Tissue Fluid Pressure and Flow during Pneumatic Compression in Lymphedema of Lower Limbs

Wl, Olszewski; Jain, Pradeep; Ambujam, G.; Zaleska, Marzanna; Cakala, Marta; Grądalski, Tomasz

doi:10.1089/lrb.2009.0025

Cited by 43 publications

(29 citation statements)

References 5 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…1). 23 The sleeve was composed of 8 chambers each 9 cm long; it was sequentially inflated, inflation pressures were regulated from 50 to 120 mmHg, gradient pressures were decreasing proximally by 20%.…”

Section: Compression Devicementioning

confidence: 99%

“…23 Calf and thigh skin were disinfected with isopropyl alcohol. One mL of 2% xylocaine with 5 lg/mL adrenaline was injected intradermally and subcutaneously at six points of calf and thigh (Fig.…”

Section: Tissue Fluid Pressure Measurementmentioning

confidence: 99%

“…22 Moreover, we noticed that tissue fluid pressures had the tendency to be lower than in the compression chamber. 23 A number of other important issues remain to be determined, such as optimum pumping pressures, the length and frequency of pumping sessions, and the need for continuation of pumping after initial reduction has been attained.…”

mentioning

confidence: 99%

See 2 more Smart Citations

Pressures and Timing of Intermittent Pneumatic Compression Devices for Efficient Tissue Fluid and Lymph Flow in Limbs with Lymphedema

Zaleska

Jain

et al. 2013

Lymphatic Research and Biology

Self Cite

View full text Add to dashboard Cite

Pneumatic compression of tissues with lymph stasis is, aside from the manual massage, a commonly used therapeutic modality in limb lymphedema. A number of pneumatic devices have been constructed. There is lack of reports of comparative studies determining inflation pressure levels, inflation/deflation cycle times, and total pumping times. Aim: We tried to answer the question how high compression pressure and how long compression timing should be applied to the limb soft tissues to reach tissue fluid (TF) head pressure above 30 mmHg, necessary to initiate proximal flow. Methods: TF pressures were measured subcutaneously during intermittent pneumatic compression in the lymphedematous limbs stage II to IV. Pressures of 50, 80, and 120 mmHg and timing 5, 20, and 50 sec were applied. Results: a) the TF head pressures were lower than those in inflated chambers, b) inflation time of 5 and 20 sec was not long enough to generate TF head pressures above 30 mmHg, even if the compression pressures were as high as 120 mmHg, c) the 50 sec timing allowed to reach head pressures above 30 mmHg; however, they remained always lower than in the compression chamber, d) TF head pressures differed at various levels of the limb depending on the soft tissue mass, e) deflation of the inflated whole sleeve for 5 and 20 sec was followed by high end pressures, whereas that of 50 sec brought about pressure drop to 0, facilitating refilling with TF of the distal parts of the massaged limb. Conclusions: Our observations point to the necessity of applying high pressures and compression times over 50 sec, to generate effective TF pressures and provide enough time for creating TF flow. Short inflation times generate TF pressures as in one-chamber devices that preclude its effectiveness compared to the multi-chamber devices.

show abstract

Section: Compression Devicementioning

confidence: 99%

Section: Tissue Fluid Pressure Measurementmentioning

confidence: 99%

See 1 more Smart Citation

Pressures and Timing of Intermittent Pneumatic Compression Devices for Efficient Tissue Fluid and Lymph Flow in Limbs with Lymphedema

Zaleska

Jain

et al. 2013

Lymphatic Research and Biology

Self Cite

View full text Add to dashboard Cite

show abstract

“…The construction and function of these devices should be based on the physiological parameters of tissue fluid (edema fluid) hydromechanics. 1,2 We measured the tissue fluid (edema fluid) (TF) pressures and flow using various types pneumatic compression devices in a group of patients with lower limb lymphedema and estimated the most effective parameters for fluid movement. 3 It was found that the highest flow of 20 to 120 mL/1 h cycle was obtained with compression pressures between 80 and 120 mmHg and inflation timing 6-7 min, sequentially from foot to groin.…”

