Volume 52, Issue 4 p. 397-405
Original Manuscript

Adjunctive Intermittent Pneumatic Compression in Hospitalized Patients Receiving Pharmacologic Prophylaxis for Venous Thromboprophylaxis: A Systematic Review and Meta-Analysis

Chaofeng Fan BS

Chaofeng Fan BS

Senior nurse, West China Hospital, Sichuan University, Chengdu, Sichuan, China

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Lu Jia PhD

Lu Jia PhD

Associate Professor, Shanxi Provincial People's Hospital, Taiyuan, Shanxi, China

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Fang Fang PhD

Corresponding Author

Fang Fang PhD

Professor, West China Hospital, Sichuan University, Chengdu, Sichuan, China

Correspondence

Dr. Fang Fang, West China Hospital, Sichuan University, No. 37, Guo Xue Xiang, Chengdu, Sichuan, 610041, China.

E-mail: [email protected]

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Yu Zhang MD

Yu Zhang MD

Research Associate, Affiliated Hospital of Chengdu University, Chengdu, Sichuan, China

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Andrew Faramand MD

Andrew Faramand MD

Resident, University of Pittsburgh Medical Center, Pittsburgh, PA, USA

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Weelic Chong MD

Weelic Chong MD

Resident, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA

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Yang Hai MD

Yang Hai MD

Resident, Zucker School of Medicine at Hofstra/Northwell, New York, NY, USA

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First published: 29 May 2020
Citations: 6

Abstract

Objectives

This study assessed the effect of adjunctive intermittent pneumatic compression (IPC) on venous thromboembolism incidence in hospitalized patients receiving pharmacologic thromboprophylaxis.

Methods

We searched Medline, Embase, and the Cochrane Central Register with no language restrictions from inception until May 15, 2019, for randomized clinical trials comparing adjunctive IPC in pharmacologic thromboprophylaxis and pharmacologic thromboprophylaxis for venous thromboembolism. Two researchers extracted data from published reports independently. A meta-analysis was conducted to calculate the risk ratio (RR) using random-effects models. Primary outcomes were deep venous thrombosis (DVT) and pulmonary embolism (PE).

Results

Eight trials with a total of 7,354 participants were eligible for analysis. Addition of IPC to pharmacologic prophylaxis compared to pharmacologic prophylaxis alone reduced the risk of DVT by 43% (RR 0.57, 95% confidence interval [CI] 0.35–0.93; I2 = 0%), with benefit only seen in surgical patients (RR 0.30, 95% CI 0.15–0.59; I2 = 0%) and not in medical patients (RR 0.80, 95% CI 0.60–1.07; I2 = 0%; p for interaction = .008). Addition of IPC reduced the risk for PE by 54% (RR 0.46, 95% CI 0.30–0.72; I2 = 0%), with benefit only seen in surgical patients (RR 0.40, 95% CI 0.24–0.65; I2 = 0%) and not in medical patients (RR 0.82, 95% CI 0.32–2.26; I2 = 0%; p for interaction = .18)

Conclusions

Addition of IPC to pharmacologic prophylaxis confers moderate benefit on venous thromboembolism, with benefit confined to surgical patients. For medical patients, there was a trend toward reduced DVT with adjunctive IPC, which warrants further investigation.

Clinical Relevance

Venous thromboembolism is not unusual among hospitalized patients despite pharmacologic thromboprophylaxis. Nursing personnel should use adjunctive IPC in surgical patients receiving pharmacologic thromboprophylaxis to prevent venous thromboembolism.