What anticoagulants are released with the use of Sequential Compression Devices (SCDs)?

From the Guidelines

Sequential Compression Devices (SCDs) do not release any anticoagulants, but rather stimulate the body's own anticoagulation mechanisms by increasing blood flow velocity, reducing venous stasis, and releasing natural anticoagulants from the blood vessel walls, such as tissue plasminogen activator (tPA), prostacyclin, and nitric oxide. SCDs are mechanical devices that improve blood flow and reduce the risk of blood clots without using medications. They work by applying intermittent pressure to the legs, typically from the ankles up to the thighs, which helps to:

• Increase blood flow velocity in the deep veins
• Reduce venous stasis
• Stimulate the release of natural anticoagulants from the blood vessel walls These endogenous substances help prevent blood clot formation, but they are not directly released by the SCD itself, as noted in the context of mechanical prophylaxis for venous thromboembolic disease 1. SCDs are often used in combination with pharmacological anticoagulants for enhanced thromboprophylaxis, especially in high-risk patients or when medication is contraindicated, and are particularly useful in immobile patients, such as those recovering from surgery or confined to bed rest, as discussed in the operative management of acute abdomen after bariatric surgery in the emergency setting 1.

From the Research

Anticoagulants Released with Sequential Compression Devices (SCDs)

• There is no direct evidence in the provided studies that specifies the type of anticoagulants released with the use of SCDs.
• However, the studies mention the use of SCDs in combination with anticoagulants, such as subcutaneous low-dose unfractionated heparin (UH) 2, and heparin 3.
• One study compared the use of SCDs alone versus SCDs with subcutaneous low-dose UH for thromboembolic prophylaxis in gynecologic oncology patients, and found no significant difference in the incidence of venous thromboembolism between the two groups 2.
• Another study compared the use of SCDs and foot pumps for prophylaxis of deep venous thrombosis in high-risk trauma patients, and found no significant difference in the incidence of deep venous thrombosis between the two groups 4.

Types of Anticoagulants Mentioned

• Subcutaneous low-dose unfractionated heparin (UH) 2
• Heparin 3
• No specific type of anticoagulant is mentioned as being released by SCDs themselves.

Limitations

• The provided studies do not directly address the question of what anticoagulants are released with the use of SCDs.
• The studies focus on the effectiveness of SCDs in preventing venous thromboembolism, rather than the specific anticoagulants released by the devices 4, 5, 6, 3.