Lee Wonhee, Seo Jong Hyun, Kim Hyun Beom, Chung Seung Hyun, Lee Seung Hoon, Kim Kwang Gi, Kang Hyun Guy
1 Biomedical Engineering Branch, National Cancer Center, Goyang-si, Gyeonggi-do, Republic of Korea.
2 Department of Radiology, National Cancer Center, Goyang-si, Gyeonggi-do, Republic of Korea.
Clin Appl Thromb Hemost. 2018 Mar;24(2):338-347. doi: 10.1177/1076029616683044. Epub 2016 Dec 18.
Intermittent pneumatic compression (IPC) is now a widely used therapy for the prophylaxis of deep vein thrombosis and pulmonary embolism. In general, the IPC sequence is composed of sequential compression and simultaneous deflation. Typically, veins are considered to be squeezed and emptied during the compression phase and to be refilled during the deflation phase. However, because the stop or sudden increase in blood flow can be dangerous, a further investigation is needed with respect to the blood flow.
We demonstrated a new compression protocol based on the investigation results of venous blood flow during IPC. This new compression protocol involves successive compression without the deflation phase; thus, the expelled blood volume flow during a given period can be maximized. To investigate the blood flow during IPC, sonography movie clips and in-laboratory developed blood flow analysis software was used.
The increases in the peak volume flow during IPC were 49% (±24%) and 25% (±29%) with the conventional protocol and the new protocol, respectively, whereas the total volume flow (TVF) was not significantly changed (-1.0% and -13.0%, respectively). With the new protocol, the peak velocity (PV) was 49% lower than that with the conventional protocol. Thus, the new protocol has an effect of maintaining TVF without resulting in a sudden large increase or decrease in PV.
The new suggested protocol might improve safety because it can maintain the stability of blood flow by reducing the risk of blood stasis and a rapid change in blood flow.
间歇性气动压迫(IPC)现在是预防深静脉血栓形成和肺栓塞的一种广泛使用的疗法。一般来说,IPC序列由顺序压迫和同时放气组成。通常,在压迫阶段静脉被认为会被挤压并排空,在放气阶段会重新充盈。然而,由于血流的停止或突然增加可能是危险的,因此需要对血流进行进一步研究。
我们基于IPC期间静脉血流的研究结果展示了一种新的压迫方案。这种新的压迫方案包括连续压迫而不放气阶段;因此,在给定时间段内排出的血容量流量可以最大化。为了研究IPC期间的血流,使用了超声电影片段和实验室开发的血流分析软件。
使用传统方案和新方案时,IPC期间峰值流量的增加分别为49%(±24%)和25%(±29%),而总体积流量(TVF)没有显著变化(分别为-1.0%和-13.0%)。使用新方案时,峰值速度(PV)比传统方案低49%。因此,新方案具有维持TVF而不会导致PV突然大幅增加或减少的效果。
新建议的方案可能会提高安全性,因为它可以通过降低血液淤滞和血流快速变化的风险来维持血流的稳定性。