PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “Intermittent Pneumatic Compression Devices”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 109 records · Page 6Linked to original sources
PubMed2006

[Effectiveness of intermittent pneumatic compression (IPC) on thrombosis prophylaxis: a systematic literature review].

Despite changes in patient demographics and short-ened length of hospital stay deep vein thrombosis (DVT) remains a major health care problem which may lead to a variety of other high risk complications. Current treatment guidelines focus on preventive measures. Beside drug therapy, physical measures executed by nursing professionals exist, the outcomes of which are discussed controversially. Based on 25 studies that were found in MEDLINE and the Cochrane library, this systematic literature review identifies the effectiveness of intermittent pneumatic compression (IPC) on thrombosis prophylaxis. In almost all medical settings IPC contributes to a significant reduction of the incidence of DVT. At the same time, IPC has minimal negative side effects and is also cost effective. Correct application of IPC and patient compliance are essential to achieve its effectiveness. An increased awareness within the healthcare team in identifying the risk for and implementing measures against DVT is needed. Guidelines need to be developed in order to improve the effectiveness of thrombosis prophylaxis with the implementation of IPC.

Humans↗
PubMed2006

Vena cava filters in spinal cord injuries: evolving technology.

BACKGROUND: Asymptomatic deep venous thrombosis (DVT) has been reported in 60% to 100% of persons with spinal cord injury (SCI). Several guidelines have been published detailing recommended venous thromboembolism (VTE) prophylaxis after acute SCI. Low-molecular-weight heparin, intermittent pneumatic compression (IPC) devices, and/or graduated compression stockings are recommended. Vena cava filters (VCFs) are recommended for secondary prophylaxis in certain situations. OBJECTIVE: To clarify the use of vena cava filters in patients with SCI. METHODS: Literature review. RESULTS: Prophylactic use of vena cava filters has expanded in trauma patients, including individuals with SCI. Filter placement effectively prevents pulmonary emboli and has a low complication rate. Indications include pulmonary embolus while on anticoagulant therapy, presence of pulmonary embolus and contraindication for anticoagulation, and documented free-floating ileofemoral thrombus. VCFs should be considered in patients with complete motor paralysis caused by lesions in the high cervical cord (C2 and C3), with poor cardiopulmonary reserve, or with thrombus in the inferior vena cava despite anticoagulant prophylaxis. Three optional retrievable filters that are approved for use are discussed. CONCLUSION: Retrievable VCFs are a safe, feasible option for secondary prophylaxis of VTE in patients with SCI. Objective criteria for temporary and permanent placement need to be defined.

Anticoagulants↗
PubMed1999

Facilitating edema resolution with a foot pump after calcaneus fracture.

OBJECTIVES: To determine whether the use of a foot pump (intermittent pneumatic pedal compression device) in patients with excessive edema precluding surgery after acute fracture of the calcaneus leads to more rapid resolution of the edema. DESIGN: Prospective randomized setting. Standard hospital in-patient ward at a Level I trauma center. PATIENTS: Those patients with excessive edema precluding operative intervention upon admission after an intraarticular calcaneus fracture who signed an informed consent participated in the study. Twenty-eight patients were enrolled and completed the study: thirteen patients in the foot pump group and fifteen patients in the control group. INTERVENTION: In the control group, patients had a bulky compression dressing, posterior splint, and elevation while awaiting surgery. In the study group, the patients had a foot pump applied to the foot with a posterior splint and elevation while awaiting surgery. MAIN OUTCOME MEASUREMENTS: The volumetric change of the foot at twenty-four-hour intervals for up to seventy-two hours in both the control and study groups. RESULTS: All thirteen patients tolerated the foot pump. The differences in the volume between Day I (baseline) and Day 2 for the foot pump and control groups were minus forty and plus seventy-six milliliters, respectively (p = 0.02). Between Days 1 and 3, the differences were minus ninety-six milliliters for the foot pump group and plus thirty-seven milliliters for the control group (p = 0.02). CONCLUSIONS: A significant progressive decrease in the foot volume was noted during the first forty-eight hours after application of the foot pump in patients with excessive edema precluding operative fixation of a calcaneus fracture upon presentation. The pump was well tolerated by all the patients in the study group. Thus, we believe the pump serves as a useful adjunct in the preoperative edema resolution following these complicated fractures.

