Thrombosis / Q000209:etiology* / Q000503:physiopathology* / Q000517:prevention & control*
keywords: arthroplasty; hemodynamics; intermittent pneumatic compression device; knee; venous thrombosis