Intermittent pneumatic compression of legs increases microcirculation in distant skeletal muscle

Liu, Kang; Chen, Long‐En; Seaber, Anthony V.; Johnson, Glenn W.; Urbaniak, James R.

doi:10.1002/jor.1100170114

Cited by 46 publications

(29 citation statements)

References 26 publications

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“…Our cell culture results are consistent with previous studies in animal models (26), which showed that pneumatic compression causes vasodilation in arteries and veins. In those experiments, vasodilation reached maximum levels 30 min after initiation of compression and could be completely blocked by an inhibitor of NOS.…”

Section: Discussionsupporting

confidence: 93%

“…This result suggests that inhibition of the tissue factor pathway, the major physiological initiating mechanism of blood coagulation, might be an important mechanism for the antithrombotic effect of EPC. 3) Recently, Liu et al (26) showed in an animal model that there is significant vasodilation in arterial and venous vessels during the application of EPC and further demonstrated that the vasodilation could be completely blocked by nitric oxide synthase (NOS) inhibitor. They also found that the inflation rate is a dominant factor in determining the degree of vasodilation by EPC (27).…”

mentioning

confidence: 99%

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Endothelial nitric oxide production during in vitro simulation of external limb compression

Dai

Tsukurov

Chen

et al. 2002

American Journal of Physiology-Heart and Circulatory Physiology

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External pneumatic compression (EPC) is effective in preventing deep vein thrombosis (DVT) and is thought to alter endothelial thromboresistant properties. We investigated the effect of EPC on changes in nitric oxide (NO), a critical mediator in the regulation of vasomotor and platelet function. An in vitro cell culture system was developed to simulate flow and vessel collapse conditions under EPC. Human umbilical vein endothelial cells were cultured and subjected to tube compression (C), pulsatile flow (F), or a combination of the two (FC). NO production and endothelial nitric oxide synthase (eNOS) mRNA expression were measured. The data demonstrate that in the F and FC groups, there is a rapid release of NO followed by a sustained increase. NO production levels in the F and FC groups were almost identical, whereas the C group produced the same low amount of NO as the control group. Conditions F and FC also upregulate eNOS mRNA expression by a factor of 2.08 ± 0.25 and 2.11 ± 0.21, respectively, at 6 h. Experiments with different modes of EPC show that NO production and eNOS mRNA expression respond to different time cycles of compression. These results implicate enhanced NO release as a potentially important factor in the prevention of DVT.

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Section: Discussionsupporting

confidence: 93%

mentioning

confidence: 99%

Endothelial nitric oxide production during in vitro simulation of external limb compression

Dai

Tsukurov

Chen

et al. 2002

American Journal of Physiology-Heart and Circulatory Physiology

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“…The reason for the discrepancy between these two studies (18,25) is not readily apparent, because the method used to assess changes in leg blood flow was identical. Another previous study comprising 14 healthy subjects reported the effects of leg compression by bandaging on leg pulsatile blood flow using a nuclear MR flowmeter (18,19). A flow increase of 29% was reported for a pressure increase of ϳ40 mmHg.…”

Section: Discussionmentioning

confidence: 97%

“…An effect on arterial flow is indicated by a study on volunteers in whom, during foot-to-knee compression bandaging, an increase of lower leg pulsatile blood flow was observed by nuclear magnetic resonance (MR) flowmetry (22,23). Intermittent pneumatic foot and calf compression is also an effective therapeutic means to reduce the symptoms of venous insufficiency (4,17,19,26). Using color flow duplex imaging of the popliteal artery, Labropoulos et al (17) found increased blood flow in healthy volunteers during intermittent pneumatic foot and calf compression.…”

