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 127 records · Page 7Linked to original sources
PubMedDate not supplied

Use of intermittent pneumatic compression for treatment of upper extremity vascular ulcers.

Ischemic vascular ulcerations of the upper extremities are an uncommon and frequently painful condition most often associated with scleroderma and small vessel inflammatory diseases. Digital amputation has been advocated as primary therapy because of the poor outcome with medical care. Intermittent pneumatic compression (IPC) pump therapy can improve ulcer healing in lower extremity ischemic ulcerations; however, the value of this treatment in upper extremity ischemic ulcerations is not known. This observational pilot study consisted of a consecutive series of 26 patients with 27 upper extremity ischemic vascular ulcers seen at the Mayo Gonda Vascular Center from 1996 to 2003. Inclusion criteria were documented index of ulcer size and follow-up ulcer size and use of the IPC pump as adjunctive wound treatment. Twenty-six of 27 ulcers (96%) healed with the use of the IPC pump. Mean baseline ulcer size was 1.0 cm2 (SD=0.3 cm2) and scleroderma was the underlying disease in 65% (17/26) of cases. Laser Doppler blood flow in the affected digit was 7 flux units (normal greater than 100). The mean ulcer duration before IPC treatment was 31 weeks. The average pump use was 5 hours per day. The mean time to wound healing was 25 weeks. Twenty-five of 26 patients reported an improvement in wound pain with pump use. Intensive IPC pump use is feasible and associated with a high rate of healing in upper extremity ischemic ulcers. A prospective, randomized, sham-controlled study of IPC is needed to determine whether IPC treatment improves wound healing compared to standard medical care.

Adult↗
PubMed2005

The case for intermittent pneumatic compression of the lower extremity as a novel treatment in arterial claudication.

Appreciation of the physiologic role of the natural muscle pumps of the lower limb in enhancing the return of venous blood promoted the development of intermittent pneumatic limb compression (IPC) systems that could activate these pumps artificially. The application of IPC to the foot (IPC(foot)), calf (IPC(calf)) or both (IPC(foot + calf)) on dependency generates a significant acute arterial leg inflow enhancement in patients with intermittent claudication that is highest with IPC(foot + calf), followed by IPC(calf) and IPC(foot). This enhancement is attributable to the leg venous pressure decrease after venous expulsion with IPC, which results in arteriovenous pressure elevation, and a marked attenuation in peripheral resistance to flow due to a transient abolition of peripheral sympathetic autoregulation and the release of nitric oxide. Implementation of IPC(foot) and IPC(foot + calf) for 3 to 5 months (> or = 2.5 hours/day) has been shown to improve the walking capacity and the ankle pressure indices of patients with intermittent claudication, with a significant beneficial impact on the quality of life. As the prevalence of symptomatic peripheral arterial disease is projected to increase substantially over the next decades with the aging population in Western societies and in the absence of established, cost-effective methods of treatment for claudication, the reported efficacy of IPC in claudication certainly warrants clinical attention. Level-1 clinical evidence by three independent investigators supports the clinical role of IPC in arterial claudication, reinforced by its domiciliary applicability, the high patient compliance with which it is associated, and the modest cost. This review offers an insight into the hemodynamic and clinical effects of IPC in patients with claudication in relation to the physiologic mechanisms proposed in explanation of these effects.

Blood Flow Velocity↗
PubMed2005

Prevention of venous thrombosis in patients with acute intracerebral hemorrhage.

