Investigation of Blood Flow During Intermittent Pneumatic Compression and Proposal of a New Compression Protocol

Abstract

Introduction: Intermittent pneumatic compression (IPC) is now a widely used therapy for the prophylaxis of deep vein thrombosis and pulmonary embolism. In general, the IPC sequence is composed of sequential compression and simultaneous deflation. Typically, veins are considered to be squeezed and emptied during the compression phase and to be refilled during the deflation phase. However, because the stop or sudden increase in blood flow can be dangerous, a further investigation is needed with respect to the blood flow. Materials and Methods: We demonstrated a new compression protocol based on the investigation results of venous blood flow during IPC. This new compression protocol involves successive compression without the deflation phase; thus, the expelled blood volume flow during a given period can be maximized. To investigate the blood flow during IPC, sonography movie clips and in-laboratory developed blood flow analysis software was used. Results: The increases in the peak volume flow during IPC were 49% (+24%) and 25% (+29%) with the conventional protocol and the new protocol, respectively, whereas the total volume flow (TVF) was not significantly changed (À1.0% and À13.0%, respectively). With the new protocol, the peak velocity (PV) was 49% lower than that with the conventional protocol. Thus, the new protocol has an effect of maintaining TVF without resulting in a sudden large increase or decrease in PV. Conclusion: The new suggested protocol might improve safety because it can maintain the stability of blood flow by reducing the risk of blood stasis and a rapid change in blood flow.

Effects of transcutaneous electrical nerve stimulation via peroneal nerve or soleus muscle on venous flow

“…There is a possibility of a nondesirable backward flow when a strong negative pressure—related to a high PV—is generated. [ 30 ] This can be amplified when partial venous obstruction with stenosis or malfunctioning venous valves exists, as it creates the conditions for eddy blood flow. [ 31 ] For this reason, other factors related to venous volume have been proposed to test the different applications.…”