PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “COMPRESSION”

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 19 recordsLinked to original sources

Effect of compression speeds on the compaction properties of a 1:1 paracetamol-microcrystalline cellulose mixture prepared by single compression and by combinations of pre-compression and main-compression.

A 1:1 blend of paracetamol and microcrystalline cellulose was compacted at different compression speeds by single compression or combinations of pre- and main-compression. The tensile strengths of the tablets decreased from 0.74+/-0.01 to 0.44+/-0.05 MPa as the compression speed was increased from 78 to 390 mm/s when a single compression pressure of 80 MPa was used to compress the tablets. When combinations of pre- and main-compression of 320 and 240 MPa were used to compress the tablets, tensile strengths decreased from 3.12+/-0.67 MPa at a compression speed of 78 mm/s to 1.24+/-0.36 MPa when the compression speed was 390 mm/s. The energies of compression and the ratio of elastic to plastic energies increased with increase in compression speed. This was because the material was becoming more elastic and more energy was required for the elastic expansion leading to a reduction in the energy available for plastic deformation and bond formation which resulted in a decrease in tensile strengths. Pre-compression played a major role at high compression speeds. The tensile strengths of tablets (1.2+/-0.08 MPa) compressed with a pre-compression of 160 MPa followed by a main-compression of 80 MPa (compression speed of 390 mm/s) were similar to the tensile strengths of tablets (1.1+/-0.10 MPa) compressed using a single compression of 320 MPa at the same compression speed of 390 mm/s. Thus, combinations of lower pressures can be employed to compress the material to the same tensile strength as a high single compression.

Journal Article↗

Intermittent pneumatic compression to prevent proximal deep venous thrombosis during and after total hip replacement. A prospective, randomized study of compression alone, compression and aspirin, and compression and low-dose warfarin.

A prospective, randomized study of the effectiveness of intraoperative and postoperative use of intermittent pneumatic compression, alone or in combination with oral administration of either aspirin or low-dose warfarin, was done of a consecutive series of patients who had a total hip replacement and were more than thirty-nine years old. All patients began walking by the third postoperative day. One hundred and ninety-six patients who had 217 total hip arthroplasties were included. Twenty-eight per cent of the procedures were revisions of a previous total hip replacement or of an endoprosthesis, and the remainder were primary arthroplasties. Patients were randomized as to the type of prophylaxis that they received: intermittent pneumatic compression alone, seventy-six hips; intermittent pneumatic compression and aspirin, seventy-two hips; or intermittent pneumatic compression and low-dose warfarin, sixty-nine hips. Before discharge from the hospital, and at an average of seven days after the operation, all patients were evaluated for the presence of proximal deep-vein thrombosis with either venography on the side of the operation or with bilateral venous ultrasonography. The relative frequency with which thrombosis occurred in a proximal vein was not significantly different in the three groups; the over-all relative frequency was 10 per cent. Intermittent compression during and after the operation effectively reduces the rate of proximal-vein thrombosis after total hip replacement. With the number of patients in our study, the effectiveness of this technique could not be shown to be augmented by oral administration of either aspirin or low-dose warfarin.

Adult↗

Compression bandages and stockings for venous leg ulcers.

