Review of Literature and Incorporating Theory

Topic 2: Checklist

Review of Literature and Incorporating Theory

DETAILS:REVIEW OF LITERATURE

Write a paper (1,500-2,000 words) in which you analyze and appraise each of the (15) articles identified in Topic 1. Pay particular attention to evidence that supports the problem, issue, or deficit, and your proposed solution.

Hint: The Topic 2 Readings provide appraisal questions that will assist you to efficiently and effectively analyze each article.

Refer to "Sample Format for Review of Literature," "RefWorks," and "Topic 2: Checklist."

Prepare this assignment according to the APA guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

• Analyze and appraise each of the 15 articles identified in module 1. (15 articles).

• Analysis organized using the sample provided in “Sample Format for Review of Literature.”

• Identified a theory that can be used to support proposed solution.

• Main components of theory described.

• Rationale for selecting theory provided.

• Discussed how theory works to support proposed solution.

• Explained how theory will be incorporated into project.

ARTICLE 1

Sheth, N. P., Lieberman, J. R., & Della Valle, C. J. (2010). DVT prophylaxis in total joint reconstruction.Orthopedic Clinics of North America,41(2), 273-280.

Problem identified- Patients undergoing major lower extremity orthopedic surgery are at high risk of developing post-operative deep vein thrombosis or embolism.

Statistical data shows that approximately 20% of the total set of patients undergoing total hip arthroplasty (THA) develops symptomatic pulmonary embolus. Similarly, approximately 8% of the total set of patients undergoing total knee arthroplasty (THA) develops symptomatic pulmonary embolus.

Study – the patients of total hip arthroplasty were treated with warfarin as a prophylactic agent.The patients treated with warfarin were noted to show a lowest rateof deep vein thrombosis (DVT) i.e. 0.16%. generally, the these patients when treated with other medications may report a complication of bleeding, but the study showed warfarin to be one of the suggestive medication having side effects almost equivalent to patientstreated witha placebo. The study showed that other medications such as aspirin may alsobe used for treating such patients.

In addition, mechanical compression devices, such as pneumatic compression boots can be used to reduce rate of formation of proximal clots (thrombus) in undergoing THA. However, the study says that furtherinvestigation is needed to declare the mechanical compression devices as sole mode of treatment for THA patients.

Result - The study proposes use of intermittent pneumatic compression device along with anticoagulation medication (such as heparin, warfarin, aspirin, and fondaparinux) to reduce chances or risk of DVT after knee and hip surgeries.

ARTICLE 2

Chin, P. L., Amin, M. S., Yang, K. Y., Yeo, S. J., & Lo, N. N. (2009). Thromboembolic prophylaxis for total knee arthroplasty in Asian patients: a randomised controlled trial.Journal of orthopaedic surgery,17(1).

Problem identified– As compared to the western population, asian population thought to be at lower risk of developing DVT after total knee arthroplasty. Statistical data shows that in western population approximately 46-84% of the patients undergoing total knee arthroplasty (THA) develop deep vein thrombosis. However, in recent years the chances of developing post-surgery DVT in asian population is increasing.

Study – this study was done to see the effect of different modalities (e.g., graduated elastic compression stocking, IPC, and anticoagulation therapy)on the asian population who underwent total knee arthroplasty.

Result (Statistical data) – A control group was a population that was not receiving any therapy. So, the chances of developing deep vein thrombosis (DVT) in this group was highest i.e. 22%. The risk of patients treated with IPC was 8%, which was slightly higher than the group treated with anticoagulation therapy (i.e. enoxaparin) that is 6%. However, the group treated with anticoagulation therapy got complications of bleeding and many of the patients in this group required blood transfusion.

Conclusion the intermittent pneumatic compression (IPC) was concluded to be a best mode of treatment for post-operative patients. As there were no side effects of this modality.

