Murakami M, McDill TL, Cindrick-Pounds L, Loran DB, Woodside KJ, Mileski WJ, Hunter GC, Killewich LA.
Deep venous thrombosis prophylaxis in trauma: improved compliance
with a novel miniaturized pneumatic compression device.
J Vasc Surg. 2003 Nov;38(5):923-7.

Section of Vascular Surgery, Department of Surgery, University of
Texas Medical Branch, Galveston, 77555-0541, USA.
OBJECTIVE: Intermittent pneumatic compression (IPC) devices
prevent lower-extremity deep venous thrombosis (LEDVT) when
used properly, but compliance remains an issue. Devices are
frequently discontinued when patients are out of bed, and they are
rarely used in emergency departments. Trauma patients are at high
risk for LEDVT; however, IPCs are underused in this population
because of compliance limitations. The hypothesis of this study
was that a new miniaturized, portable, battery-powered pneumatic
compression device improves compliance in trauma patients over
that provided by a standard device. METHODS: This was a
prospective trial in which trauma patients (mean age, 46 years;
revised trauma score, 11.7) were randomized to DVT prophylaxis
with a standard calf-length sequential IPC device (SCD group) or
a miniaturized sequential device (continuous enhanced-circulation
therapy [CECT] group). The CECT device can be battery-operated
for up to 6 hours and worn during ambulation. Timers attached to
the devices, which recorded the time each device was applied to
the legs and functioning, were used to quantify compliance. For
each subject in each location during hospitalization, compliance
rates were determined by dividing the number of minutes the device was functioning by the total minutes in that location.
Compliance rates for all subjects were averaged in each location:
emergency department, operating room, intensive care unit, and
nursing ward. RESULTS: Total compliance rate in the CECT
group was significantly higher than in the SCD group (77.7% vs.
58.9%, P =.004). Compliance in the emergency department and
nursing ward were also significantly greater with the CECT device
(P =.002 and P =.008 respectively). CONCLUSIONS: Previous
studies have demonstrated that reduced compliance with IPC
devices results in a higher incidence of LEDVT. Given its ability
to improve compliance, the CECT may provide superior DVT
prevention compared with that provided by standard devices.