Reference Search

Current Recommendations for Prevention of Deep Venous Thrombosis

Source:
Heit JA. Handbook of Venous Disorders 2nd Edition Chapter 23: 224–234, 2001

Summary:
This chapter identifies risk factors for venous thromboembolism (VTE) and provides an overview of the efficacy and safety of prophylaxis regimens for DVT prophylaxis. Intermittent pneumatic compression (IPC) is “useful as either primary prophylaxis or as an adjunct combined with anticoagulant prophylaxis... IPC is an attractive prophylaxis option for multiple trauma patients or medical patients in whom anticoagulant-based prophylaxis is contraindicated due to active bleeding, or surgery in which even minimal bleeding could be catastrophic (i.e., neurosurgery or spinal surgery).” Moderate, high and very high risk general and vascular surgery recommendations included IPC as primary defense or component of combination therapy. “IPC is the most effective nonpharmacological prophylaxis for total knee replacement patients. IPC may provide a risk reduction that is similar to LMWH [low molecular weight heparin].”

As for timing of IPC application, it is recommended that ”IPC should be initiated preoperatively if possible, and continued until the patient is fully ambulatory.”