OBJECTIVES: To assess the effectiveness and cost-effectiveness of compression bandaging and stockings in the treatment of venous leg ulcers. SEARCH STRATEGY: Searches of 19 databases, hand searching of journals, conference proceedings and bibliographies. Manufacturers of compression bandages and stockings and an Advisory Panel were contacted for unpublished studies. SELECTION CRITERIA: Trials that evaluated compression bandaging or stockings, as a treatment for venous leg ulcers. There was no restriction on date or language. Ulcer healing was the primary endpoint. DATA COLLECTION AND ANALYSIS: Details of eligible studies were extracted and summarised using a data extraction sheet. Data extraction was verified by two reviewers independently. MAIN RESULTS: Twenty two trials reporting 24 comparisons were identified. Compression was more effective than no compression (4/6 trials). When multi-layered systems were compared, elastic compression was more effective than non-elastic compression (5 trials). There was no difference in healing rates between 4-layer bandaging and other high compression multi-layered systems (3 trials). There was no difference in healing rates between elastomeric multi-layered systems (4 trials). Multi-layered high compression was more effective than single layer compression (4 trials). Compression stockings were evaluated in two trials. One found a high compression stocking plus a thrombo stocking to be more effective than a short stretch bandage. The second small trial reported no difference between the compression stockings and Unna's boot. There was insufficient data to draw conclusion about the relative cost-effectiveness of different regimens. REVIEWER'S CONCLUSIONS: Compression increases ulcer healing rates compared with no compression. Multi-layered systems are more effective than single-layered systems. High compression is more effective than low compression but there are no clear differences in the effectiveness of different types of high compression.

Bandages↗

Changes in femoral vein blood flow velocity by intermittent pneumatic compression: calf compression device versus plantar-calf sequential compression device.

Intermittent pneumatic compression has become widely used to prevent deep venous thrombosis potentially causing fatal pulmonary embolism. Although uniform compression has been commonly applied, a new method of sequential compression from plantar to calf has recently been developed. In this report, changes in maximum blood flow velocity in the femoral vein were compared with compression of only the calf uniformly and compression from plantar to calf sequentially in 10 healthy adult volunteers. A compression pressure of 60 mm Hg was applied for 5 min, and the velocity was measured before and after this treatment by ultrasound echography. There was no statistically significant difference in the change in maximum velocity between calf compression and plantar-calf sequential compression. The maximum velocity increased significantly with both compressions. However, plantar-calf sequential compression tended to have a greater effect. Although the results did not demonstrate an advantage of plantar-calf sequential compression compared with calf compression only, if the former compression is applied for a long time, it may have a greater effect.

Adult↗

Compression forces and amount of outer coating layer affecting the time-controlled disintegration of the compression-coated tablets prepared by direct compression with micronized ethylcellulose.

The influence of compression force to inner core tablet or to outer coating layer of the compression-coated tablet on the function of time-controlled disintegration was investigated. The inner core tablet was directly compacted by sodium diclofenac (model drug) and ethylcellulose (EC) with 4.6-microm particle size was used as an outer coating layer. The immersion time of the compression-coated tablet previously soaked in pH 1.2 solution to simulate the residence time of the tablet in the GI tract affecting the dissolution behavior of the compression-coated tablet was also investigated. The effect of the amount of the outer coating layer used on the drug release was examined. The results indicate that sodium diclofenac released from these compression-coated tablets exhibited a longer lag of a period about 16.3 h in both distilled water and pH 6.8 buffer solution, followed by a different drug release behavior. The lag time was independent of the pH of dissolution medium, and the immersion time in pH 1.2 solution. After that lag time, the outer shell of the compression-coated tablets broke into two halves to make a rapid drug release. However, the drug release behavior of the soaked tablet in pH 6.8 buffer solution was dependent on the immersion time. The compression force < 200 kg/cm(2) to the inner core tablet influenced the release behavior of drug less, but > 200 kg/cm(2) might delay the lag time. The lag time of the compression-coated tablets was linearly correlated with the compression force to the outer coating layer (r = 0.9896). We also found that the more the amount of outer coating layer added, the longer the lag time obtained. The study demonstrates that the time-controlled disintegration of the compression-coated tablet was effectively controlled by the compression force applied and the amount of outer coating layer added.

Cellulose↗

A model for chronic nerve root compression studies. Presentation of a porcine model for controlled, slow-onset compression with analyses of anatomic aspects, compression onset rate, and morphologic and neurophysiologic effects.

