title: Comparison of clinical and physiological efficacies of different intermittent sequential pneumatic compression devices in preventing deep vein thrombosis: a prospective randomized study.
abstract: BACKGROUND
  There are few comparative studies about the optimal method of pneumatic compression to prevent deep vein thrombosis (DVT). The aim of this prospective randomized study was to compare venous hemodynamic changes and their clinical influences between two graded sequential compression groups (an alternate sequential compression device [ASCD] vs. a simultaneous sequential compression device [SSCD]).
  
  
  METHODS
  In total, 34 patients (68 limbs) undergoing knee and spine operations were prospectively randomized into two device groups (ASCD vs. SSCD groups). Duplex ultrasonography examinations were performed on the 4th and 7th postoperative days for the detection of DVT and the evaluation of venous hemodynamics. Continuous data for the two groups were analyzed using a two-tailed, unpaired t-test. Relative frequencies of unpaired samples were compared using Fisher exact test. Mixed effects models that might be viewed as ANCOVA models were also considered.
  
  
  RESULTS
  DVT developed in 7 patients (20.6%), all of whom were asymptomatic for isolated calf DVTs. Two of these patients were from the ASCD group (11.8%) and the other five were from the SSCD group (29.4%), but there was no significant difference (p = 0.331). Baseline peak velocity, mean velocity, peak volume flow, and total volume flow were enhanced significantly in both device groups (p < 0.001). However, the degrees of flow and velocity enhancement did not differ significantly between the groups. The accumulated expelled volumes for an hour were in favor of the ASCD group.
  
  
  CONCLUSIONS
  Both graded sequential compression devices showed similar results both in clinical and physiological efficacies. Further studies are required to investigate the optimal intermittent pneumatic compression method for enhanced hemodynamic efficacy and better thromboprophylaxis.
authors.affiliation: Department of Orthopedic Surgery, Dongguk University Ilsan Hospital, Dongguk University College of Medicine, Goyang, Korea.
authors.forename: Ki Hyoung
authors.initials: KH
authors.lastname: Koo
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, SMG-SNU Boramae Medical Center, Seoul, Korea.
authors.forename: Jae-Sung
authors.initials: JS
authors.lastname: Choi
authors.affiliation: Department of Orthopedic Surgery, Dongguk University Ilsan Hospital, Dongguk University College of Medicine, Goyang, Korea.
authors.forename: Ji Hyun
authors.initials: JH
authors.lastname: Ahn
authors.affiliation: Department of Radiology, Dongguk University Ilsan Hospital, Dongguk University College of Medicine, Goyang, Korea.
authors.forename: Jae Hyun
authors.initials: JH
authors.lastname: Kwon
authors.affiliation: Department of Neurosurgery, Dongguk University Ilsan Hospital, Dongguk University College of Medicine, Goyang, Korea.
authors.forename: Keun-Tae
authors.initials: KT
authors.lastname: Cho
mesh_terms: D000368:Aged; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects; D005592:Fracture Fixation / Q000009:adverse effects; D006439:Hemodynamics; D006801:Humans; D048228:Intermittent Pneumatic Compression Devices; D007717:Knee / Q000601:surgery; D011446:Prospective Studies; D012307:Risk Factors; D013123:Spinal Fusion / Q000009:adverse effects; D013131:Spine / Q000601:surgery; D016896:Treatment Outcome; D014463:Ultrasonography; D020246:Venous Thrombosis / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control*
keywords: Hemodynamics; Intermittent pneumatic compression device; Venous thromboembolism; Venous thrombosis