ARTICLE 3

Kakkos, S. K., Caprini, J. A., Geroulakos, G., Nicolaides, A. N., Stansby, G. P., & Reddy, D. J. (2008). Combined intermittent pneumatic leg compression and pharmacological prophylaxis for prevention of venous thromboembolism in high-risk patients. Cochrane Database Syst Rev, 4(4).

Problem identified– Deep vein thrombosis (DVT) is a possible complication that may occur after a patient undergoes surgery. The focus of this article is to study the risk and treatment options for patients developing venous thrombosis (e.g., DVT) post hip or knee replacement surgery.

Study - embolism after undergoing major abdominal surgery. The study was done on around 11 controls/trials that involved around 7431 patients who underwent surgery. mean age of these patients was reported to be 65.5 years. The surgical procedures were orthopedic surgery in sixtrials.

Results showed that a combination of two modalities i.e. intermittent pneumatic compression and anticoagulation therapy was more effective in preventing the chances of deep vein thrombosis, as compared to the compression or anticoagulant alone. The data states that the incidence of developing DVT is reduced from 4% to 1.6% when post-surgery patient was treated with either of the compression or anticoagulation therapy. However, combined modality of compression and anticoagulation therapy reduced the chances of DVT in these patients from about 4.21% to 0.65%.

ARTICLE 4

Urbankova, J., Quiroz, R., Kucher, N., &Goldhaber, S. Z. (2005). Intermittent pneumatic compression and deep vein thrombosis prevention.ThrombHaemost,94(6), 1181-1185.

Problem identified– Patients undergoing orthopedic surgery and other surgeries, for that matter, are at high risk of developing post-operative deep vein thrombosis.

Study –The patients were treated prior and post-operation or surgery. Basically, the compression was provided using an IPC via two modes - uniform and sequential. In the uniform compression modality, a compression was applied in a cyclical fashion below the knee, whereas in the sequential compression a series of sequentially compressions were applied along a target region such as along the caudal to cranialdirection, applying more pressure on the ankle.

DVT was been tested through fibrinogen uptake test and impedance plethysmography test.

Result- The study comprises 16 treatment groups, where a total of 5 groups included the patients who underwent orthopedic surgeries. It has been resulted that IPC decreased 60% risk of developing DVT in patient’s underwent orthopedic surgeries, as compared to the control group that did not receive any treatment option.

ARTICLE 5

Nicolaides, A. N., Fernandes, J. F., & Pollock, A. V. (1980). Intermittent sequential pneumatic compression of the legs in the prevention of venous stasis and postoperative deep venous thrombosis. Surgery, 87(1), 69-76.

Problem Statement –The mechanical modalities or devices can be used to prevent formation of thrombus in veins after an orthopedic surgery. Generally, the devices used to compress a portion of limb in an intermittent fashion such as to produce pulsatile flow in the blood vessels sucha s veins. The compression although empty the veins to prevent any stasis of clotting factors. However, there still is a need for device that can avoid further chances of clot formation after using such IPC devices.

Study–The study is based on a theory that states that thrombosis not only occurs as a result of activation of clotting factors but also due to stasis of these clotting factors. Therefore, in this study an intermittent compression device is used that has 6 chambers 4 placed on the thigh and two on the calf. There is a non-compressing section that is placed on the knee to provide flexion. These 6 chambers are compressed intermittently to wash out the dye injected in the femoral vein. The study was done to identify the interval between compressions of these 6 chambers such that the chances of thrombosis decrease. The interval was found to be between 45sec - 1 min.

Conclusion - This sequential device with multiple inflation chambers was more effective in clearing the dye (i.e. the contrast medium) from the tibial and femoral veins. Thereby reducing the chances of thrombus formation in patients.

ARTICLE 6

Hills, N. H., Pflug, J. J., Jeyasingh, K., Boardman, L., &Calnan, J. S. (1972). Prevention of deep vein thrombosis by intermittent pneumatic compression of calf.British medical journal,1(5793), 131.

Problem identified– The effect of conventional methods to prevent deep vein thrombosis has different effect on patients, based on their medical condition. Basically, patients suffering froma malignant disease may have a different effect of a modality as compared to patient group having no such malignant disease.