STUDY DESIGN: Compression onset rate, anatomic aspects, and morphologic and neurophysiologic effects in spinal nerve roots were studied in a nerve root compression model in pigs. OBJECTIVES: To analyze the compression onset rate by measuring the gradual reduction of the inner diameter of the constrictor, the motor nerve conduction velocity by electromyography, the morphologic changes by light microscopy, and the gross and vascular anatomy by dissection and ink injections, respectively, in a model for experimental chronic nerve root compression. SUMMARY OF BACKGROUND DATA: Chronic nerve root compression is recognized to be related to back pain syndromes, including sciatica. Various aspects of morphologic and physiologic changes have been studied previously in models for acute compression and chronic nerve root irritation, but a controlled, graded chronic nerve root compression model has not been described. METHODS: An ameroid constrictor was applied around a spinal nerve root just cranial to the dorsal root ganglion. The inner diameter of this constrictor gradually becomes reduced. After 1 week or 4 weeks, electromyographic measurements were performed, and tissue samples were harvested for histologic analyses. The gross and vascular anatomy of the pigs' spinal nerve roots were studied by dissection and ink injections. RESULTS: There was a statistically significant decrease in the nerve conduction velocity in compressed compared with noncompressed spinal nerve roots after 1 week and after 4 weeks. The ameroid constrictors induced nerve fiber damage, endoneural hyperemia, bleeding, and inflammation at the compression zone. There was often a severe reduction in the number of myelinated fibers after 4 weeks. CONCLUSION: A model for controlled, chronic, partial nerve root injury using a gradual compression-onset constrictor is presented. This model allows for induction of a controlled graded chronic nerve root injury and can be used for research on basic pathophysiologic mechanisms and on the effects of various interventions on nerve root injury development.

Animals↗

Influence of tabletting speed on compactibility and compressibility of two direct compressible powders under high speed compression.

To examine the influence of tabletting speed on compactibility and compressibility under high speed compression, two direct compressible powders, alpha-lactose monohydrate and microcrystalline cellulose of different particle size ranges were compressed using an instrumented rotary press with varying tabletting speed and compression force. The maximum applied force and total time during compression (contact time) were determined from a time-force profile, and the relation between these parameters and properties of compacts was examined. For all lactose tablets, the porosity and tensile strength of compacts were less affected by compression rate though they depended on the applied force. However, the properties of microcrystalline cellulose tablets were varied depending on the tabletting speed in addition to the applied force. In an attempt to quantitatively evaluate the effect of compression rate on the compactibility, an empirical equation was derived from the numerical analysis of the experimental data. The compactibility parameters deduced from the equation well elucidated the effect of tabletting speed on the properties of microcrystalline cellulose tablets and lactose tablets made of various particle size powders.

Chemistry, Pharmaceutical↗

[A hydrostatic compression device capable of generating both intermittent compressive forces and continuous compressive forces].

A hydrostatic compression device has been designed to study the effects of intermittent or continuous compressive forces on cells by trying to mimic in vivo forces. The model system is composed of two pistons that deliver and release compressed air under control of a motor to form an enclosed tissue culture chamber housing numerous tissues culture dishes. The continuous compressive forces and intermittent compressive forces are within 100-300 KPa and 0-30 KPa respectively. The compressive force is uniform in the system and can also result in the generation of shear forces along the interface between the cells and culture substratum, so the hydrostatic compression device can be used to study the characteristics of in vitro cells loading models.

Biomechanical Phenomena↗

Prevention of deep vein thrombosis in potential neurosurgical patients. A randomized trial comparing graduated compression stockings alone or graduated compression stockings plus intermittent pneumatic compression with control.