Ankle Injuries↗
PubMed2004

The efficacy of the A-V Impulse system in the treatment of posttraumatic swelling following ankle fracture: a prospective randomized controlled study.

OBJECTIVES: To determine whether the use of the A-V Impulse "in-cast" system conveyed any clinical benefit in the treatment of post-traumatic swelling following ankle fracture. DESIGN: A prospective randomised study comparing the effectiveness of the A-V Impulse "in-cast" system to that of elevation and plaster in the treatment of preoperative swelling. SETTING: Clinical management in a large level 2 trauma center. PATIENTS: Sixty-four adult patients were recruited to the study who had sustained closed unilateral ankle fractures requiring internal fixation, but for whom immediate surgery was not possible. INTERVENTION: All fractured ankles were treated with initial application of a plaster back-slab splint. Patients were randomized to either a control group of limb elevation or to a study group in whom an A-V Impulse bladder was fitted under the arch of the foot within the plaster back-slab and intermittent pneumatic pedal compression provided until surgery. MAIN OUTCOME MEASUREMENTS: Daily circumferential ankle girth measurements were performed. The time taken for swelling to resolve sufficiently to permit surgery, the development of skin complications, and the duration of hospitalisation were recorded. RESULTS: Ten patients were withdrawn from the study. Twenty-seven patients in each group were followed up until discharge from outpatient care. Statistical analysis revealed a significant reduction in time taken for ankle swelling to settle prior to surgery (P = 0.01) in the study group, together with a reduction in wound and skin complications (P < 0.01) and final preoperative ankle swelling (P = 0.03). CONCLUSION: The A-V Impulse "in-cast" system demonstrated significant benefit in the management of adults with isolated ankle fractures who could not undergo immediate open reduction and internal fixation.

Adult↗
PubMed2004

Point of view.

Explore the source record for details and available documents.

Ankle Injuries↗
PubMed2006

Cost-effectiveness of thromboprophylaxis with intermittent pneumatic compression at cesarean delivery.

OBJECTIVE: To evaluate the cost-effectiveness of thromboprophylaxis at cesarean delivery with intermittent pneumatic compression. METHODS: A decision tree model using Markov analysis was developed to compare two approaches to perioperative care at the time of cesarean delivery: 1) no use of perioperative thromboprophylaxis and 2) the use of intermittent pneumatic compression for thromboprophylaxis at the time of cesarean delivery. Postcesarean deep venous thrombosis was estimated to occur in 0.7% of patients (75% of whom were asymptomatic), and result in a 9% chance of postthrombotic syndrome. Mechanical prophylaxis was assumed to decrease the risk of deep venous thrombosis by 70% and to cost 120 dollars. Probability of morbidity and mortality of venous thromboembolism as well as anticoagulation and the costs and utilities for different health state were derived from published studies. Sensitivity analysis was performed over a wide range of variable estimates. RESULTS: Using the assumptions in our base case, routine thromboprophylaxis for cesarean delivery cost 39,545 dollars per quality-adjusted life year. One-way sensitivity analysis revealed that as long as the incidence of postcesarean deep venous thrombosis was at least 0.68%, intermittent pneumatic compression reduced the incidence of deep venous thrombosis by at least 50%, or the cost of intermittent pneumatic compression was less than 180 dollars, the cost-effectiveness of mechanical prophylaxis did not exceed 50,000 dollars per quality-adjusted life year. CONCLUSION: Mechanical thromboprophylaxis is estimated to be a cost-effective strategy under a wide range of circumstances.

Adult↗
PubMed2005

Tourniquets may increase postoperative swelling and pain after internal fixation of ankle fractures.