OBJECTIVE: To assess intermittent pneumatic compression (IPC) in the prevention of venous thromboembolism (VTE). METHODS: The authors randomly allocated patients with a documented intracerebral hemorrhage (ICH) to elastic stockings (ES) alone or combined with IPC. The primary outcome was a combined criteria assessed at day 10: a symptomatic and well-documented VTE, or a death arising before day 10 and related to pulmonary embolism (PE), or an asymptomatic deep vein thrombosis (DVT) of the lower limbs detected by compression ultrasonography (CUS). Outcome assessment was blinded. RESULTS: One hundred fifty-one patients were randomized; 133 (88%) patients were evaluated at day 10. No clinical suspicion of VTE arose before day 10. Fourteen patients died before having a CUS but no death was definitely related to PE. Fourteen asymptomatic DVT were detected by CUS: three (4.7%) in the ES + IPC group (all distal) and 11 (15.9%) in the ES group (three proximal and eight distal). ES combined with IPC is associated with a reduced risk of asymptomatic DVT compared to ES alone: relative risk, 0.29 (95% CI 0.08 to 1.00). CONCLUSIONS: Asymptomatic deep vein thrombosis (DVT) was detected at day 10 in 15.9% of patients wearing elastic stockings alone. Intermittent pneumatic compression significantly decreased the occurrence of asymptomatic DVT for patients with intracerebral hemorrhage.

Acute Disease↗
PubMed2005

Pharmacological prevention of venous thromboembolism in medical patients at risk.

Acutely ill general medical patients are at moderate-to-high risk of venous thromboembolism (VTE); approximately 10-30% may develop deep vein thrombosis or pulmonary embolism, the latter being a leading contributor to deaths in hospital. Medical conditions associated with a high risk of VTE include cardiac disease, cancer, respiratory disease, inflammatory bowel disease, and infectious disease. Predisposing risk factors for VTE in medical patients include history of VTE, history of malignancy, complicating infections, increasing age, thrombophilia, prolonged immobility, and obesity. Unfractionated heparin (UFH), low-molecular weight heparin (LMWH), and fondaparinux sodium have been shown to be effective agents in the prevention of VTE in medical patients. In this setting, UFH has a higher rate of bleeding complications than LMWH. There is no evidence supporting the use of aspirin, warfarin, or mechanical methods to prevent VTE in medical patients. We recommend either LMWH or fondaparinux sodium as well tolerated and effective thromboprophylactic agents in medical patients.

Anticoagulants↗
PubMed2004

The use of a pneumatic leg brace in soldiers with tibial stress fractures--a randomized clinical trial.

STUDY DESIGN: Single blind randomized controlled replication study. OBJECTIVES: Evaluate the effect of a pneumatic leg brace on return-to-activity and pain in soldiers with tibial stress fractures. METHODS AND MEASURES: Thirty-one subjects diagnosed with tibial stress fractures were randomly assigned to either a brace or control group. Dependent variables included time to pain-free single-leg hopping, visual analog pain scale, and time to a pain-free 1-mile run. Twenty subjects (10 brace, 10 control) completed a detailed functional progression culminating in a 1-mile run. RESULTS: There was no difference between groups for time to pain-free hop (p > 0.86; power = 0.43) and time to pain-free 1-mile run (p > 0.24; power = 0.92). Subjects in both groups experienced statistically significant improvements in pain measurements (p < 0.002), but no difference was found between groups (p > 0.93). CONCLUSION: The current study demonstrated no added benefit of Aircast leg braces in the treatment of tibial stress fractures in the military training environment.

Adult↗
PubMed2003

[Incidence and clinical characteristics of perioperative pulmonary thromboembolism under the use of intermittent pneumatic compression as a preventive measure].

Pulmonary thromboembolism (PTE) is a crucial complication characterized by rapid onset and a high mortality rate. There are few reports concerning perioperative incidence of PTE and deep vein thrombosis (DVT) among Japanese population. All surgical patients excluding young patients for minor surgery were equipped with calf- or thigh-length intermittent pneumatic compression (IPC) device as a DVT preventive method during the period of immobility. Incidence and clinical characteristics of perioperative PTE and DVT under the use of IPC device were analyzed at Kobe University Hospital. One patient developed DVT and four patients developed PTE among the 6500 surgical cases. All patients with DVT or PTE were 66 years or older, and all patients were diagnosed by computer tomography, venography and pulmonary angiography between 7 to 14 days after each operation. One patient was surgically treated by embolectomy and removal of intraarterial thrombus, and others were treated with thrombolysis, anticoagulants and placement of vena cava filters. For prevention of DVT and PTE, other preventive methods such as anticoagulants and prolonged application of IPC should be necessary.