In a randomized trial of neurosurgical patients, groups wearing graduated compression stockings alone (group 1) or graduated compression stockings plus intermittent pneumatic compression (IPC) (group 2) were compared with an untreated control group in the prevention of deep vein thrombosis (DVT). In both active treatment groups, the graduated compression stockings were continued for 14 days or until hospital discharge, if earlier. In group 2, IPC was continued for seven days. All patients underwent DVT surveillance with iodine 125-labeled fibrinogen leg scanning and impedance plethysmography. Venography was carried out if either test became abnormal. Deep vein thrombosis occurred in seven (8.8%) of 80 patients in group 1, in seven (9.0%) of 78 patients in group 2, and in 16 (19.8%) of 81 patients in the control group. The observed differences among these rates are statistically significant. The results of this study indicate that graduated compression stockings alone or in combination with IPC are effective methods of preventing DVT in neurosurgical patients.

Clinical Trials as Topic↗

Multiple-level compression myelopathy: concomitant asymptomatic cervical compression adversely affects surgical outcome for thoracic compression myelopathy.

To determine whether asymptomatic spinal cord compression affects surgical outcome for another compression, we retrospectively reviewed the outcome for thoracic myelopathy due to spinal ligament ossification. Improvement assessed by changes in motor function of the lower extremity using the Japanese Orthopedic Association Classification was significantly less in cases associated with asymptomatic cervical ligament ossification (C+T group, N = 5) than in cases without cervical ligament ossification (T group, N = 13) (p < 0.05, Mann- Whitney U test). The "no disability" recovery rate was 61.5% in the T group and none in the C+T group (p < 0.05, Fisher's exact probability test). There was no significant difference in background parameters between the two groups. This study showed that concomitant spinal cord compression, even if asymptomatic itself, can adversely affect surgical outcome at a separate segment.

Aged↗

Increased resistance to acute compression injury in chronically compressed spinal nerve roots. An experimental study.

STUDY DESIGN: Nerve conduction velocity was studied in the dog cauda equina subjected to chronic and, 1 week later, additional acute compression. OBJECTIVES: To model the situation of spinal stenosis by first inducing a controlled, chronic compression injury and then to add compression at various pressure levels to the already compressed cauda equina. SUMMARY OF BACKGROUND DATA: Previous models on nerve root and cauda equina compression have analyzed the effects of compression only on noninjured nerves. Clinically, the nerves that are compressed in spinal stenosis already are exposed to chronic compression. METHODS: The cauda equine in the lumbar spine of 10 dogs was first compressed by inflating a plastic balloon, which was placed in the spinal canal, to 10 mm Hg with a viscous substance or leaving it noninflated for control. After 1 week, a second plastic balloon, which was welded together with the first balloon, which had been located in the spinal canal for 1 week, was inflated to 50 or 100 mm Hg for 2 hours with 1.5 hour of recovery, and changes in the nerve conduction velocity were analyzed. Before inflation, baseline data, reflecting the effects of the chronic compression per se, were obtained. RESULTS: After 1 week, the nerve conduction velocity was significantly lower in the compressed cauda equina than in the control series, as an effect of the chronic compression. Additional compression demonstrated that the chronically compressed cauda equina was less susceptible to the compression-induced effects at 100 mm Hg compression. CONCLUSIONS: The data of the present study indicate that chronically compressed nerve roots acquire a tolerance to acute compression, which may indicate that there has been adaptation processes present in the compressed nerve tissue.

Acute Disease↗

Spinal nerve root compression. Nutrition and function of the porcine cauda equina compressed in vivo.

