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Neuromuscular electrical stimulation (NMES) for the prevention of venous thromboembolism (VTE)

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Title: Neuromuscular electrical stimulation (NMES) for the prevention of venous thromboembolism (VTE)
Authors: Ravikumar, R
Williams, KJ
Babber, A
Moore, HM
Lane, T
Shalhoub, J
Davies, AH
Item Type: Journal Article
Abstract: Objective Venous thromboembolism (VTE), encompassing deep vein thrombosis (DVT) and pulmonary embolism (PE), is a significant cause of morbidity and mortality, affecting 1 in 1000 adults per year. Neuromuscular electrical stimulation (NMES) is the transcutaneous application of electrical impulses to elicit muscle contraction, preventing venous stasis. This review aims to investigate the evidence underlying the use of NMES in thromboprophylaxis. Methods The Medline and Embase databases were systematically searched, adhering to PRISMA guidelines, for articles relating to electrical stimulation and thromboprophylaxis. Articles were screened according to a priori inclusion and exclusion criteria. Results The search strategy identified 10 randomised controlled trials, which were used in three separate meta-analyses; 5 trials compared NMES to control, favouring NMES (odds ratio (OR) of DVT 0.29, 95%CI 0.13-0.65; P=.003); 3 trials compared NMES to heparin, favouring heparin (OR of DVT 2.00, 95%CI 1.13-3.52; P=.02); 3 trials compared NMES as an adjunct to heparin versus heparin only, demonstrating no significant difference (OR of DVT 0.33, 95%CI 0.10-1.14; P=.08). Conclusion NMES significantly reduces the risk of deep vein thrombosis compared to no prophylaxis. It is inferior to heparin in preventing DVT and there is no evidence for its use as an adjunct to heparin.
Issue Date: 1-Jul-2018
Date of Acceptance: 31-Jan-2017
URI: http://hdl.handle.net/10044/1/45381
DOI: https://dx.doi.org/10.1177/0268355517710130
ISSN: 0268-3555
Publisher: Sage Publications
Start Page: 367
End Page: 378
Journal / Book Title: Phlebology
Volume: 33
Issue: 6
Copyright Statement: © The Author(s) 2017. The final, definitive version of this paper has been published in Phlebology by Sage Publications Ltd. All rights reserved. It is available at: http://journals.sagepub.com/doi/10.1177/0268355517710130
Sponsor/Funder: Imperial College Trust
Actegy Limited
Funder's Grant Number: N/A
Keywords: Venous thromboembolism prophylaxis
deep vein thrombosis
1102 Cardiovascular Medicine And Haematology
Cardiovascular System & Hematology
Publication Status: Published
Online Publication Date: 2017-06-13
Appears in Collections:Department of Surgery and Cancer