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confidence: 99%

External compression increases forearm perfusion

Bochmann¹,

Seibel²,

Haase³

et al. 2005

Journal of Applied Physiology

101

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Application of compression stockings to the lower extremities is a widely used therapeutic intervention to improve venous return, but there is little information about the effects of compression on local arterial perfusion. Therefore, we tested the hypothesis that a positive external pressure increases forearm perfusion. The relation of increasing external pressure induced by standardized compression to the arterial inflow and arterial flow reserve of the forearm was critically evaluated in a group of healthy young men (n = 9). Flow was measured with venous occlusion plethysmography after a 10-min application of six different stockings with compression pressure increasing from 13 to 23 mmHg. During compression, the arterial inflow increased significantly from 3.7 +/- 0.85 to 8.8 +/- 2.01 ml.min(-1).100 ml tissue(-1) (P < 0.001) and the arterial flow reserve increased from 17.7 +/- 4.7 to 28.3 +/- 7.0 ml.min(-1).100 ml tissue(-1). The flow increase was persistent after 3 h of constant application of external pressure and also during simultaneous low-intensity hand grip. Similar results obtained with occlusion plethysmography were seen with MRI. During the interventions, forearm temperature was unchanged, and the volunteers reported no discomfort. In conclusion, 1) arterial perfusion of the human forearm increases more than twofold during application of external compression over a pressure range of 13-23 mmHg, and 2) the result is interpreted as an autoregulatory response following the decrease of the vascular transmural pressure gradient.

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“…The search for the biological basis of the beneficial effects of IPC application through the use of animal models (25,46) requires that the protocols used and, most importantly, the effects evoked by the compressions mimic the ones obtained in the clinical scenario. Accordingly, the protocol employed in the present investigation was based on the most commonly used stimulation characteristics utilized for treatment of patients with PAD, i.e., 120 mmHg, with cycles of 4 s of inflation and 16 s of deflation and a minimum time of exposure of 150 min (13,47).…”

Section: Discussionmentioning

confidence: 99%

Intermittent pneumatic leg compressions acutely upregulate VEGF and MCP-1 expression in skeletal muscle

Roseguini

Soylu

Whyte

et al. 2010

American Journal of Physiology-Heart and Circulatory Physiology

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Roseguini BT, Soylu SM, Whyte JJ, Yang HT, Newcomer S, Laughlin MH. Intermittent pneumatic leg compressions acutely upregulate VEGF and MCP-1 expression in skeletal muscle. Am J Physiol Heart Circ Physiol 298: H1991-H2000, 2010. First published March 26, 2010; doi:10.1152/ajpheart.00006.2010.-Application of intermittent pneumatic compressions (IPC) is an extensively used therapeutic strategy in vascular medicine, but the mechanisms by which this method works are unclear. We tested the hypothesis that acute application (150 min) of cyclic leg compressions in a rat model signals upregulation of angiogenic factors in skeletal muscle. To explore the impact of different pressures and frequency of compressions, we divided rats into four groups as follows: 120 mmHg (2 s inflation/2 s deflation), 200 mmHg (2 s/2 s), 120 mmHg (4 s/16 s), and control (no intervention). Blood flow and leg oxygenation (study 1) and the mRNA expression of angiogenic mediators in the rat tibialis anterior muscle (study 2) were assessed after a single session of IPC. In all three groups exposed to the intervention, a modest hyperemia (ϳ37% above baseline) between compressions and a slight, nonsignificant increase in leg oxygen consumption (ϳ30%) were observed during IPC. Compared with values in the control group, vascular endothelial growth factor (VEGF) and monocyte chemotactic protein-1 (MCP-1) mRNA increased significantly (P Ͻ 0.05) only in rats exposed to the higher frequency of compressions (2 s on/2 s off). Endothelial nitric oxide synthase, matrix metalloproteinase-2, and hypoxia-inducible factor-1␣ mRNA did not change significantly following the intervention. These findings show that IPC application augments the mRNA content of key angiogenic factors in skeletal muscle. Importantly, the magnitude of changes in mRNA expression appeared to be modulated by the frequency of compressions such that a higher frequency (15 cycles/min) evoked more robust changes in VEGF and MCP-1 compared with a lower frequency (3 cycles/min).angiogenesis; intermittent pneumatic compression; vascular endothelial growth factor; monocyte chemotactic protein-1

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Intermittent pneumatic compression of legs increases microcirculation in distant skeletal muscle

Cited by 46 publications

References 26 publications

Endothelial nitric oxide production during in vitro simulation of external limb compression

Endothelial nitric oxide production during in vitro simulation of external limb compression

External compression increases forearm perfusion

Intermittent pneumatic leg compressions acutely upregulate VEGF and MCP-1 expression in skeletal muscle

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