Ramos R, Salem BI, De Pawlikowski MP, Coordes C, Eisenberg S, Leidenfrost R.
The efficacy of pneumatic compression stockings in the prevention of pulmonary
embolism after cardiac surgery.
Chest 1996 Jan;109(1):82-5

Department of Cardiology, St. Luke's Hospital, Chesterfield, Md, USA.

INTRODUCTION: Pneumatic compression stocking (PCS) devices have been introduced
to decrease the incidence of postoperative deep venous thrombosis (DVT). However,
their role in the prophylaxis against pulmonary embolism (PE) remains unclear.
This study was undertaken to compare the prophylactic effectiveness of
subcutaneous heparin (SCH) alone vs the combined use of PCS and SCH in the
prevention of PE following cardiac surgery. METHODS: We studied 2,551 consecutive
patients who underwent cardiac surgery over a 10-year period. They were randomly
allocated to two groups. Group A included 1,196 patients who were treated with
5,000 U of SCH every 12 h and group B included 1,355 patients treated with a
combined prophylactic regimen of PCS and SCH. RESULTS: The diagnosis of PE was
established in 69 patients by either high-probability ventilation perfusion scan,
pulmonary angiogram, or autopsy. The incidence of PE in group A patients was 4%
(48/1,196) and in group B was 1.5% (21/1,355). The concomitant use of bilateral
PCS and SCH reduced the frequency of postoperative PE in 62% in comparison to the
prophylaxis with SCH alone (p < 0.001). CONCLUSIONS: These data suggest that the
combined prophylactic method of bilateral PCS and SCH is superior to SCH alone in
the prevention of PE after cardiac surgery.