A model for experimental studies of acute, graded compression of the cauda equina in pigs was presented (Olmarker et al. 1991a). Detailed analyses of the neural and vascular anatomy demonstrated a close resemblance to the human cauda equina. There were structural and vascular differences between spinal nerve roots and peripheral nerves that could contribute to differences in compression susceptibility between these two parts of the nervous system. The pressure transmission from the balloon to the nerve roots showed to have a high accuracy. The occlusion-pressures for the arterioles, capillaries and venules of the cauda equina were determined (Olmarker et al. 1989a). Arteriolar blood flow was stopped at a pressure close to the mean arterial blood pressure. Capillary blood flow was found to be dependent upon flow in the connected venules. The blood flow in some venules was found to be stopped at 5-10 mm Hg. However, venular occlusion pressures ranged from 5 to 60 mm Hg. Compression up to 200 mm Hg for 2 hours did not induce a "no-reflow" phenomenon when the compression was ended. However, a transient hyperemia was noted at all pressure/time relations studied, indicating nutritional deficit in the compressed segment during compression. Signs of edema were seen in nerve roots exposed to compression for 2 hours at either 50 or 200 mm Hg. The nutritional supply to the cauda equina was found to be impaired at low pressure levels (less than 10 mm Hg; Olmarker et al. 1990a). Diffusion from adjacent tissues with a better nutritional supply, including the cerebrospinal fluid, could thus not compensate completely for compression-induced effects on the transport of nutrients. However, a certain nutritional supply to the compressed segment was present even at 200 mm Hg compression. There were more pronounced effects on the nutritional supply induced by a rapid (0.05-0.1 sec.) than a slow (20 sec.) compression onset rate. Nutritional impairment was noted both within and outside the compressed nerve segment. An increase in vascular permeability was induced by compression at 50 mm Hg for 2 minutes (Olmarker et al. 1989b). The magnitude of this permeability increase was dependent on both the magnitude and the duration of compression. The permeability increase was more pronounced for the rapid than for the slow compression onset rate at all pressure/time relations studied. Reduction of muscle action potential (MAP) amplitude in tail muscles, after stimulation cranial to the compression zone, was induced by compression at 100 and 200 mm Hg for 2 hours (Olmarker et al. 1990b).(ABSTRACT TRUNCATED AT 400 WORDS)

Acute Disease↗

Post-sclerotherapy compression: controlled comparative study of duration of compression and its effects on clinical outcome.

BACKGROUND: Although much has been published on the effects of compression on the venous system, relatively few studies address the duration of compression following sclerotherapy of telangiectatic webs associated with reticular veins. OBJECTIVE: To perform a controlled study comparing the effects of different durations of compression following sclerotherapy of reticular veins and telangiectasias in similar locations. METHOD: This study consisted of a total of 40 patients, 30 patients who received compression therapy and 10 control patients who did not receive compression therapy. The compression group consisted of 10 in each of three duration groups: 3 days, 1 week, and 3 weeks. Patients were evaluated at 1 week, 2 weeks, 6 weeks, 12 weeks, and 24 weeks for degree of improvement and side effects. RESULTS: The three compression groups showed significantly greater improvement at 6 weeks (p = .004). There was a strong correlation between the length of time compression was applied and degree of improvement at 6 weeks, 12 weeks, and 24 weeks of clinical follow-up; r = .74, p = .0006, r = .59, p = .006, r = .66, p = .0001, respectively. The patients treated with compression for 3 days and 1 week had more improvement than the control patients while the patients treated for 3 weeks of continuous compression had the most improvement. In terms of side effects, the 1 week and 3 week compression groups experienced the least amount of post-sclerotherapy hyperpigmentation. CONCLUSIONS: Compression enhances the results following sclerotherapy in a statistically significant way and is directly correlated with duration of compression. Three weeks of continuous compression leads to the best results, although even 3 days of compression results in greater improvement than no compression. Compression leads to a statistically significant reduction of post-sclerotherapy hyperpigmentation.

Adult↗

Client preferences for compression threshold in single-channel wide dynamic range compression hearing aids.