Section: Introductionmentioning

confidence: 99%

The Effectiveness of Intermittent Pneumatic Compression in Long-Term Therapy of Lymphedema of Lower Limbs

Zaleska

Durlik

2014

Lymphatic Research and Biology

Self Cite

View full text Add to dashboard Cite

Background: The manual lymphatic drainage in lymphedema has proved to be successful; however, this method cannot be applied to millions of patients around the world. The only solution is to offer inexpensive, easily accessible mechanical devices for pneumatic compression (IPC). These devices should be designed on parameters of edema fluid hydromechanics. Recent data point to high pressures and long time of compression. Aim: To validate the effects of 3 years daily high pressure, long inflation time IPC therapy in terms of decrease of limb circumference/volume, tissue elasticity, histological changes, and incidental complications. Methods: A group of 18 patients with unilateral leg lymphedema stage II to IV was treated for a period of 3 years using an 8-chamber sleeve, sequential inflation of chambers to 100-120 mmHg for 50 sec (total 400 sec). Limb circumference and tissue tonicity were measured at monthly intervals. Correlation between decrease in calf and thigh circumference and increase in elasticity was done. Results: The treatment revealed durable permanent decrease of limb circumference and increased elasticity of tissues. The improvement was most expressed in the calf above the ankle and mid-calf. No complications as thigh ring or chronic genital edema were observed. There was no direct correlation between the decrease in limb circumference and increase in elasticity, most likely due to different mass of fibrous tissue. Conclusions: IPC takes over the permanently missing function of the obliterated lymphatics by squeezing edema tissue fluid to the regions with normal lymphatic drainage. The limb circumference is decreased or at least does not further increase, elasticity of tissue is increased and maintained. No complications in limb tissues were observed. The long-term, high pressure IPC, long inflation timed therapy can be safely be recommended to patients with lower limb lymphedema.

show abstract

“…The study [38] shows that the pressure in the upper limb with lymphedema is in the range between −1.5 and 10 mmHg. The median of maximum pressure generated by the lymphatic pump is 39 ± 14 mmHg for healthy subjects [39].…”

Section: Pressure and Boundaries Conditionsmentioning

confidence: 94%

A 2D Computational Model of Lymphedema and of its Management with Compression Device

Eymard

Volpert

Quéré

et al. 2017

Math. Model. Nat. Phenom.

View full text Add to dashboard Cite

Abstract. The purpose of this study is to model a lymphedema following a mastectomy and its management (compression therapy). During surgery for breast cancer, an axillary node dissection can be done and cause damages to the lymphatic system leading to a secondary lymphedema located in upper limb. Limb lymphedema is an incurable disease associated with chronic and progressive limb swelling condition. The main clinical consequence of lymphedema is the limb edema, clinically resulting in pain, discomfort, strength reduction and musculoskeletal complications due to limb excessive heaviness. Some devices for lymphedema (e.g. bandaging and garments) could be more personalized, taking into account both characteristics of compressions and patients. Before the evaluation of these therapeutic strategies in humans, an "in silico" approach could be used to investigate the interest of gradual or intermittent compression testing in virtual patients. For that purpose, we developed a simplified model of the lymph flow through the lymphatic system in a whole upper limb including the corresponding interstitial fluid exchanges.

show abstract

Tissue Fluid Pressure and Flow during Pneumatic Compression in Lymphedema of Lower Limbs

Cited by 43 publications

References 5 publications

Pressures and Timing of Intermittent Pneumatic Compression Devices for Efficient Tissue Fluid and Lymph Flow in Limbs with Lymphedema

Pressures and Timing of Intermittent Pneumatic Compression Devices for Efficient Tissue Fluid and Lymph Flow in Limbs with Lymphedema

The Effectiveness of Intermittent Pneumatic Compression in Long-Term Therapy of Lymphedema of Lower Limbs

A 2D Computational Model of Lymphedema and of its Management with Compression Device

Contact Info

Product

Resources

About