Study - They studied effect of intermittent pneumatic compression of the calf on the incidence of postoperative deep vein thrombosis. The study was performed on patients having no malignant disease and other patients having malignant disease.

Results - The chances of deep vein thrombosis (DVT) in the controlpopulation was 30% and in the population treated with IPC the result is 12%, which is significantly less than the control population.

ARTICLE 7

Ho, K. M., & Tan, J. A. (2013). Stratified meta-analysis of intermittent pneumatic compression of the lower limbs to prevent venous thromboembolism in hospitalized patients. Circulation, 128(9), 1003-1020.

Problem identified – This article is focused on analysis of whether intermittent pneumatic compression (IPC) of the lower limbs is effective in reducing venous thromboembolism and whether combining pharmacological therapy with IPC would enhance its effectiveness.

Statistical data - Thromboembolism affects approximately 900,000 individuals each year only in US.

Conclusion - Article proposes use of intermittent pneumatic compression device for lower limbs to decrease risk of deep vein thrombosis (DVT). The article also discusses effect of pneumatic compression device in decreasing risk of deep vein thrombosis (DVT) after orthopaedic surgery.

ARTICLE 8

Vignon, P., Dequin, P. F., Renault, A., Mathonnet, A., Paleiron, N., Imbert, A., ... &Lacut, K. (2013). Intermittent pneumatic compression to prevent venous thromboembolism in patients with high risk of bleeding hospitalized in intensive care units: the CIREA1 randomized trial. Intensive care medicine, 39(5), 872-880.

Brief - This article describes use of intermittent pneumatic compression to prevent venous thromboembolism in patients admitted in ICU. This can be used for treatment in cases where use of anti-coagulants is contraindicated because of high risk of bleeding.

Statistical data - Reported incidence rates of VTE for patients admitted in hospital range between 20 – 80% of the population depending upon various factors such as screening test, studied population.

Study – The study included a 30% of the population that included patients who underwent surgery, rest 70% are patients in ICU. Approximately 407 patients who were at high risk of bleeding received intermittent pneumatic compression(IPC) in conjunction with graduatedcompression stockings (GCS) for 6 days.

Conclusion–The results support GCS alone to be a better option as compared to the combination ofIPC and GCS for ICU patients.

ARTICLE 9

Feist, W. R., Andrade, D., &Nass, L. (2011). Problems with measuring compression device performance in preventing deep vein thrombosis. Thrombosis research, 128(3), 207-209.
FocusThe article focuses on the major issues regarding the use of mechanical compression devices in preventing DVT.

Study- The article focuses on issues related to use of mechanical devices for treatment of DVT.

Conclusion - Over due course of time, the prevention methods of DVT are evolved. Although the mechanical compression such as IPC and GCS are accepted as effective mechanical compression methods for reducing risk of DVT, a check should be done to reexamine these methods.

Typically, there is no good evidence that can prove one mechanical compression method is best over another. A number of issues are been reported with mechanical compression forpreventing DVT, which are not yet resolved.

ARTICLE 10

Kakkos, S. K., Warwick, D., Nicolaides, A. N., Stansby, G. P., &Tsolakis, I. A. (2012). Combined (mechanical and pharmacological) modalities for the prevention of venous thromboembolism in joint replacement surgery. Journal of Bone & Joint Surgery, British Volume, 94(6), 729-734.

Focus -The article focuses on use of combined modality, i.e., pharmacological as well as mechanical treatment, to prevent venous thromboembolism in joint replacement surgery.

Study - The article focuses on use of compression devices after joint replacement surgery.

Conclusion - In hip replacement surgeries, the patients provided with mechanical compression modalities showed a non-significant reduction in DVT i.e. from 8.7% when compared with pharmacological modalities 7.2%. Also, a significant reduction is shown in DVT alone with anticoagulation therapy i.e. from 9.7% to 0.9%

ARTICLE 11

Charles, T., Mackintosh, S., Fingleton, J., Braithwaite, I., Weatherall, M., & Beasley, R. (2013). Efficacy of Micromobile Foot Compression Device in Increasing Lower Limb Venous Blood Flow. International journal of vascular medicine, 2013.