UNLABELLED: Tourniquets frequently are used in orthopaedic surgery to provide a bloodless field. There is still controversy among authors regarding the benefits and potential risks of using a tourniquet. The objective of this prospective randomized study was to quantify the effect of tourniquet use on postoperative swelling, pain, and range of motion after open reduction and internal fixation of ankle fractures. Fifty-four patients with closed ankle fractures were treated surgically; 26 patients were operated on using a thigh tourniquet (Group A), and 28 patients had surgery without the use of a tourniquet (Group B). The groups of patients were similar for age, gender, fracture types, and operative procedures. There was no difference in operation time. Using a tourniquet during open reduction and internal fixation of ankle fractures did increase postoperative swelling and postoperative pain at Day 5 and at Week 6 after surgery. We found a trend for a better range of motion in the ankle until the 6-week followup in the nontourniquet group compared with the group in which the tourniquet was inflated. According to these results we do not recommend using a tourniquet for osteosynthesis of ankle fractures. LEVEL OF EVIDENCE: Therapeutic study, Level I-1 (randomized controlled trial). See the Guidelines for Authors for a complete description of levels of evidence.

Adolescent↗
PubMed2006

Multimodal prophylaxis for THA with mechanical compression.

We used mechanical thromboembolism prophylaxis using intraoperative thigh-calf pneumatic compression and other measures in 1032 consecutive primary and revision total hip arthroplasties. No chemical prophylactic measures were used until after duplex ultrasonography was performed by experienced technologists before discharge. Asymptomatic proximal thrombi were treated with low molecular weight heparin and warfarin, whereas those patients with a negative scan or distal thrombi only were advised to take aspirin 325 mg twice a day for 6 weeks. Regional anesthesia was used in 95% of the arthroplasties. Using this protocol, the 30-day mortality was 0.3%. There was one autopsy-proven fatal pulmonary embolism (0.09%). One other patient died suddenly with cardiac arrest after abdominal pain and vomiting, but no autopsy was performed. Symptomatic pulmonary embolism occurred in seven patients (0.7%), four occurring early and three late. Only one of these seven patients had a positive duplex scan. Deep vein thrombosis occurred in 41 patients (3.9%) and 35 remained asymptomatic. We observed no association between type of surgery (primary or revision), age, gender or preoperative diagnosis and pulmonary embolism or deep vein thrombosis. The data confirm the efficacy of a multimodal protocol with thigh-calf mechanical prophylaxis for almost all patients undergoing primary or revision total hip arthroplasty.

Adult↗
PubMed2005

The effect of intermittent pneumatic compression on fracture healing.

OBJECTIVES: Continuously increased venous pressure has been shown to enhance bone growth, stimulate fracture healing, and prevent bone loss, but also causes soft-tissue breakdown as a result of chronic edema. This study was designed to test the hypothesis that intermittently increased venous pressure improves fracture healing without injuring soft tissue. DESIGN: An ostectomy was created in the right radius of 30 skeletally mature male beagles. On postoperative day 7, a pneumatic cuff was placed around the forelimb of each dog. In experimental animals (n = 13), the cuff compressed for 5 minutes followed by no compression for 2.5 minutes. This cycle was repeated 100 times per day for 8 weeks. Control animals (n = 15) wore a nonfunctional cuff. Fracture healing was assessed with dual-energy x-ray absorptiometry, histologic analysis, and biomechanical testing. RESULTS: No soft-tissue complications were noted. Bone mineral content at the ostectomy increased significantly more in the experimental group than in the control group (P < 0.05). Histology revealed that the bone defects in the experimental group were significantly more healed than those in the control group (P < 0.005). No differences were noted between groups in the biomechanical properties of the healing bones. CONCLUSIONS: Intermittently increased venous pressure proximal to a bone defect seems to enhance the formation of new bone without soft-tissue complications. These findings can potentially be applied to the clinical treatment of "difficult to heal" fractures. Further work is necessary to determine the most effective ratio of the presence and absence of pneumatic compression.

Absorptiometry, Photon↗
PubMed2006

Efficacy of pneumatic compression stocking prophylaxis in the prevention of deep venous thrombosis and pulmonary embolism following 139 lumbar laminectomies with instrumented fusions.

