Labropoulos N, Cunningham J, Kang SS, Mansour MA, Baker WH.
Optimising the performance of intermittent pneumatic compression devices.
Eur J Vasc Endovasc Surg 2000 Jun;19(6):593-7

Department of Surgery, Loyola University Medical Center, Maywood, IL 60153-3304, USA.

OBJECTIVES: this study was designed to determine whether an intermittent
pneumatic compression device (IPC) with an increased maximal inflation pressure,
a decreased time to maximal pressure and a longer duration of compression would
improve venous return compared to a standard IPC device. METHODS: thirty limbs in
15 volunteers without evidence of venous disease were studied using duplex
scanning at rest and during the application of two different IPC devices with
different compression parameters. The first device IPC-1 (SCD 5325, Kendall) has
a six-chambered cuff applying 45 mmHg after 12 s, sequentially from ankle to
thigh followed by 60 s of non-compression. The second device IPC-2
(Vena-Assist(R), ACI Medical) has a foot, ankle and calf cuff, applies a pressure
of 80 mmHg, has a pressure rise time of 0.3 s, maintains inflation for 5.5 s, and
has a cycling time of 1 min. Peak venous velocity and acceleration time were
measured at rest and during the IPC application. Measurements were obtained in
supine position from the common femoral vein 1 cm above the saphenofemoral
junction to include the entire venous outflow from the limb. RESULTS: peak venous
velocity at rest was significantly higher in the right limb than in the left limb
(26+/-7.2 vs. 22+/-5.7 cm/s, p<0.01). Peak venous velocity was significantly
increased by both IPC devices (p <0.0001). IPC-2 achieved significantly higher
peak venous velocity than IPC-1 (55.1+/-17.8 vs. 37.4+/-6.9 cm/s, p<0.0001).
Acceleration time was also found to be significantly shorter (370+/-93.4 vs.
560+/-83.5 ms, p<0.0001) in IPC-2 than in IPC-1, respectively. CONCLUSIONS: we
have demonstrated that progressive inflation at the foot, ankle and calf,
increasing maximal inflation pressure and decreasing time to maximal pressure
result in increased venous return. These changes may improve the efficacy of IPC
devices in the prevention of deep-venous thrombosis (DVT) formation. Copyright
2000 Harcourt Publishers Ltd.