Jacobs DG, Piotrowski JJ, Hoppensteadt DA, Salvator AE, Fareed J.
Hemodynamic and fibrinolytic consequences of intermittent pneumatic compression:
preliminary results.
J Trauma 1996 May;40(5):710-16; discussion 716-7

Carolinas Medical Center, Charlotte, North Carolina 28232-2861, USA.

OBJECTIVE: To elucidate the time course and magnitude of hemodynamic and
fibrinolytic changes associated with sequential gradient intermittent pneumatic
compression (SGIPC). DESIGN: Two-phase, intervention and response investigation
in normal volunteers. MATERIALS AND METHODS: Subjects were assigned to control
(phase I) or compression (phase II) groups. Serial blood samples were obtained
via femoral venous catheters for tissue plasminogen activator (tPA), plasminogen
activator inhibitor (PAI-1), tPA-PAI-1 complex (tPA-PAI), and euglobulin lysis
time (ELT) from all subjects and for fibrin degradation products (FbDP) and
fibrinogen degradation products (FgDP) from phase II subjects. Duplex venous
scanning was carried out on phase II subjects before and during SGIPC. RESULTS:
Catheter placement caused elevations in PAI-1 and tPA-PAI, which stabilized
within 4 hours of catheter insertion. In phase II, SGIPC induced significant
increases in FbDP, FgDP, and tPA-PAI and decreases in ELT and PAI-1, all of which
quickly reverted to baseline on termination of compression. Femoral venous blood
flow increased by more than 100% with SGIPC. CONCLUSIONS: Sequential gradient
intermittent pneumatic compression induces prompt, but short-lived, alterations
in both fibrinolytic and hemodynamic function. Noncontinuous SGIPC may result in
suboptimal thromboembolic prophylaxis.