Comparison of Chemical and Mechanical Prophylaxis of Venous Thromboembolism in Nonsurgical Mechanically Ventilated PatientsReport as inadecuate




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ThrombosisVolume 2015 2015, Article ID 849142, 6 pages

Research Article

Division of Pulmonary and Critical Care Medicine, Cooper University Hospital, Camden, NJ 08103, USA

Cooper Research Institute, Cooper University Hospital, Camden, NJ 08103, USA

Division of Critical Care Medicine, Cooper University Hospital, Camden, NJ 08103, USA

Received 31 August 2015; Revised 2 November 2015; Accepted 4 November 2015

Academic Editor: Giovanni de Gaetano

Copyright © 2015 Dany Gaspard et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. Thromboembolic events are major causes of morbidity, and prevention is important. We aimed to compare chemical prophylaxis CP and mechanical prophylaxis MP as methods of prevention in nonsurgical patients on mechanical ventilation. Methods. We performed a retrospective study of adult patients admitted to the Cooper University Hospital ICU between 2002 and 2010. Patients on one modality of prophylaxis throughout their stay were included. The CP group comprised 329 patients and the MP group 419 patients. The primary outcome was incidence of thromboembolic events. Results. Acuity measured by APACHE II score was comparable between the two groups . Univariate analysis showed 1 DVT-no PEs in the CP group and 12 DVTs-1 PE in the MP group . Overall mortality was 34.3% and 50.6%, respectively. ICU LOS was similar. Hospital LOS was shorter in the MP group. Multivariate analysis showed a significantly higher incidence of events in the MP prophylaxis group odds ratio 9.9. After excluding patients admitted for bleeding in both groups, repeat analysis showed again increased events in the MP group odds ratio 2.9 but this result did not reach statistical significance. Conclusion. Chemical methods for DVT-PE prophylaxis seem superior to mechanical prophylaxis in nonsurgical patients on mechanical ventilation and should be used when possible.





Author: Dany Gaspard, Karen Vito, Christa Schorr, Krystal Hunter, and David Gerber

Source: https://www.hindawi.com/



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