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Effects of supine intermittent compression on arterial inflow to the lower limb
Rhys J Morris1, John P Woodcock
1Department of Medical Physics and Bioengineering, University of Wales College of Medicine, Cardiff, Wales. morrisrj@cf.ac.uk
Hypothesis:
Intermittent pneumatic compression will affect the arterial blood flow in the lower limb at moderate pressure, without requiring dependency.
Design:
Before-after trial.
Setting:
Vascular ultrasound unit of a university hospital.
Patients:
A volunteer sample of 19 healthy subjects without symptoms or history of vascular disease and 17 patients with peripheral arterial disease were studied. Six patients and 1 healthy volunteer were not included in the study group because of measurement difficulties or refusal when approached.
Interventions:
Common femoral artery blood flow velocities were measured with Doppler ultrasound during 10 minutes of intermittent compression of the calf and thigh at 60 mm Hg, while the subject was supine. The data were collected every 5 seconds from 4 minutes before to 4 minutes after the therapy period, and toe temperatures were also measured with an infrared radiometer.
Main Outcome Measures:
Resting to postcompression percentage increases in flow velocity were measured, along with more representative measures of the total flow change during the intermittent compression period.
Results:
On compression, the blood flow velocity decreased slightly (15% in healthy subjects and 6% in patients) and increased on release (21% and 29%, respectively). Overall, blood flow did not decrease during therapy as expected (increases of 1% and 2%, respectively), and the toes of the patients warmed (by 2.2 degrees C).
Conclusions:
This work confirms the initial hypothesis in both subject groups. There appears to be physiological justification for investigating intermittent compression as a therapy for patients with intermittent claudication and rest pain in the supine position as well as seated.