Shahbaz Aaisha, Wannakuwatte Randev A, Mohammed Cara, Alzarooni Abdulaziz, Pendem Harini, Majeed Farhat, Kuruba Venkataramana, Metry Sherien, Mahajan Tanvi, Reza Hasim, Benjamen Mariam, Rai Manju
Trauma and Orthopedic Surgery, University Hospitals Birmingham, Birmingham, GBR.
Surgery, Grodno State Medical University, Grodno, BLR.
Cureus. 2024 Oct 1;16(10):e70639. doi: 10.7759/cureus.70639. eCollection 2024 Oct.
Deep vein thrombosis (DVT) is a critical complication and concern in hospitalized patients due to its significant morbidity and mortality. Given the complex and multifaceted pathophysiology surrounding DVT formation, patients who have had surgical interventions faced acute or chronic trauma and prolonged immobility are at substantially high risk. Identifying these risk factors early is essential for early intervention and prophylaxis. Current standard-of-care prophylaxis for DVT includes pharmacological agents such as anticoagulants, and recently, there has been an increase in the use of mechanical medical devices such as sequential compression devices (SCDs). Pharmacological prophylaxis, while shown to be effective in some patients, carries certain risks of complications such as bleeding. SCDs offer a safer and more effective approach for these patients. SCDs function by artificially replicating the "pumping mechanism" present in the soleus muscle to enhance venous return and reduce stasis. Various types of SCDs, namely intermittent pneumatic compression and graduated compression stockings, have demonstrated clinical efficacy when used as an adjunctive intervention with anticoagulant medications. This narrative review explores the pathophysiology, risk factors, and prophylactic measures for DVT, focusing on the use of SCDs as a non-pharmacological intervention. Through synthesizing evidence from various studies obtained from PubMed, MEDLINE, and Cochrane Library and evaluating the benefits and limitations of SCD use, this review highlights the need for tailored prophylactic strategies, considering patient-specific risk factors and preferences.
深静脉血栓形成(DVT)是住院患者中一种严重的并发症,因其具有较高的发病率和死亡率而备受关注。鉴于DVT形成的病理生理学复杂且多方面,接受手术干预、面临急性或慢性创伤以及长期制动的患者风险极高。早期识别这些风险因素对于早期干预和预防至关重要。目前DVT的标准护理预防措施包括使用抗凝剂等药物,最近,序贯加压装置(SCDs)等机械医疗设备的使用有所增加。药物预防虽然在一些患者中显示有效,但存在出血等并发症的风险。SCDs为这些患者提供了一种更安全、更有效的方法。SCDs通过人工复制比目鱼肌中存在的“泵机制”来增强静脉回流并减少血液淤积。各种类型的SCDs,即间歇性气动压迫装置和分级加压弹力袜,在与抗凝药物联合使用时已显示出临床疗效。这篇叙述性综述探讨了DVT的病理生理学、风险因素和预防措施,重点关注SCDs作为一种非药物干预措施的应用。通过综合从PubMed、MEDLINE和Cochrane图书馆获取的各种研究证据,并评估使用SCDs的益处和局限性,本综述强调了考虑患者特定风险因素和偏好制定个性化预防策略的必要性。