OBJECTIVE: Compression in hearing aids can be applied with low compression ratios over a wide range of input levels, but reverts to linear amplification below the compression threshold (CT). In this study, we aimed to determine which of two CTs was preferred by subjects as they used their hearing aids in their own environments, and whether they would prefer to have no low ratio compression at all. DESIGN: Subjects were fitted with a multimemory hearing aid incorporating input controlled compression with a 2:1 compression ratio and output controlled compression limiting. The two memories contained identical programs except that they differed in CT. Sixteen mild to moderately sensorineurally hearing-impaired subjects compared low (approximately 40 dB SPL) and moderate (approximately 65 dB SPL) CTs over 2 mo of field trials using hand held remote controls to switch between the alternatives. In a third month's trial, the preferred option (which also included output controlled compression limiting) was compared with compression limiting alone. RESULTS: The higher CT was preferred by 14 of the subjects. The combination of input compression and output compression limiting was preferred to compression limiting alone by 14 of the subjects. CONCLUSIONS: Several real world advantages of frequency independent 2:1 compression with a CT of about 65 dB SPL were demonstrated over linear amplification. Extending the compression to much lower input levels appears to carry more disadvantages than advantages, at least for clients with mild and moderate hearing losses, when fitted with single-channel compression aids with a 2:1 compression ratio.

Aged↗

Effect of compression force, compression speed, and particle size on the compression properties of paracetamol.

The compression characteristics of two particle size fractions (< 90 microm, 105-210 microm) of paracetamol were examined. Each fraction produced extremely weak tablets and displayed a high tendency to cap. Low correlation coefficients of the initial parts of the Heckel plots, a low strain rate sensitivity, and an increase in mean yield pressure (from 34.2 to 45.5 MPa) with decrease in particle size all confirmed that the main mechanism during the compaction of paracetamol was fragmentation. The 105-210-microm particles underwent more fragmentation than the less than 90-microm powder. Heckel analysis confirmed that the larger size fraction of paracetamol produced denser compacts than the smaller fraction. The 105-210-microm fraction resulted in tablets with lower elastic recoveries and elastic energies. The elastic, plastic energy ratios indicated that the majority of energy involved during the compaction of paracetamol was utilized as elastic energy, indicative of massive elastic deformation of paracetamol particles under pressure.

Acetaminophen↗

A model for acute, chronic, and delayed graded compression of the dog cauda equina. Presentation of the gross, microscopic, and vascular anatomy of the dog cauda equina and accuracy in pressure transmission of the compression model.

STUDY DESIGN: A new model for controlled, graded compression of the dog cauda equina was developed using the dog lumbar spine. The model was defined regarding macroscopic, microscopic, and vascular anatomy and regarding accuracy in pressure transmission. OBJECTIVES: The study was performed to develop a model for controlled, graded compression that would allow for acute, chronic, and delayed compression. SUMMARY OF BACKGROUND DATA: There has been an increasing interest for the reactions of the spinal nerve roots to mechanical deformation. The previously used models have had limitations regarding the duration and the onset of the compression and possibilities for a controlled variation of the compression pressure on chronically compressed nerve roots. METHODS: Macroscopic examination, light microscopy, and ink injection of the vasculature was used to assess the anatomic characteristics of the nerve tissue and the vasculature of the cauda equina in the dog lower lumbar spine. The relation between known pressures in the compression balloon used to compress the cauda equina and the pressure in the central thecal sac was assessed by measuring the pressure in an artificial thecal sac with a pressure transducer. RESULTS. The neural and vascular anatomy was found to have a close resemblance to the human cauda equina. The pressure in the thecal sac was within 5% of the pressure in the compression balloon at various pressures between 0-200 mm Hg. CONCLUSION: The presented model provides a good pressure transmission to the dog cauda equina, which has an anatomy that closely resembles the human cauda equina. The model may be well suited for physiologic studies of cauda equina compression. A double-balloon system may provide unique opportunities to induce chronic compression and delayed compression, i.e., additional compression after a certain time of chronic compression to resemble the changes in pressure that are characteristic for neurogenic claudication.

Animals↗

Active chest compression-decompression for cardiopulmonary resuscitation.

