Strup SE, Gudziak M, Mulholland SG, Gomella LG.
The effect of intermittent pneumatic compression devices on intraoperative blood
loss during radical prostatectomy and radical eystectomy.
J Urol 1993 Oct;150(4):1176-8

Department of Urology, Jefferson Medical College, Philadelphia, Pennsylvania 19107.

Intermittent pneumatic compression devices are a widely used, effective and
presumed risk-free method of deep venous thrombosis prophylaxis, presumably by
increasing peak venous blood velocity, and stimulating local and systemic
fibrinolysis. We investigated whether intermittent pneumatic compression devices
had any effect on intraoperative blood loss or transfusion during radical pelvic
urological surgery. To our knowledge no previous study has addressed these
issues. Records were reviewed for patients undergoing radical retropubic
prostatectomy or radical cystectomy with diversion from 1985 to 1990. A total of
91 cases was reviewed: 38 radical retropubic prostatectomies and 53 radical
cystectomies with diversion (34 male and 19 female patients). There were 59
patients with intermittent pneumatic compression devices (29 radical retropubic
prostatectomies and 30 radical cystectomies with diversion) and 32 without
intermittent pneumatic compression devices (9 radical retropubic prostatectomies
and 23 radical cystectomies with diversion). Intraoperative blood loss and
transfusions were calculated for each group with and without intermittent
pneumatic compression devices. No clinically apparent lower extremity deep venous
thrombosis or pulmonary embolus was diagnosed in any patient. For the group with
intermittent pneumatic compression devices mean intraoperative blood loss was
2,541 ml. (range 700 to 8,850) versus 1,807 ml. (range 450 to 5,100) without a
device, for a statistically significant difference of 734 ml. (p = 0.005). When 5
patients with excessive intraoperative blood loss (more than 5,000 ml.) were
excluded the statistically significant difference was maintained. When comparing
radical retropubic prostatectomy and radical cystectomy with diversion, with and
without intermittent pneumatic compression devices, blood loss was greater for
the group with a device for each procedure. Differences in intraoperative blood
loss were independent of sex or tumor stage. Intraoperative transfusions were
increased by approximately 0.6 units per patient with the device. Our study
suggests that intermittent pneumatic compression devices may increase blood loss
during a radical pelvic operation.