Intermittent Pneumatic Compression for Preventing Lower Extremity Deep Vein Thrombosis in Patients with Severe Acute...

To systematically evaluate the efficacy and safety of intermittent pneumatic compression (IPC) in preventing lower extremity deep vein thrombosis (DVT) in patients with severe acute pancreatitis (SAP).

Randomized controlled trials (RCTs) and non-randomized controlled trials on IPC for DVT prevention in SAP patients were retrieved from PubMed, Web of Science, Cochrane Library, CNKI, Wanfang, VIP, and the Chinese Biomedical Literature Database from inception to 30 April 2026. Two reviewers independently screened the literature, extracted data, and assessed the risk of bias. Meta-analyses were performed using R software (version 4.2.2). Subgroup analyses were conducted based on study design and treatment frequency. This review is registered in PROSPERO (CRD420261379348).

A total of 10 studies (7 RCTs and 3 non-RCTs) involving 970 patients (484 in the intervention group and 486 in the control group) were included. Meta-analysis showed that IPC significantly reduced the incidence of DVT (RR = 0.22, 95% CI 0.13 - 0.38, P < 0.0001, I² = 0%). IPC also reduced fibrinogen levels (MD = - 1.05, 95% CI - 1.50 to - 0.59, P < 0.0001, I² = 97%), prolonged activated partial thromboplastin time (APTT) (MD = 5.94, 95% CI 2.46 - 9.42, P < 0.0001, I² = 94%) and prothrombin time (PT) (MD = 1.82, 95% CI 1.24 - 2.40, P < 0.0001, I² = 85%), and increased peak blood flow velocity (MD = 9.82, 95% CI 7.63 - 12.00, P < 0.0001, I² = 83%) and mean blood flow velocity (MD = 8.12, 95% CI 5.66 - 10.59, P < 0.0001, I² = 95%). Subgroup analyses indicated that study design and treatment frequency (twice daily vs. four times daily) did not significantly affect DVT prevention outcomes. No serious adverse events related to IPC were reported in any of the included studies.

Intermittent pneumatic compression may reduce DVT risk, improve hypercoagulability and lower extremity blood flow in SAP patients, with a favourable safety profile. However, confidence in the evidence is limited by the geographical concentration of the studies, heterogeneity, and inclusion of non‑randomised trials. High‑quality studies are needed to confirm these findings.