Age Factors↗
PubMed2005

Evaluation of two different intermittent pneumatic compression cycle settings in the healing of venous ulcers: a randomized trial.

BACKGROUND: Intermittent pneumatic compression (IPC) has been successfully used in the treatment of venous ulcers, although the optimal setting of pressure, inflation and deflation times has not yet been established. The aim of this study was to compare the effect of two different combinations of IPC pump settings (rapid vs slow) in the healing of venous ulcers. MATERIAL/METHODS: 104 patients with pure venous ulcers were randomized to receive either rapid IPC or slow IPC for one hour daily. The primary and secondary end points were the complete healing of the reference ulcer and the change in the area of the ulcer over the six months observational period, respectively. RESULTS: Complete healing of the reference ulcer occurred in 45 of the 52 patients treated with rapid IPC, and in 32 of the 52 patients treated with slow IPC. Life table analysis showed that the proportion of ulcers healed at six months was 86% in the group treated with the fast IPC regimen, compared with 61% in the group treated with slow IPC (p=0.003, log-rank test). The mean rate of healing per day in the rapid IPC group was found to be significantly faster compared to the slow IPC group (0.09 cm2 vs 0.04 cm2, p=0.0002). CONCLUSIONS: Treatment with rapid IPC healed venous ulcers more rapidly and in more patients than slow IPC. Both IPC treatments were well tolerated and accepted by the patients. These data suggest that the rapid IPC used in this study is more effective than slow IPC in venous ulcer healing.

Adult↗
PubMed2006

[Prophylactic strategies for perioperative pulmonary embolism: the second report; reevaluation of usefulness of combination of elastic stockings and intermittent pneumatic compression].

BACKGROUND: The incidence of perioperative pulmonary thromboembolism (PTE) has increased in Japan. As the mortality rate of PE is very high, its prophylaxis is important. METHODS: From January 1998 to December 1999 no prophylactic strategies were employed. From May 2000 to December 2004, elastic stockings (ES) for prevention of perioperative deep vein thrombosis were worn from the morning of the operation until the beginning of ambulation. Intermittent pneumatic compression (IPC) apparatuses were used in combination with ES right after the induction of anesthesia until leaving ICU. Sixty percent of patients stayed in ICU until the next morning after the operation and the other patients for a few hours after the end of surgery. RESULTS: We managed 4,511 patients without any preventing method and 11,688 patients with the combination of ES and IPC. Seven patients developed PTE without any prophylaxis and one with preventative methods. The incidence of PTE was significantly decreased from 15.51 persons/10,000 cases to 0.86 person/10,000 cases. Symptomatic deep vein thrombosis occurred in 3 cases in spite of preventative methods. CONCLUSIONS: Our preventive strategies with the combination of ES and IPC seem to be useful to decrease the incidence and severity of perioperative PTE.

Aged↗
PubMed2006

[Prevention of venous thromboembolism: generally accepted guidelines].

This article summarizes the published data on the prevention of venous thromboembolism. Routine thromboprophylaxis is the best way to lower the risk. It is recommended to sort patients according the thrombosis risk and to make use of the standard prophylactic modes. In low risk patients, no specific thromboprophylaxis is needed. Patients with moderate risk levels are candidates for administration of subcutaneous low molecular weight heparin (LMWH) at doses under 3 400 anti-Xa units a day and patients with increased risk at doses higher than 3400 anti-Xa units a day during the period of higher risk. In order to decrease the risk of bleeding, a half dose 2 hours prior or 4-6 hours after the operation can be administered. Under the highest risk conditions, there is a recommendation to combine LMWH over 3 400 anti-Xa units with elastic panty-hose or, alternatively, with intermittent pneumatic compression. At moderate risk levels, subcutaneous administration of unfractionated heparin at the doses of 5 000 units twice a day is also possible and at increased risk levels, a TID administration over the increased risk period. In patients with a significant bleeding risk, the physical method of thromboprophylaxis can be used and pharmacological prophylaxis can set in after the risk of bleeding has passed. Fondaparinux is the alternative to LMWH in people after major orthopaedic surgeries and with a history of heparin induced thrombocytopenia over the past three months. An alternative to the administration of LMWH even after the end of the hospitalization can be warfarin in certain situations. The sole use of acetylsalicylic acid or Rheodextran is not recommended. While undertaking epidural anaesthesia or analgesia, it is necessary to follow strictly the guidelines of the use of pharmacological thromboprophylaxis.

