Can Intermittent Pneumatic Compression Reduce the Incidence of Venous Thrombosis in Critically Ill Patients: A Systematic Review and Meta-Analysis

Venous thromboembolism (VTE) is a common complication for critically ill patients. Intermittent pneumatic compression (IPC) is recommended for patients with high risk of bleeding. We aim to evaluate the effectiveness of IPC for thromboprophylaxis in critically ill patients. We searched PubMed, Embase, and ClinicalTrials for randomized controlled trials (RCTs) and observational studies that evaluated IPC in critically ill patients. RevMan 5.3 software was used for the meta-analysis. A total of 10 studies were included. The IPC group significantly reduced the VTE incidence compared with no thromboprophylaxis group (risk ratio [RR]: 0.35, confidence interval [CI]: 0.18-0.68, P = .002) and the IPC group also showed lower VTE incidence than the graduated compression stockings (GCS) group (RR: 0.47, CI: 0.24-0.91, P = .03). There were no significant differences between using IPC and low-molecular-weight heparin (LMWH) for VTE incidence (RR: 1.26, CI: 0.72-2.22, P = .41), but LMWH showed significantly more bleeding events. Intermittent pneumatic compression as an adjunctive treatment did not further reduce VTE incidence (RR: 0.55, CI: 0.24-1.27, P = .16). Intermittent pneumatic compression can reduce the incidence of VTE for critically ill patients, which is better than GCS and similar to LMWH, but it has no significant advantage as an adjunct therapy for thromboprophylaxis.

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777-P: Enteral Nutrition in Critically Ill Patients with Hyperglycemia: A Meta-analysis of Randomized Controlled Trials with Trial Sequential Analysis

Diabetes ◽

10.2337/db19-777-p ◽

2019 ◽

Vol 68 (Supplement 1) ◽

pp. 777-P

Author(s):

MAGALI KUMBIER ◽

FLAVIA MORAES SILVA ◽

LANA C. PINTO ◽

JUSSARA ALMEIDA ◽

FRANZOSI OELLEN

Keyword(s):

Enteral Nutrition ◽

Randomized Controlled Trials ◽

Critically Ill ◽

Critically Ill Patients ◽

Sequential Analysis ◽

Meta Analysis ◽

Trial Sequential Analysis ◽

Controlled Trials ◽

Randomized Controlled

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Rotational Bed Therapy to Prevent and Treat Respiratory Complications: A Review and Meta-Analysis

American Journal of Critical Care ◽

10.4037/ajcc2007.16.1.50 ◽

2007 ◽

Vol 16 (1) ◽

pp. 50-61 ◽

Cited By ~ 53

Author(s):

David R. Goldhill ◽

Michael Imhoff ◽

Barbara McLean ◽

Carl Waldmann

Keyword(s):

Mechanical Ventilation ◽

Randomized Controlled Trials ◽

Critically Ill ◽

Critically Ill Patients ◽

Meta Analysis ◽

Convincing Evidence ◽

Controlled Trials ◽

Respiratory Complications ◽

Randomized Controlled ◽

Meta Analyses

• Background Immobility is associated with complications involving many body systems. • Objective To review the effect of rotational therapy (use of therapeutic surfaces that turn on their longitudinal axes) on prevention and/or treatment of respiratory complications in critically ill patients. • Methods Published articles evaluating prophylaxis and/or treatment were reviewed. Prospective randomized controlled trials were assessed for quality and included in meta-analyses. • Results A literature search yielded 15 nonrandomized, uncontrolled, or retrospective studies. Twenty prospective randomized controlled trials on rotational therapy were published between 1987 and 2004. Various types of beds were studied, but few details on the rotational parameters were reported. The usual control was manual turning of patients by nurses every 2 hours. One animal investigation and 12 clinical trials addressed the effectiveness of rotational therapy in preventing respiratory complications. Significant benefits were reported in the animal study and 4 of the trials. Significant benefits to patients were reported in 2 of another 4 studies focused on treatment of established complications. Researchers have examined the effects of rotational therapy on mucus transport, intrapulmonary shunt, hemodynamic effects, urine output, and intracranial pressure. Little convincing evidence is available, however, on the most effective rotation parameters (eg, degree, pause time, and amount of time per day). Meta-analysis suggests that rotational therapy decreases the incidence of pneumonia but has no effect on duration of mechanical ventilation, number of days in intensive care, or hospital mortality. • Conclusions Rotational therapy may be useful for preventing and treating respiratory complications in selected critically ill patients receiving mechanical ventilation.

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