No advantage for adding intermittent pneumatic compression to thromboprophylaxis of DVT

No advantage for adding intermittent pneumatic compression to thromboprophylaxis of DVT: PREVENT Trial

Intermittent pneumatic compression of calf muscles is often given to postoperative patients who are bedridden, to prevent deep vein thrombosis (DVT). It is also used in critically ill medical patients who are similarly bedridden, both in the intensive care unit and in the wards. PREVENT Trial [1] addressed whether it gives an additional advantage over and above pharmacological thromboprophylaxis when the two are combined. Using intermittent pneumatic compression alone when pharmacological thromboprophylaxis is contra-indicated, has been recommended by guidelines. Sometimes the two modalities are combined in the hope of giving better protection as DVT may develop in 5-20% of critically ill patients who are given pharmacological thromboprophylaxis.

In the multi-country, multi-centric PREVENT Trial, it was found that adjunctive intermittent pneumatic compression added to pharmacological thromboprophylaxis provided no added protection.

Reference

1. Arabi YM, Al-Hameed F, Burns KEA, Mehta S, Alsolamy SJ, Alshahrani MS, Mandourah Y, Almekhlafi GA, Almaani M, Al Bshabshe A, Finfer S, Arshad Z, Khalid I, Mehta Y, Gaur A, Hawa H, Buscher H, Lababidi H, Al Aithan A, Abdukahil SAI, Jose J, Afesh LY, Al-Dawood A; Saudi Critical Care Trials Group. Adjunctive Intermittent Pneumatic Compression for Venous Thromboprophylaxis. N Engl J Med. 2019 Feb 18. doi: 10.1056/NEJMoa1816150. [Epub ahead of print]