Lurie F, Awaya DJ, Kistner RL, Eklof B.
Hemodynamic effect of intermittent pneumatic compression and the position of the
body.
J Vasc Surg 2003 Jan;37(1):137-42

Straub Foundation, Honolulu, HI 96814, USA.

PURPOSE: The purpose of this study was to investigate the three likely mechanisms
of intermittent pneumatic compression (IPC) in deep vein thrombosis prophylaxis
(increased volume flow, increased flow velocity, and acceleration of flow) and to
do this in a variety of positions, in different venous segments, and with the
stimulus of three different compression garments. METHODS: In 12 healthy
volunteers, three types of compression cuffs were used: foot, calf, and calf +
thigh. The foot was compressed with 80 mm Hg, and the calf and thigh with 40 mm
Hg. Duplex ultrasound scan was performed before and during the compression in the
horizontal, 15-degree head-down, and 15-degree head-up positions. The common
femoral, greater saphenous, profunda femoral, superficial femoral, and popliteal
veins were examined. RESULTS: In comparison with the horizontal position, the
15-degree head-down position was associated with an increase of volume flow and
velocities and the head-up position was associated with decreased flow and
velocities in the deep veins. The application of IPC caused significant increases
in velocities and volume flow in all venous segments. The lowest increase in
velocities and volume flow in the deep veins was observed with the subjects in
the head-down position, and in the two other positions, the increases were
greater and similar to each other. IPC caused a much more prominent increase in
flow velocities and volume flow in deep veins compared with simple elevation of
the legs. CONCLUSION: IPC produces significant increases of venous flow volume
and flow velocity and acceleration of flow. This is true whether the limbs are
elevated, horizontal, or dependent. Segmental flow changes vary with the position
of the patient and the compression garment used. Foot compression increases
volume flow and velocity primarily in the popliteal vein. Calf compression
provides maximal increases of volume flow and flow velocity through the deep
veins.