Focus -This article focuses on use of compression devices to increase venous blood flow in lower limbs while seated. The study used an artificial foot as a mechanical compression device for all patients.

Statistical info - The article provides good statistical information for the tests conducted.

Conclusion –Studysuggest that the device can have efficacy as a prophylactic mode and can reduce risk of thromboembolism after orthopaedic surgery. Also, the device can be used potentially in other patients and situations having prolonged immobility.

ARTICLE 12

Kearon, C., & O’Donnell, M. (2011). Graduated compression stockings to prevent venous thromboembolism in hospital. PolskieArchiwumMedycynyWewnętrznej, 121(1-2), 40-43.

Focus -This article describes use of compression stockings to prevent venous thromboembolism in patients admitted in hospitals. We can also compare the advantage of using such stockings over other mechanical compression methods such as IPC. In addition, the focus of the article is on hospitalized patients (both general and surgical).

Results - The study proved another advantage of graduated compression stockings (GCS) and intermittent pneumaticcompression (IPC) devices. As these devices barely increase bleeding, which makes them useful for patients at high bleeding risk. For example, patients with acute stroke may fall into the category of this study, and one such category of patients are intracerebralhemorrhage patients.

ARTICLE 13

Flam, E., Berry, S., Coyle, A., Dardik, H., &Raab, L. (1996). Blood-flow augmentation of intermittent pneumatic compression systems used for the prevention of deep vein thrombosis prior to surgery.The American journal of surgery,171(3), 312-315.

Focus - The article focuses on use of gradual compression stockings and intermittent pneumatic compression devices for potential neurosurgical patients.

Stats - Incident of DVT in neurosurgical population has been reported to be 20-30%.

The focus of the article is not on patients who have undergone orthopedic surgery but is on potential neurosurgical patients.

ARTICLE 14

Hooker, J. A., Lachiewicz, P. F., & Kelley, S. S. (1999). Efficacy of Prophylaxis Against Thromboembolism with Intermittent Pneumatic Compression After Primary and Revision Total Hip Arthroplasty*. The Journal of Bone & Joint Surgery, 81(5), 690-6.

Focus - Thromboembolism is a general complication after total hip arthroplasty (THA). Studies have been performed that used pharmacological and mechanical modalities for prevetion of thrombosis after surgeries. The main purpose of this study was to evaluate efficacy of intermittent pneumatic compression devices (IPC) as anti-thrombotic therapy in patients who underwent total hip arthroplasty (THA).

Study- The study involved 425 patients out of which 502 underwent total hip arthroplasties performed by two surgeons. The patients were given postoperative elastic compression stockings and intermittent pneumatic compression devices upto their thighs.

Conclusion - The use of thigh-high IPC combined with ultrasonography is seen effective against thromboembolism after both total hip arthroplasties.

ARTICLE 15

Kesieme, E., Kesieme, C., Jebbin, N., Irekpita, E., &Dongo, A. (2011). Deep vein thrombosis: a clinical review. Journal of blood medicine, 2, 59.

Focus–This study was performed on a group of patients undergoing total hip replacement. The study was done to evaluate effectiveness of sequential intermittent compression of calf and thigh that can prevent venous thrombosis as compared with control group that has given no treatment.

Study - Both control group and THR patient group underwent tests for finding of deep vein thrombosis using tests such as combined fibrinogen leg scanning, impedance plethysmography, venography, etc. Deep vein thrombosis was found in 49%of control patients as compared to 24% of patients given intermittent compression. It has been shown that vein thrombosis was present in 27% as compared with 14%who were given intermittent compression.

Result - Sequential intermittent compression of leg clinically and statistically reduced the occurrence and of proximal and calf vein thrombosis.