![]() ![]() While recognized as an effective thrombophylactic strategy, the role of mechanical compression in the setting of an acute distal DVT remains a debatable issue that has not been well-established in current literature. Studies have demonstrated their effectiveness in the prophylaxis against DVT combined with a pharmacologic agent and singly as a standalone strategy 15-19. These methods have been used in DVT prophylaxis involving a spectrum of patients, including the medically ill, trauma patients, and those undergoing elective total hip and total knee arthroplasty. No mechanical device has been demonstrated to be superior to the other 10-14. The various types of MCD could vary by the speed of cuff inflation, duration of compression, duration of deflation, as well as fixed cycle vs. These devices exert their prophylactic effect by decreasing peripheral venous stasis and promoting endogenous fibrinolysis, both contributing to a continuous blood flow and potential clot dissolution 1, 4. The use of MCD has ranged from intermittent pneumatic compression (IPC), and sequential compression of the calves and thighs to plantar compression pumps and even compression sleeves applied to the upper extremities 9. Mechanical compression devices (MCD) are an alternative prophylactic measure that has been recommended in recent guidelines, mainly as a combined approach with chemoprophylaxis in high-risk patients 6-8. Pharmacological methods presented in current guidelines considerably reduce the risk of VTE, as has been evidenced in most clinical situations through all the available studies 1, 2. ![]() ![]() For this reason, significant effort has been placed over the years on studying prophylactic alternatives for VTE, such as chemoprophylaxis and mechanical prophylaxis 5. However, this method is not always feasible in some individuals, such as critically ill or traumatic patients. The oldest and simplest VTE prophylactic approach is early mobilization 1. These events result from the dynamic influence of 3 factors: hypercoagulability, venous stasis, and endovascular injury, commonly recognized as the Virchow’s triad 3, 5. Critically ill patients and those that underwent major surgical interventions are at a particularly increased risk of VTE, i.e., DVT and pulmonary embolism (PE) 2, 5. It represents a common complication for hospitalized patients that could prolong hospital stay and significantly cause increased morbidity and mortality 1-4. Rationale: Venous thromboembolism (VTE) constitutes a major interdisciplinary challenge in health care 1. Response/Recommendation: The practitioner might continue the mechanical compression device in patients with an acute distal deep venous thrombosis (DVT), in combination with the DVT treatment protocol (anticoagulation) recommended in current guidelines. Torres-Lugo, Roberto Colón-Miranda, Ruben Tresgallo-Parés. Kwong, David Beatón-Comulada, Norberto J. Pedro Tort-Saade, Antonio Otero-López, Louis M. ![]()
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