Role of thrombelastograph haemostasis analyser in detection of hypercoagulability following surgery with and without use of intermittent pneumatic compression.

 



Lee BY, Butler G, Al-Waili N, Herz B, Savino J, Delguercio LR, Garcia J, Al-Waili A, Al-Waili D.

J Med Eng Technol. 2010 Apr;34(3):166-71.

 

The effect of using intermittent pneumatic compression on incidence of postoperative thromboembolic events was studied, and hypercoagulability following various kinds of surgery with or without use of intermittent pneumatic compression was evaluated with the use of a thrombelastograph. The study included 317 male patients undergoing various surgical procedures; 193 patients used intermittent pneumatic compression after surgery and 124 did not use intermittent pneumatic compression. Their ages ranged between 52 and 75 years. Thrombelastograph was used to detect hypercoagulability. Results showed that in patients using intermittent pneumatic compression, 67% of the hip surgery patients had hypercoagulability one to three days postoperatively, as did 34% having major thoracic or abdominal procedures and 18% in the remaining general surgery. Of 18 hip surgery patients who did not use intermittent pneumatic compression, 10 sustained thromboembolic complications following operation. Three deaths resulted from pulmonary embolism. For the remaining 106 patients who did not use intermittent pneumatic compression, seven patients manifested Deep venous thrombosis (DVT) and pulmonary embolism, and three deaths resulted from pulmonary embolism. There was no incident of thromboembolic complications for the 24 patients with hip surgery who used the intermittent pneumatic compression. There were no complications following various surgical procedures in the 169 patients who used intermittent pneumatic compression. It might be concluded that the thrombelastograph is useful to detect hypercoagulability postoperatively, and intermittent pneumatic compression is useful for thromboembolic prophylaxis.