Anticoagulants↗
PubMed2006

Total knee replacement: prevention of deep-vein thrombosis using pharmacological (low-molecular-weight heparin) and mechanical (intermittent foot sole pump system) combined prophylaxis. Preliminary results.

AIM: The aim of this study was to determine the role of combined mechanical and pharmacological prophylaxis in the prevention of deep venous thrombosis (DVT) after total knee replacement (TKR). DESIGN: prospective case series study. METHODS: Between October 2002 and June 2003, 38 total knee procedures were carried out on 34 patients (4 patients had bilateral TKR). To exclude the presence of a concomitant DVT echo-color-flow of the legs was performed between 2 and 1 week prior to surgery, in the postoperative period (before discharging) and 30 days after surgery. Patients received one daily subcutaneous injection of nadroparin calcium (dosage adapted to body-weight). An intermittent foot sole pump (IFSP) was applied in the recovery room postoperatively, in both feet for about 5 h a day and all night long, and continued at home until the 15(th) day. RESULTS: No major perioperative or rehabilitation phase-related complications were observed (2 patients required manual drainage of blood clots from the wound). The incidence of DVT was 7.9% (3 cases). In one of these cases we observed a previous DVT so it was classified as rethrombosis. All were successfully treated with therapeutic introduced low molecular weight heparin (LMWH) therapy. No pulmonary embolism or deaths associated with the use of LMWH or IFSP were observed. CONCLUSIONS: In our experience the combined prophylaxis with nadroparin calcium and IFSP significantly reduced the incidence of DVT.

Aged↗
PubMed2006

The current status of thromboprophylaxis after trauma: a story of confusion and uncertainty.

It is difficult to support a standard of care for venous thromboprophylaxis after trauma when there is no convincing research that any of the currently used methods is consistently effective. Because many conclusions from the nontrauma literature have been misleadingly extrapolated to trauma patients, this review focuses exclusively on trauma articles. These articles present variable results. The rates of deep venous thrombosis and pulmonary embolism are widely different even among similar trauma populations. The heparin-unfractionated or low-molecular-weight and calf compression methods fail to show a reproducible effect in decreasing venous thromboembolic events. The current methods of venous thromboprophylaxis after trauma are inadequate and further research in this area is direly needed.

Clinical Trials as Topic↗
PubMedDate not supplied

[Complications in complex fractures of the tibial plateau and associated factors].

BACKGROUND: We undertook this study to identify factors associated with surgical complications of complex fractures of the tibial plateau. METHODS: We designed a case-control study with 56 patients with a diagnosis of complex fracture in the tibial plateau (IV-VI Schatzker) and with 12.9 +/- 3.2 (8-18) months of follow-up. Risk factor exposure was defined as having one or more of the following characteristics: age >60 years; co-morbidity (diabetes mellitus, systemic arterial hypertension); time of "Kidde" (>60, >90, >120 min) and fracture type IV, V or VI. A case was considered with one or more complications. RESULTS: Mean age was 50.1 +/- 15.7 (17-87) years old; 35 patients (62.5%) were males. Homogeneity between groups was shown for age, sex, side effects, type of fracture and time of follow-up; 41.1% of patients had pathological history. All surgeries used pneumatic compression (Kidde) for 91 +/- 27.2 (40-175) min. The implants used were plate plus cancellous screws (53.6%), external fixators plus cancellous screws (35.7%), double plate and intramedullary nail. Complications appeared in 37.5% of all patients. Complications reported were superficial infection (16.1%), residual angular deformities (10.7%, varum [7.1%]), peroneal nerve injury (5.4%), non-union (3.5%) and deep venous thrombosis (1.8%); 22.2% of all patients presented more than one complication. CONCLUSIONS: Statistically significant risk factors were age >60 years and pneumatic compression >120 min. Patients with one of these characteristics had a three-times risk of complications. No association was demonstrated between type of fracture, surgical treatment, time between injury and the surgery, with development of complications.

