Mechanical DVT prophylaxis devices

This was vaguely mentioned in the discussion of Question 4 from the first paper of 2003, "Critically evaluate the strategies for prevention of deep venous thrombosis in the critically ill.".

Sequential / intermittent compression devices

• inflation pressures:
  — up to 50 mmHg at the knee
  — up to 35 mmHg at the calf
  —up to 30 mmHg at the thigh
• 10 seconds inflated, then 60 seconds deflated.
• Intermittent compression stockings are better than nothing according to a recent prospective cohort study.

Complications

• Pressure areas
• Worsening limb perfusion
• Worsening compartment syndrome
• Potential to dislodge an existing DVT

TEDS (Thromboembolism Deterrent Stockings)

Complications

• Pressure areas
• Worsening limb perfusion
• Worsening compartment syndrome
• Potential to dislodge an existing DVT

Evidence:

• Compression stockings in the ICU are purely decorative
• In the general hospital population they are better than nothing
• They have a cumulative benefit when used together with other methods of DVT prophylaxis.