BACKGROUND: Active compression-decompression cardiopulmonary resuscitation (ACD CPR) uses a hand-held suction device, applied mid sternum, to compress the chest then actively decompress the chest after each compression. Randomised controlled trials on use of active compression decompression cardiopulmonary resuscitation have results which are discordant. OBJECTIVES: To determine clinical effects and safety of active compression-decompression cardiopulmonary resuscitation compared with standard manual cardiopulmonary resuscitation (STR). SEARCH STRATEGY: We searched the Cochrane Heart Group Specialised register (April 2001), the Cochrane library, MEDLINE and EMBASE. We checked the reference list of retrieved articles and contacted enterprises manufacturing the active decompression devices. SELECTION CRITERIA: All randomized or quasi-randomized studies comparing active compression-decompression cardiopulmonary resuscitation compared with standard manual cardiopulmonary resuscitation in adults with a cardiac arrest who received cardiopulmonary resuscitation by a trained medical or paramedical team. DATA COLLECTION AND ANALYSIS: Data were independently extracted. All data were analysed on an intention-to-treat basis. The authors of the primary studies were contacted for more information when needed. Studies were cumulated, if appropriate, and pooled relative risk (RR) estimated. Subgroup analysis according to setting (out of hospital or in hospital) and attending team composition (with physician or paramedic only) were predefined. MAIN RESULTS: Twelve trials were included: 10 were in out-of-hospital settings, one set in-hospital only and one had both in-hospital and out-of-hospital components. Allocation concealment was adequate in 4 trials. The two in-hospital studies were very different in quality (A and C) and size (773 and 53 patients). Both found no differences between ACD CPR and STR in any outcome. Trials conducted in out-of-hospital settings cumulated 4162 patients. There were no differences between ACD CPR and STR for mortality either immediately (RR 0.98 [95% CI 0.94 - 1.03]) or at hospital discharge (RR 0.99 [95% CI 0.98 - 1.01]). The pooled RR of neurological impairment, any severity, was 1.71 [95% CI 0.90 - 3.25], with a non-significant trend to more frequent severe neurological damage in survivors of ACD CPR (RR 3.11 [95% CI 0.98 - 9.83]). However, assessment of neurological outcome was limited and there were few patients with neurological damage. There was no difference between ACD CPR and STR with regard complications such as rib or sternal fractures, pneumothorax or hemothorax (RR 1.09 [95% CI 0.86 - 1.38]). Skin trauma and ecchymosis were more frequent with ACD CPR. REVIEWER'S CONCLUSIONS: Active chest compression-decompression in patients with cardiac arrest is not associated with clear benefit.

Adult↗

Calf-thigh sequential pneumatic compression compared with plantar venous pneumatic compression to prevent deep-vein thrombosis after non-lower extremity trauma.

OBJECTIVE: To compare the effectiveness of calf-thigh sequential pneumatic compression devices with the effectiveness of plantar venous intermittent pneumatic compression devices in prevention of venous thrombosis after major trauma. SUBJECTS AND METHODS: We evaluated 181 consecutive patients after major trauma without lower extremity injuries that precluded the use of pneumatic compression devices. We randomly assigned 149 patients to either calf-thigh sequential pneumatic compression or plantar venous pneumatic compression. After blinding the observers to the method of prophylaxis against deep-vein thrombosis, we performed bilateral compression ultrasonography on or before day 8 after randomization. RESULTS: Among 149 randomized patients, 62 who received calf-thigh sequential pneumatic compression and 62 who received plantar venous intermittent pneumatic compression devices completed the trial. Thirteen patients randomized to plantar venous intermittent pneumatic compression (21.0%) and 4 patients randomized to calf-thigh sequential pneumatic compression (6.5%) had deep-vein thrombosis (p = 0.009). Seven of 13 patients with deep-vein thrombosis after prophylaxis with plantar venous intermittent pneumatic compression had bilateral deep-vein thromboses, whereas all 4 patients with deep-vein thrombosis after prophylaxis with calf-thigh sequential pneumatic compression had unilateral deep-vein thrombosis. CONCLUSION: Calf-thigh sequential pneumatic compression prevents deep-vein thrombosis more effectively than plantar venous intermittent pneumatic compression after major trauma without lower extremity injuries.

Adult↗