Department of Respiratory and Critical Care Medicine, West China School of Medicine and West China Hospital, Sichuan University, Chengdu, Sichuan, China.
Clin Appl Thromb Hemost. 2020 Jan-Dec;26:1076029620913942. doi: 10.1177/1076029620913942.
Venous thromboembolism (VTE) is a common complication for critically ill patients. Intermittent pneumatic compression (IPC) is recommended for patients with high risk of bleeding. We aim to evaluate the effectiveness of IPC for thromboprophylaxis in critically ill patients. We searched PubMed, Embase, and ClinicalTrials for randomized controlled trials (RCTs) and observational studies that evaluated IPC in critically ill patients. RevMan 5.3 software was used for the meta-analysis. A total of 10 studies were included. The IPC group significantly reduced the VTE incidence compared with no thromboprophylaxis group (risk ratio [RR]: 0.35, confidence interval [CI]: 0.18-0.68, = .002) and the IPC group also showed lower VTE incidence than the graduated compression stockings (GCS) group (RR: 0.47, CI: 0.24-0.91, = .03). There were no significant differences between using IPC and low-molecular-weight heparin (LMWH) for VTE incidence (RR: 1.26, CI: 0.72-2.22, = .41), but LMWH showed significantly more bleeding events. Intermittent pneumatic compression as an adjunctive treatment did not further reduce VTE incidence (RR: 0.55, CI: 0.24-1.27, = .16). Intermittent pneumatic compression can reduce the incidence of VTE for critically ill patients, which is better than GCS and similar to LMWH, but it has no significant advantage as an adjunct therapy for thromboprophylaxis.
静脉血栓栓塞症（VTE）是危重症患者的常见并发症。对于有高出血风险的患者，推荐使用间歇气动压迫（IPC）。我们旨在评估 IPC 对危重症患者血栓预防的有效性。我们检索了 PubMed、Embase 和 ClinicalTrials 中评价 IPC 用于危重症患者的随机对照试验（RCT）和观察性研究。采用 RevMan 5.3 软件进行荟萃分析。共纳入 10 项研究。IPC 组与无血栓预防组相比，VTE 发生率显著降低（风险比 [RR]：0.35，置信区间 [CI]：0.18-0.68， =.002），IPC 组也低于梯度压力袜（GCS）组（RR：0.47，CI：0.24-0.91， =.03）。IPC 与低分子肝素（LMWH）用于 VTE 发生率的差异无统计学意义（RR：1.26，CI：0.72-2.22， =.41），但 LMWH 出血事件明显更多。IPC 作为辅助治疗并未进一步降低 VTE 发生率（RR：0.55，CI：0.24-1.27， =.16）。间歇气动压迫作为辅助治疗并不能进一步降低 VTE 发生率，其疗效与 GCS 相当，与 LMWH 相近，但作为血栓预防的辅助治疗并无显著优势。