Adolescent↗
PubMed1990

Modified stirrups for dorsal lithotomy positioning.

The modified dorsal lithotomy position is excellent for radical pelvic operations. Use of modified Krauss arm supports as stirrups, along with pneumatic devices that intermittently compress the legs, significantly reduces postoperative morbidity in patients who undergo operations in this position.

Cystectomy↗
PubMed1985

[New aspects of lymphedema].

Present knowledge on primary and secondary lymphedema of the extremities is reviewed. Conventional lymphography with contrast media requires surgical cannulation of pedal lymphatics and is indicated only in a few specific situations. Clinical findings, results of the patent blue test and possibly fluorescence microlymphography with fluorescent dextrans, indirect lymphography with iotasul, or isotope studies, suffice for correct diagnosis. In hereditary lymphedema present at birth (Milroy's disease) the lymphatic capillaries and precollectors are aplastic, whereas in sporadic lymphedema with postpubertal onset the large collectors are hypoplastic or aplastic. Conventional lymphography still yields the best results in differentiating between primary lymphedema with aplasia of the aorto-iliac collectors and a secondary form due to neoplastic disease. Combined physical therapy with tight bandages and stockings, massage and use of pneumatic devices for intermittent compression considerably reduces the edema and renders surgery unnecessary in most patients. Diuretics have a beneficial effect during early management, and benzopyrones for longterm treatment.

Adolescent↗
PubMedDate not supplied

External pneumatic intermittent compression for treatment of dependent pregnancy edema.

A portable external pneumatic intermittent compression (EPIC) device has been successful in reducing peripheral edema. This study explored the effectiveness of EPIC for treating dependent pregnancy edema. In the study, 42 healthy pregnant women received EPIC for 30 minutes at 40 torr while in the left lateral recumbent position: Group One with mid-thigh boots, and Group Two with below-knee boots. Prior to compression, descriptive data were gathered, leg circumference measurements made, and surface skin temperatures recorded for three sites per leg. Vital signs were taken and pedal edema subjectively indexed. Following compression, circumferences, skin temperatures, vital signs, and edema indices were rerecorded. Three volumes were calculated for each leg using a mathematical model of leg segments as conical frustum units. Mean volume reductions for each leg were significant. The mid-thigh-length boots produced greater mean volume decreases. The volume decrease for calf, lower leg, and foot frustum units were significant. EPIC holds promise as a useful treatment for dependent pregnancy edema.

Adolescent↗
PubMed2005

Blood flow velocity of the femoral vein with foot exercise compared to pneumatic foot compression.

STUDY OBJECTIVE: To compare the effects of foot exercise with an intermittent pneumatic foot compression (IPC) device on blood flow velocity of the femoral veins. DESIGN: Prospective, controlled study. SETTING: General intensive care unit of a university hospital. PATIENTS: 20 patients on bed rest in the intensive care unit. INTERVENTIONS: Patients were divided into 2 groups: group A, foot exercise (n = 10); and group B, IPC device (n = 10). The foot exercise was done once by a nurse for 5 minutes with the dorsiflexion of the ankle (15 times per minute) in group A patients. The IPC device (A-V Impulse System, compression setting: 130 mm Hg for 3 seconds followed by a resting period of 60 seconds) was used for 2 hours in group B. MEASUREMENTS: Peak blood flow velocity of the femoral vein was measured using the ultrasound unit with a 7.5-MHz linear array probe (ALOKA SSD-5500) at 0, 5, 15, 30, 60, and 120 minutes. MAIN RESULTS: Peak blood flow velocities in both groups increased significantly vs the control values during the study. At 5 minutes, group A showed a significant increase in the peak blood flow velocity compared with group B. CONCLUSIONS: Foot exercise by a nurse for 5 minutes was equally or more effective compared with the IPC device in increasing peak blood flow velocity of the femoral vein. The effect of the 5-minute foot exercise lasted for 2 hours.

Aged↗