Flam E, Berry S, Coyle A, Dardik H, Raab L.
Blood-flow augmentation of intermittent pneumatic compression systems used for
prevention of deep vein thrombosis prior to surgery.
Am J Surg 1996 Mar;171(3):312-5

UMDNJ-Robert Wood Johnson Medical School, Piscataway, USA.

PURPOSE: To compare, using Duplex ultrasonography, different intermittent
pneumatic compression (IPC) systems to augment venous blood flow for deep venous
thrombosis (DVT) prevention during and after surgery and during periods of
immobility. METHODS: This cross-over study randomly assigned 26 young, healthy,
adult subjects, without history of DVT, hypertension, diabetes, stroke. vascular
or cardiac pathologies, to an order of knee-high, foam, single-pulse IPC device
and thigh-high, vinyl, sequential-pulse pneumatic compression systems. Prior to
making the flow measurement, the girth of the calf and thigh and length of the
leg of each subject were determined. The right leg was used in this evaluation.
RESULTS: The average flow augmentation, which is a direct measure of the amount
of femoral vein blood flow velocity increase over the base, was 107%+/-49% with
the knee-high system, and 77%+/-35% with the thigh-high IPC system (P<0.002).
Augmentation was higher for 62% of the subjects with knee-high IPC, and for 23%
of the subjects with the thigh-high system. Overall, the blood was actively
moving through the vein during the decompression phase. On occasion, the velocity
during the decompression phase would fall to zero for short intervals with both
systems, indicating complete emptying of the vessel. Variation in limb anatomy
did not significantly affect blood-flow augmentation with the knee-high IPC, but
augmentation decreased with increase in girth with the thigh-high IPC.
CONCLUSIONS: The study indicates that the knee-high, foam, single-pulse IPC
device produces a significantly higher venous blood-flow augmentation than the
thigh-high, vinyl, sequential-pulse system.