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Clincial Guidelines

Given the relatively simple and effective measures available to prevent Venous Thromboembolism (VTE) and improve patient wellness, a number of national and international best practice guidelines and technology reviews have been developed through systematic literature review and expert consensus (1-7).

These documents recognise that Intermittent Pneumatic Compression (IPC) devices, such as the Flowtron® IPC, have a robust evidence base and provide a safe and effective therapeutic option for a wide range of patients.

General consensus indicates

  • IPC is effective as a stand alone therapy, and when used in combination with other forms of prophylaxis. 
  • It does not increase the risk of bleeding, so it is particularly useful for patients in whom anticoagulation is a risk or contraindicated (4). 

Specific indications

  • IPC is more effective than antiembolic stockings when anticoagulation is contraindicated [5]
  • Reduces the risk of asymptomatic DVT (6).

Independent technology review

  • IPC is effective in general, but no evidence has been found demonstrating that any one type of IPC therapy or device is superior. Device selection should take into account comfort, safety and ease of use. The Flowtron Universal received the highest overall rating in 2007 and 2009 (7).

References

  1. National Institute for Health and Clinical Excellence. Clinical Guideline 92 Venous thromboembolism: Reducing the risk. http://www.nice.org.uk/CG092.
  2. National Health and Medical Research Council. Clinical practice guidelines for the prevention of venous thromboembolism (deep vein thrombosis and pulmonary embolism) in patients admitted to Australian hospitals. Melbourne: National Health and Medical Research Council. 2009 http://www.nhmrc.gov.au/guidelines/publications/cp115
  3. Geerts WH, Bergqvist D, Pineo GF et al. Prevention of venous thromboembolism: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th edition). Chest. 2008; 133 (6 suppl): 381S–453S.
  4. Cohen AT, Tapson VF, Bergman J-F et al. Venous thromboembolism and prophylaxis in the acute hospital setting (ENDORSE study): a multinational cross-sectional study. Lancet. 2008; 371: 387-394.
  5. Australia and New Zealand Working Party on the Management and Prevention of Venous Thromboembolism. Prevention of venous thromboembolism best practice guidelines for Australia and New Zealand, 4th ed. Health Education and Management Innovations, Sydney. 2007
  6. Nicolaides AN, Fareed J, Kakkar AK et al. Prevention and treatment of venous thromboembolism. International Consensus Statement (Guidelines according to scientific evidence). Int Angiol. 2006; 25: 101-161. 
  7. ECRI Institute. Intermittent pneumatic compression device evaluation. Health Devices. USA. 2007; 36(6): 177-204.

Pathophysiology of VTE

Venous thrombus formation and propagation is associated with one or more of the elements collectively known as Virchow’s triad.

Read more about pathophysiology of VTE