Mechanical Thromboprophylaxis in Critically Ill Patients: a systematic review and meta-analysis

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Title Mechanical Thromboprophylaxis in Critically Ill Patients: a systematic review and meta-analysis
Author Limpus, Anthony; Chaboyer, Wendy; McDonald, Ellen; Thalib, Lukman
Journal Name American Journal of Critical Care
Year Published 2006
Place of publication United States
Publisher American Association of Critical Care Nurses
Abstract Objective To systematically review the randomized trials, observational studies, and survey evidence on compression and pneumatic devices for thromboprophylaxis in intensive care patients. Methods Published studies on the use of compression and pneumatic devices in intensive care patients were assessed. A meta-analysis was conducted by using the randomized controlled trials. Results A total of 21 relevant studies (5 randomized controlled trials, 13 observational studies, and 3 surveys) were found. A total of 811 patients were randomized in the 5 randomized controlled trials; 3421 patients participated in the observational studies. Trauma patients only were enrolled in 4 randomized controlled trials and 4 observational studies. Meta-analysis of 2 randomized controlled trials with similar populations and outcomes revealed that use of compression and pneumatic devices did not reduce the incidence of venous thromboembolism. The pooled risk ratio was 2.37, indicative of favoring the control over the intervention in reducing the deep venous thrombosis; however, the 95% CI of 0.57 to 9.90 indicated no significant differences between the intervention and the control. A range of methodological issues, including bias and confounding variables, make meaningful interpretation of the observational studies difficult. Conclusions The limited evidence suggests that use of compressive and pneumatic devices yields results not significantly different from results obtained with no treatment or use of low-molecular-weight heparin. Until large randomized controlled trials are conducted, the role of mechanical approaches to thromboprophylaxis for intensive care patients remains uncertain.
Peer Reviewed Yes
Published Yes
Publisher URI
Copyright Statement Self-archiving of the author-manuscript version is not yet supported by this journal. Please refer to the journal link for access to the definitive, published version or contact the author[s] for more information.
Volume 15
Issue Number 4
Page from 402
Page to 410
ISSN 1062-3264
Date Accessioned 2007-02-14
Date Available 2015-02-04T04:26:45Z
Language en_US
Research Centre Centre for Health Practice Innovation; Menzies Health Institute Qld
Faculty Griffith Health Faculty
Subject PRE2009-Clinical Nursing: Secondary (Acute Care)
Publication Type Journal Articles (Refereed Article)
Publication Type Code c1

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