A TEG parameter, maximum amplitude (MA), has been linked to an increase of thrombotic complications in a postoperative population (McCrath, 2005). In addition to standard laboratory tests, the investigators will use thrombelastography (TEGĀ®) to assess all phases of coagulation. The investigators aim to assess the effects on coagulation when SCD are applied to patients at high risk of DVT in addition to standard LMWH therapy.The investigators chose to study a population in whom SCD may be useful in reducing the incidence of DVT, such as patients undergoing postoperative monitoring in the intensive care unit (ICU) after major abdominal surgery for cancer. There is also some evidence that SCD activity may influence the coagulation/fibrinolysis system towards hypocoagulability (Dai, 2000 Kohro, 2003) Kohro and colleagues have also hypothesized that the shear forces generated by SCD may alter platelet adhesion by a direct effect on platelets and/or by increasing the release of factors from the venous endothelium (Kohro, 2005). The mechanism of action of SCD seems to be primarily mechanical, through a displacement of a column of blood through the venous system and towards the heart they act as a surrogate of the muscular pump in immobilized patients (Killewich, 1995). They have also been employed to complement anticoagulant therapy in patients at high risk of DVT, such as those undergoing orthopedic surgery (Fordyce, 1992 Handoll, 2002 Warwick, 2002 Pitto, 2004). This devices are being employed for DVT prophylaxis in patients for whom anticoagulation therapy is contraindicated, or in those who have a low risk of DVT. Overall incidence without prophylaxis is estimated to be 40 based on a meta-analysis of DVT in patients with acute spinal cord injury. Pressure is also applied intermittently according to predetermined schedules. In prospective studies, the incidence of DVT following acute spinal cord injury has been reported at 18-100, depending on the diagnostic technique used, time after injury, and concurrent risk factors. A computerized pump applies a gradient of pressure which decreases from the foot cranially. Sequential compressing devices (SCD) are relatively novel pneumatic stockings with several air chambers. LMWHs have been proved to be safe and equipotent or superior when compared with unfractionated heparin. Low molecular weight heparins (LMWH) are routinely used in perioperative prophylaxis of thromboembolic complications. Why Should I Register and Submit Results?.
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