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Rivista sulle Malattie delle Vene e dei Linfatici
Acta Phlebologica 2007 August;8(2):71-7
Venous thromboembolism in neurosurgical patient: intermittent pneumatic compression as enforced prophylactic method?
Apperti M. 1, Goffredi L. 1, Di Lucia A. 1, Luongo M. 2, Moraci A. 2
1 Section of Phlebology and Study of Tissue Repair Department of Anesthesiological Surgical and Emergency Sciences Second University of Naples, Naples, Italy
2 Department of Neurosurgery and Neuroradiology Second University of Naples, Naples, Italy
Aim. Venous thromboembolism in neurosurgical patient represents a real problem favoured by venous stasis, before patient’s mobilization. The aim of the study is to verify the efficacy of elastic compression in patients with severe activity limitations, so to individuate the candidate to pneumatic compression.
Methods. We studied 15 patients (6 females and 9 males), 13 of which with lumbar disc pathology and 2 (a male and a female) affected by brain tumor. All the patients underwent neurosurgery. We used intermittent pneumatic compression (IPC) as a chosen method during the operation and in the early postoperative, when muscle pump’s deficit is total and is more probable to develop DVT.
Results. In a motionless patient or with a severe limitation in active movements, elastic compression acts only on flow velocity of deep venous system. The use of elastic stocks leads to an increase in residual volume after exercise, but there’s no possibility to improve systolic ejection fraction. We obtained with IPC an increase in flow velocity and an increment in total shifted blood volume, parameters comparable with ejection fraction and residue volume after exercise.
Conclusion. Mechanical prophylaxis to prevent venous thromboembolism must be an integral part of modern Neurosurgical practice and it is an effective methods to avoid DVT and PE, during and after surgical treatment. Elastic stocks and intermittent pneumatic compression are both useful in preventing venous thromboembolism, so we confirm the importance and the efficacy of mechanical prophylaxis in neurosurgical patients, according to recent literature’s data.