![]() ![]() The mean age was 66 years in ASCD and was 71 years in SSCD. Patients were randomized with a computerized tool. SSCD), with 68 limbs used in the physiological study. They were prospectively randomized into two different device groups (ASCD vs. SSCD).Īfter Institutional Review Board approval, 34 patients who underwent knee and spine operations and had a moderate or higher risk of VTE were enrolled in this study. Thus, our hypothesis is that a SSCD will be superior to an ASCD and the aim of this prospective randomized study was to compare the venous hemodynamic changes and their clinical influences between the two graded sequential compression groups (ASCD vs. 14, 15, 16) However, there is a theoretical presumption that simultaneous sequential compression of both legs (SSCD) may be superior to alternate compression in the effort to augment venous return and to improve hemodynamics, which seemed to be true from the results of our pilot study comparing hemodynamic data from four normal adult volunteers. 13) Moreover, it has been asked whether this refill time-adjusted compression works optimally throughout the duration of IPC, considering that venous hemodynamics can change with irregular intervals and vary depending on position, postoperative day, and the activity of the subjects. The SCD Express provided alternate sequential compression with customized compression-relaxation cycles in accordance with an individual's separate venous refill times in their lower limbs, but does not provide simultaneous bilateral compression in the limbs. A recent study using a new sequential compression device (SCD Express, Tyco Healthcare, Kendall, MA, USA) showed promising venous hemodynamic performance. They are alternate sequential compression device (ASCD) that can compress limbs alternately and simultaneous sequential compression device (SSCD) that can compress both limbs simultaneously and sequentially. There are two general types of sequential compression devices. 7, 8, 9, 10, 11, 12) Despite more than 30 years of experience using IPC to prevent DVT, there are still controversies about its physiological properties and the clinical impact of numerous issues, including the variety of cuff length, inflation rate, compression sequence, compression-relaxation cycle rate, and pressure generation characteristics. Many investigators in favor of IPC use have suggested an increased venous flow and enhanced fibrinolytic activity as possible mechanisms for VTE prevention and have demonstrated that the mechanism can be influenced by the different types of IPC devices. 4, 5, 6) IPC is now used increasingly because it is a good alternative to anticoagulation and is chosen primarily in patients at high risk of bleeding. Intermittent pneumatic compression (IPC) is a relatively well-studied mechanical thromboprophylaxis modality with much evidence for its efficacy, although it has been studied much less intensively than anticoagulation-based prevention methods. 2, 3) Although approximately two-thirds of all VTE events result from hospitalization, only one-third of all hospitalized patients at risk receive adequate prophylactic treatment. Most of the literature and international guidelines on VTE emphasize that prevention is more important and cost-effective than treatment, because once VTE develops, it can only be cured at considerable expense. It can lead to severe morbidity with poor quality of life and even sudden death related to PE. Venous thromboembolism (VTE) is a common and potentially lethal disease that includes both deep vein thrombosis (DVT) and pulmonary embolism (PE). ![]()
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