From the Journals

Supplementary compression doesn’t improve DVT odds in critically ill


 

REPORTING FROM CCC48

The proportion of patients receiving unfractionated heparin versus low-molecular-weight heparin was similar between the two groups, with about 58% treated with unfractionated heparin.

A total of 3.9% of patients in the pneumatic compression group experienced incident proximal DVT, compared with 4.2% of controls (relative risk, 0.93; P =.74). A total of 3.4% experienced prevalent proximal DVT, compared with 2.7% of controls (RR, 1.29; 95% confidence interval, 0.78-2.12). There was no significant difference in the incidence of any lower-limb DVT (9.6% vs. 8.4%; RR, 1.14; 95% CI, 0.86-1.51).

There was no difference between the two groups in a composite outcome that included pulmonary embolism or all prevalent and incident lower-limb DVT (RR, 1.11; 95% CI, 0.85-1.44), and there were no between-group differences with respect to lower-limb skin injury or ischemia.

The results should change practice among those who still provide adjunct intermittent pneumatic compression, however surprising physicians may find these new results to be, according to Dr. Arabi: “People believed strongly that (adjunct IPC) should work, but you need to be evidence based, and here it showed no difference. But that’s why we do studies, right?”

The study was funded by King Abdulaziz City for Science and Technology and King Abdullah International Medical Research Center. Dr. Arabi has no relevant financial conflicts.

SOURCE: Arabi Y et al. CCC48, Abstract 142. N Engl J Med Feb 18. doi: 10.1056/NEJMoa1816150.

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