OBJECTIVE: Low-dose heparin (LDH) regimens reduce the frequency of deep venous thrombosis (DVT) and pulmonary embolism (PE) in spinal surgery but pose a risk of postoperative hemorrhage threatening neurologic function. Pneumatic compression stocking (CS) could provide an alternative means of mechanical prophylaxis alone against DVT and PE and would possibly avoid its hemorrhagic complications. METHODS: The efficacy of CS alone in preventing DVT and PE was evaluated in 139 patients undergoing multilevel lumbar laminectomies (average 3.8 levels) with instrumented fusions (average 1.4 levels). All patients received CS stocking prophylaxis intraoperatively and throughout the average 5-day postoperative course including following ambulation. Doppler screening for DVT was routinely performed 2 days postoperatively. Subsequent Doppler studies or computed tomography angiograms were selectively performed in symptomatic patients with potential DVT/PE. RESULTS: Four (2.8%) patients developed DVT 2-6 days postoperatively and required inferior vena cava (IVC) filters. One of the four had a positive routine screening Doppler study performed the second postoperative day. Two developed DVT the fourth postoperative day. The fourth patient developed DVT 6 days postoperatively but 3 weeks later embolized around the IVC filter. This patient, the only one to develop a PE, tested positive for Factor V Leiden mutation (hypercoagulable syndrome) and remains on long-term warfarin. CONCLUSIONS: Pneumatic compression stocking prophylaxis effectively reduced the incidence of DVT (2.8%) and PE (0.7%) in 139 patients undergoing multilevel lumbar laminectomies with instrumented fusions. These rates compared favorably with those reported in spinal series employing LDH prophylaxis.

Adult↗
PubMed2006

Thromboprophylaxis in medical and surgical patients undergoing physical medicine and rehabilitation: consensus recommendations.

Venous thromboembolism (deep venous thrombosis with or without its major complication, pulmonary embolism) commonly occurs in patients undergoing rehabilitative therapy for various surgical or traumatic conditions and in patients with incapacitating medical illnesses. Thromboprophylaxis utilizes medications that interfere with the coagulation process and mechanical measures such as graded elastic stockings and intermittent pneumatic compression. To obtain a range of expert opinion on the optimal use of the numerous antithrombotic modalities now available, a consortium comprising clinical directors at a number of rehabilitative centers in south Florida met to review the literature on thromboprophylaxis in rehabilitation patients and to discuss the strategies followed at their respective facilities. The consortium then assembled a set of recommendations based on available evidence-based literature and established consensus on acceptable forms of thromboprophylaxis in each clinical condition in rehabilitation associated with an increased risk of venous thromboembolism.

Anticoagulants↗
PubMed2005

Effect of intermittent pneumatic compression of foot and calf on walking distance, hemodynamics, and quality of life in patients with arterial claudication: a prospective randomized controlled study with 1-year follow-up.

SUMMARY BACKGROUND DATA: Perioperative mortality, graft failure, and angioplasty limitations militate against active intervention for claudication. With the exception of exercise programs, conservative treatments yield modest results. Intermittent pneumatic compression [IPC] of the foot used daily for 3 months enhances the walking ability and pressure indices of claudicants. Although IPC applied to the foot and calf together [IPCfoot+calf] is hemodynamically superior to IPC of the foot, its clinical effects in claudicants remain undetermined. OBJECTIVE: This prospective randomized controlled study evaluates the effects of IPCfoot+calf on the walking ability, peripheral hemodynamics, and quality of life [QOL] in patients with arterial claudication. METHODS: Forty-one stable claudicants, meeting stringent inclusion and exclusion criteria, were randomized to receive either IPCfoot+calf and aspirin[75 mg] (Group 1; n = 20), or aspirin[75 mg] alone (Group 2; n = 21), with stratification for diabetes and smoking. Groups matched for age, sex, initial [ICD] and absolute [ACD] claudication distances, pressure indices [ABI], popliteal artery flow, and QOL with the short-form 36 Health Survey Questionnaire (SF-36). IPCfoot+calf (120 mm Hg, inflation 4 seconds x 3 impulses per minute, calf inflate delay 1 second) was used for 5 months, > or =2.5 hours daily. Both groups were advised to exercise unsupervised. Evaluation of patients, after randomization, included the ICD and ACD, ABI, popliteal artery flow with duplex and QOL* at baseline*, 1/12, 2/12, 3/12, 4/12, 5/12* and 17/12. Logbooks allowed compliance control. Wilcoxon and Mann-Whitney corrected[Bonferroni] tests were used. RESULTS: At 5/12 median ICD, ACD, resting and postexercise ABI had increased by 197%, 212%, 17%, and 64%, respectively, in Group 1 (P < 0.001), but had changed little (P > 0.1) in Group 2; Group 1 had better ICD, ACD, and resting and postexercise ABI (P < 0.01) than Group 2. Inter- and intragroup popliteal flow differences at 5/12 were small (P > 0.1). QOL had improved significantly in Group 1 but not in Group 2; QOL in the former was better (P < 0.01) than in Group 2. QOL in Group 1 was better (P < 0.01) than in Group 2 at 5/12. IPC was complication free. IPC compliance (> or =2.5 hours/d) was >82% at 1 month and >85% at 3 and 5 months. ABI and walking benefits in Group 1 were maintained a year after cessation of IPC treatment. CONCLUSIONS: IPCfoot+calf emerged as an effective, high-compliance, complication-free method for improving the walking ability and pressure indices in stable claudication, with a durable outcome. These changes were associated with a significant improvement in all aspects of QOL evaluated with the SF-36. Despite some limited benefit noted in some individuals, unsupervised exercise had a nonsignificant impact overall.

