Intermittent pneumatic compression to prevent venous thromboembolism in patients with high risk of bleeding hospitalized in intensive care units: the CIREA1 randomized trial

@article{Vignon2013IntermittentPC,
  title={Intermittent pneumatic compression to prevent venous thromboembolism in patients with high risk of bleeding hospitalized in intensive care units: the CIREA1 randomized trial},
  author={Philippe Vignon and Pierre François Dequin and Anne Renault and Armelle Mathonnet and Nicolas Paleiron and Audrey Imbert and Delphine Chatellier and Val{\'e}rie Gissot and Gw{\'e}na{\"e}lle Lh{\'e}ritier and Victor Aboyans and Gw{\'e}na{\"e}l Prat and Denis Garot and Thierry Boulain and J. L. Diehl and Luc Bressollette and Aur{\'e}lien Delluc and Karine Lacut and The Scandinavian Critical Care Trials Group},
  journal={Intensive Care Medicine},
  year={2013},
  volume={39},
  pages={872-880}
}
PurposeVenous thromboembolism (VTE) is a frequent and serious problem in intensive care units (ICU). Anticoagulant treatments have demonstrated their efficacy in preventing VTE. However, when the bleeding risk is high, they are contraindicated, and mechanical devices are recommended. To date, mechanical prophylaxis has not been rigorously evaluated in any trials in ICU patients.MethodsIn this multicenter, open-label, randomized trial with blinded evaluation of endpoints, we randomly assigned… 
Meta-Analysis of the Role of Intermittent Pneumatic Compression of the Lower Limbs to Prevent Venous Thromboembolism in Critically Ill Patients
TLDR
Among critically ill patients, IPC alone, anticoagulation alone, and IPC with anticoAGulation were associated with a significant reduction of VTE and DVT incidence compared with no treatment, however, there was no significant difference between these modalities when compared together.
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European guidelines on perioperative venous thromboembolism prophylaxis: Intensive care.
TLDR
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European guidelines on perioperative venous thromboembolism prophylaxis: Mechanical prophylaxis.
TLDR
This work recommends against the use of GCS alone without pharmacological thromboprophylaxis for prevention of VTE in patients at intermediate and high risk and suggests combined mechanical and pharmacological prophylaxis in selected patients at very high risk of V TE proplylaxis.
Pharmacological and Mechanical Thromboprophylaxis in Critically Ill Patients: a Network Meta-Analysis of 12 Trials
TLDR
A meta-analysis of randomized controlled trials that compared the overall incidence of deep vein thrombosis (DVT) for between unfractionated heparin (UFH), low-molecular-weight heparine (LMWH), and intermittent pneumatic compression (IPC) in critically ill patients found the incidence of DVT was significantly lower in patients treated with UFH than in patients treating with LMWH.
Venous thromboembolism in the ICU: main characteristics, diagnosis and thromboprophylaxis
TLDR
Thromboprophylaxis is needed in all ICU patients, mainly with low molecular weight heparin, such as fragmine, which can be used even in cases of non-severe renal failure, Nevertheless, VTE can occur despite well-conducted thrombobembolism, which has to be used if anticoagulation is not possible.
A new device for the prevention of pulmonary embolism in critically ill patients: Results of the European Angel Catheter Registry
TLDR
Early bedside placement of an IVC filter–catheter is possible, and the results suggest that this is a safe, effective alternative to short-term PE prophylaxis for high-risk patients with contraindications to anticoagulation.
Prévention de la thrombose veineuse chez les patients obèses en réanimation Thromboprophylaxis for Overweight Critically Ill Patients
TLDR
Using low molecular weight heparin (L WMHs) is logical, because LWMHs remain the best-documented anticoagulant class in OP, and benefit of weight based dosing regimens for LMWH in VTE prevention is not proven for OP in ICU or in bariatric surgery.
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