THE EFFICACY OF PNEUMATIC COMPRESSION STOCKINGS IN THE PREVENTION OF PULMONARY-EMBOLISM AFTER CARDIAC-SURGERY

Introduction: Pneumatic compression stocking (PCS) devices have been i ntroduced to decrease the incidence of postoperative deep venous throm bosis (DVT), However, their role in the prophylaxis against pulmonary embolism (PE) remains unclear, This study was undertaken to compare th e prophylactic effectiveness of subcutaneous heparin (SCH) alone vs th e combined use of PCS and SCH in the prevention of PE following cardia c surgery. Methods: We studied 2,551 consecutive patients who underwen t 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 w ith a combined prophylactic regimen of PCS and SCH. Results: The diagn osis of PE was established in 69 patients by either high-probability v entilation perfusion scan, pulmonary angiogram, or autopsy. The incide nce 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 co mbined prophylactic method of bilateral PCS and SCH is superior to SCH alone in the prevention of PE after cardiac surgery.