Aged↗
PubMed2006

Incidence and propagation of infrageniculate deep venous thrombosis in trauma patients.

BACKGROUND: The incidence and propagation of thrombosis involving vessels distal to the popliteal vein has not been clearly defined in trauma patients. Our aim was to determine the incidence and rate of propagation of infrageniculate deep venous thrombosis (DVT) in a trauma population and identify potential risk factors specific to propagation. METHODS: Retrospective review of all trauma admissions between the years 2001 and 2003 was conducted. Only those 18 years or older with an isolated infrageniculate DVT who underwent a lower extremity venous duplex scan during admission were included in the study. Nature of injury, injury severity score (ISS), method of DVT prophylaxis, thrombus location, and risk factors for hypercoagulable states were recorded. RESULTS: During the study period, 698 trauma admissions were included, and 109 (15.7%) with infrageniculate DVT were identified. Thirty-nine (35.7%) had thrombus propagation (14 suprageniculate and 25 infrageniculate) with a mean ISS of 27.6. Seventy (64.3%) had infrageniculate DVT without propagation and a mean ISS of 19.6. Thirty-eight (97%) patients with propagating infrageniculate DVT had received mechanical prophylaxis, and 33 (84%) also received chemical prophylaxis. The 14 patients with suprageniculate thrombus propagation were the most severely injured (mean ISS = 35.1). Elevated ISS, operation, age < or =62 years, and intensive care unit admission were positively correlated with propagation of infrageniculate DVT. CONCLUSION: The incidence and propagation of infrageniculate DVT in an aggressively prophylaxed trauma population are greater than previously reported. The clinical significance of isolated infrageniculate DVT remains to be determined, but when associated with a multiple injury trauma, the patient may be at risk for future suprageniculate DVT formation and may benefit from therapeutic anticoagulation.

Female↗
PubMed2026

Effects of Vacuum Compression Therapy on Healing of Chronic Lower Limb Ulcers: A Randomised Controlled Study.

Chronic lower limb ulcers remain difficult to manage when unresponsive to conventional treatment. This study evaluated the clinical and physiological effects of vacuum compression therapy on wound healing and quality of life. Fifty patients with chronic lower limb ulcers were randomised to receive 12 sessions of vacuum compression therapy plus standard care or standard care alone over 4&#x2009;weeks. Wound dimensions, exudate, pain intensity and quality of life were assessed at baseline and post-treatment. Estimated wound volume was calculated as length&#x2009;&#xd7;&#x2009;width&#x2009;&#xd7;&#x2009;depth. Tissue oxygenation was measured at the dorsum of the foot in the experimental group. The vacuum compression therapy group showed greater improvements in wound width, depth, volume and quality of life. Estimated wound volume decreased by 61% in the intervention group, whereas no statistically significant volume reduction was observed in controls. Local tissue oxygenation in the experimental group increased by 43%. Baseline wound size was associated with poorer quality of life. Vacuum compression therapy may enhance wound healing and quality of life in patients with chronic lower limb ulcers. Observed increases in local tissue oxygenation represent exploratory physiological findings within the treated cohort that warrant controlled comparative evaluation. Trial Registration: ClinicalTrials.gov identifier: NCT07737184.

