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Systemic hemodynamic effects of sequential pneumatic compression of the lower limbs: a prospective study in healthy
Guido Fanelli1, Michele Zasa1, Marco Baciarello1
1Department of Anesthesiology, Critical Care and Pain Medicine, Ospedale Maggiore di Parma and University of Parma, 43100 Parma, Italy.
Study Objective:
To evaluate the effects on systemic hemodynamics of sequential pneumatic compression of the lower limbs in healthy volunteers.
Design:
Prospective, self-controlled, volunteer study.
Setting:
University teaching hospital.
Patients:
11 healthy volunteers, aged 25 +/- 1.3 years.
Interventions And Measurements:
After volunteers underwent a 6-hour period of fasting and 15 minutes of rest in the supine position, baseline systemic hemodynamics were assessed using transthoracic electrical bioimpedance. Peripheral venous pressure was measured using a 16-gauge intravenous cannula inserted in the forearm and connected to a pressure monitor. Then sequential pneumatic compression of the lower limbs was activated for a 30-minute period, and systemic hemodynamic measurements were repeated. In each volunteer, measurements were repeated twice in two consecutive days, and average values were calculated for each volunteer.
Main Results:
After activation of sequential pneumatic compression of the lower limbs, mean arterial blood pressure increased from 90 mmHg (79-107 mmHg) to 95 mmHg (79-129 mmHg) (P = 0.02), whereas heart rate decreased from 79 bpm (51-94 bpm) to 75 bpm (53-90 bpm) (P = 0.02). This was associated with a significant increase in peripheral vascular resistance index (from 545 [440-1066] to 613 [369-1280] dynes s cm(-5) m(-2) [P = 0.013]) and reduction in cardiac index (from 3.4 [2.7- 4.5] to 3.2 [2.5-4.0] L/min per m2 [P = 0.034]).
Conclusions:
The application of sequential pneumatic compression to the lower limbs is associated with minor increases in mean arterial blood pressure, with moderate reduction of cardiac output and heart rate.
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