Intermittent pneumatic compression is effective in preventing symptomatic pulmonary embolism after thoracic surgery

Postoperative pulmonary embolism (PE) remains a fatal complication even in thoracic surgery. We have used intermittent pneumatic compression for the prophylaxis of postoperative PE since 1998, and herein examined its effectiveness. Seven hundred and six patients, whose medical records showed use/no use of pneumatic compression for prophylaxis of PE, underwent general thoracic surgery in our department from December 1995 to December 2000. Their clinical records were reviewed, and variables were compared between patients who experienced clinically apparent PE and patients who did not have PE. Three hundred and forty-four patients did not receive any prophylactic treatment, and 7 of these (2.0%) experienced postoperative PE. Three hundred and sixty-two patients received prophylactic pneumatic compression and none of these developed PE. There was a statistical correlation between the occurrence of PE and the application of pneumatic compression (Chi(2)-test, P = 0.006). Six of the seven patients with PE were operated on in the right decubitus position, and the operative position and the prevalence of PE was also significantly correlated (Chi(2)-test, P = 0.024). Other factors, such as age, sex, operative time, duration until patients became fully ambulatory, body mass index, and character of the disease, did not have significant correlation with the occurrence of PE. Pneumatic compression was found to effectively prevent postoperative PE. The right decubitus position is considered to be a risk factor for the development of postoperative PE in thoracic surgery.