Humans↗
PubMedDate not supplied

The pneumatic tourniquet technique for endoscopic radial artery harvest.

BACKGROUND: Endoscopic vessel harvest is viewed as a safe, reliable, and cost-effective method for greater saphenous vein removal. As the radial artery has more recently become a popular conduit choice in coronary artery revascularization, we describe herein an endoscopic technique for radial artery harvest in our first 50 patients as an alternative to the more traditional open technique. METHODS: From November 2001 to July 2002, 54 radial arteries were harvested endoscopically in 50 patients utilizing the VasoView Endoscopic Vessel Harvesting System, an Esmark bandage, and a pneumatic cuff tourniquet. RESULTS: No patients experienced symptoms of vascular compromise, or signs of infection in the donor arm. No adjunctive procedures were required during the vessel harvest, i.e., conversion to open technique. All radial arteries were successfully removed with endoscopic technique and 53 of the 54 radial arteries were successfully used as bypass conduits. Although the quality of the radial artery harvested remains subjective, we found less vasospasm than in our experience with the open technique. Thirty-day follow-up revealed no readmissions, no cardiac ischemic complications, no significant complications with the donor arm, and an excellent cosmetic result. CONCLUSIONS: Endoscopic harvest of the radial artery with the tourniquet technique may offer advantages over the more traditional open technique.

Adult↗
PubMed1999

Inhibition of tissue factor pathway during intermittent pneumatic compression: A possible mechanism for antithrombotic effect.

Intermittent pneumatic compression (IPC) devices are an effective prophylaxis against lower extremity deep vein thrombosis. Their antithrombotic effect has been attributed to a reduction in venous stasis and enhanced fibrinolysis. The initiating mechanism for blood coagulation is the tissue factor (TF) dependent pathway, which is inhibited by tissue factor pathway inhibitor (TFPI). We have investigated the effect of IPC on the TF pathway in 6 normal subjects and 6 patients with postthrombotic venous disease undergoing IPC for 120 minutes; all subjects were studied with each of 5 IPC devices. In normal subjects and patients, plasma factor VIIa (FVIIa) activity (the activated form of factor VII [FVII]) declined from mean values ranging 51 to 65 and 50 to 53 mU/mL before IPC with different devices to 10 to 13 and 20 to 22 mU/mL at 180 minutes, respectively (P<0.001 for all groups). FVII antigen levels were unchanged. Plasma TFPI (P<0.001) rose from mean baseline values ranging 69 to 79 and 57 to 61 ng/mL to 76 to 123 and 71 to 79 ng/mL at 180 minutes in normal subjects and patients, respectively (P<0. 001 for all groups). Plasma prothrombin fragment F1.2 levels showed minimal changes. There was an inverse relationship between TFPI and FVIIa in normal subjects (r=-0.31, P=0.001) and patients (r=-0.37, P<0.001). IPC results in an increase in plasma TFPI and decline in FVIIa. Inhibition of TF pathway, the initiating mechanism of blood coagulation, is a possible mechanism for the antithrombotic effect of IPC.

Adult↗
PubMedDate not supplied

Importance and advantages of intermittent external pneumatic compression therapy in venous stasis ulceration.

Venous ulcers are seen following postthrombophlebitic syndrome with venous insufficiency and can begin as a result of minor trauma. In this retrospective study the authors examined the value of external intermittent pneumatic compression therapy in chronic venous ulcers. Results in 1,250 patients with postthrombophlebitic syndromes, 235 of these patients with leg ulcers, revealed that this modality of therapy shortens the therapy duration, lowers the total therapy cost, and hastens the return to active life in comparison to the classical therapy with compression stockings and antiaggregant or low-dose oral anticoagulant therapy. In the light of their findings they propose the wider use of this adjuvant therapy.

Adult↗