Effects of intermittent pneumatic compression on serum HMGB1 levels of deep venous thrombosis of lower extremity in severe traumatic brain injury patients

Abstract

Objective: To investigate the efficacy of intermittent pneumatic compression (IPC) in prevention of deep venous thrombosis (DVT) in severe traumatic brain injury (TBI) patients and to observe the effects of IPC on hemorheological and coagulation indices, as well as high-mobility group box 1 (HMGB1) in severe TBI patients.

Methods: The present prospective open randomized controlled research recruited 332 severe TBI cases seen during May 2017~November 2019. All patients were randomly divided into two groups, with 166 cases in the control group and 166 cases in the IPC group. The serum levels of HMGB1 were determined using an enzyme linked immunosorbent assay (ELISA). The flow velocity of common femoral vein was also evaluated using Doppler ultrasound before treatment, as well as at 1 d, 3 d, 7 d and 14 d after admission. Levels of prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen (FIB) and D-Dimer (D-D) were also evaluated before treatment, as well as at 7 d and 14 d after admission.

Results: DVT occurred in a total of 35 (10.54%) cases of all patients, with 6 (3.61%) cases in IPC group, which was significantly lower than 29 (17.47%) cases in the control group. Serum FIB levels were significantly lower in the IPC group at 7 d and 14 d after treatment compared with the control. At 3 d, 7 d and 14 d after treatment, the levels of flow velocity of common femoral vein were markedly higher in IPC group compared with the control and after 3 d treatment, the levels of HMGB1 at 1 d, 3 d, 7 d and 14 d were all markedly lower in IPC group than the control. After admission, the serum levels of HMGB1 were markedly higher in DVT patients compared with the non-DVT patients at 1 d, 3 d, 7 d and 14 d and were negatively correlated with the flow velocity of common femoral vein at 3 d, 7 d and 14 d.

Conclusion: IPC treatment could prevent DVT in severe TBI patients, which was associated with increased velocity of common femoral vein and decreased FIB and HMGB1 levels. HMGB1 may be useful as a potential biomarker for DVT in severe TBI patients.