What are the nonpharmacologic interventions for venous thromboembolism (VTE) prevention?

Updated: Nov 05, 2020
  • Author: Vera A De Palo, MD, MBA, FCCP; Chief Editor: Vinod K Panchbhavi, MD, FACS, FAOA, FABOS, FAAOS  more...
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External pneumatic compression has been shown to be capable of temporarily preventing the reduction in fibrinolytic activity that normally follows surgical operations. Studies have found compression devices to be effective only in patients with head trauma or spinal fracture. In total hip replacement, studies have shown them to be efficacious in preventing distal DVT but not in preventing proximal DVT.

Another method of nonpharmacologic prophylaxis is early ambulation, unless the patient has an absolute contraindication. Studies have demonstrated that both symptomatic and ultrasonographically diagnosed DVT are significantly less common with early ambulation following hip arthroplasty.

A prospective cohort study including 69,950 female nurses found an association between physical inactivity and the incidence of PE in women. The data found that the risk of PE was more than twofold greater in women who spent more time sitting than it was in women who spent less time sitting. Activities that decrease the amount of time sitting may lower the risk of PE in women. [79]

In a randomized, controlled study of 90 patients undergoing total knee arthroplasty, Izumi et al found that intraoperative transcutaneous electrical nerve stimulation (TENS) had a significant effect with regard to prevention of DVT prophylaxis, preventing both venous stasis and blood hypercoagulability. [80]

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