A novel approach to mechanical prophylaxis: calf impulse technology mimics natural ambulation nmore effectively than sequential calf compression
A novel approach to mechanical prophylaxis: calf impulse technology mimics natural ambulation nmore effectively than sequential calf compression
BACKGROUND: The risk of thrombosis can be reduced by mechanical compression, but the optimal device is unknown.
OBJECTIVES: To record the effect of natural ambulation on deep venous flow, providing a reference for evaluating the efficacy of mechanical compression systems, assuming that ambulation is the gold standard against which such systems should be compared; and to compare the hemodynamic effect of the A-V Impulse System CalfPad garment (A-VI) (Orthofix Vascular Novamedix, United Kingdom) with the SCD Express calf compression garment (SCD) (Covidien, USA).
METHODS: Twelve healthy volunteers were recruited and randomly assigned to either A-VI or SCD in a two-device, two-period crossover design. Peak femoral velocity (PFV) was calculated using custom ultrasound software and compared with baseline values. Ultrasound images were recorded.
RESULTS: A-VI augmented the mean (± SD) PFV to 59.79±29.07 cm/s compared with 22.86±5.73 cm/s for SCD. The actual percentage increase from baseline was approximately five times greater for A-VI (mean increase 385%±260%) than SCD (mean increase 81%±53%). Using an analysis of covariance model, with baseline fitted as a covariate, a highly statistically significant difference in favour of A-VI was detected (P=0.0002). Least square (adjusted) means (±95% CIs) were 37.24 cm/s (21.39 cm/s to 64.84 cm/s) for A-VI and 6.71 cm/s (3.86 cm/s to 11.69 cm/s) for SCD, representing more than fivefold greater improvement in PFV from rest with the A-VI device than with the SCD device.
CONCLUSION: Pulsatile impulse calf compression (A-VI) more closely mimics PFV of normal ambulation than slow-squeeze sequential compression (SCD). Pulsatile calf compression may provide superior protection against thrombosis in immobile patients.
197-201
Warwick, DJ
fce62656-f6e7-4f8e-b92c-ea83cb506c66
Dewbury, K
09c46458-e54e-411d-b257-93dbc0351ac8
2008
Warwick, DJ
fce62656-f6e7-4f8e-b92c-ea83cb506c66
Dewbury, K
09c46458-e54e-411d-b257-93dbc0351ac8
Warwick, DJ and Dewbury, K
(2008)
A novel approach to mechanical prophylaxis: calf impulse technology mimics natural ambulation nmore effectively than sequential calf compression.
International Journal of Angiology, 17 (4), .
Abstract
BACKGROUND: The risk of thrombosis can be reduced by mechanical compression, but the optimal device is unknown.
OBJECTIVES: To record the effect of natural ambulation on deep venous flow, providing a reference for evaluating the efficacy of mechanical compression systems, assuming that ambulation is the gold standard against which such systems should be compared; and to compare the hemodynamic effect of the A-V Impulse System CalfPad garment (A-VI) (Orthofix Vascular Novamedix, United Kingdom) with the SCD Express calf compression garment (SCD) (Covidien, USA).
METHODS: Twelve healthy volunteers were recruited and randomly assigned to either A-VI or SCD in a two-device, two-period crossover design. Peak femoral velocity (PFV) was calculated using custom ultrasound software and compared with baseline values. Ultrasound images were recorded.
RESULTS: A-VI augmented the mean (± SD) PFV to 59.79±29.07 cm/s compared with 22.86±5.73 cm/s for SCD. The actual percentage increase from baseline was approximately five times greater for A-VI (mean increase 385%±260%) than SCD (mean increase 81%±53%). Using an analysis of covariance model, with baseline fitted as a covariate, a highly statistically significant difference in favour of A-VI was detected (P=0.0002). Least square (adjusted) means (±95% CIs) were 37.24 cm/s (21.39 cm/s to 64.84 cm/s) for A-VI and 6.71 cm/s (3.86 cm/s to 11.69 cm/s) for SCD, representing more than fivefold greater improvement in PFV from rest with the A-VI device than with the SCD device.
CONCLUSION: Pulsatile impulse calf compression (A-VI) more closely mimics PFV of normal ambulation than slow-squeeze sequential compression (SCD). Pulsatile calf compression may provide superior protection against thrombosis in immobile patients.
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Published date: 2008
Identifiers
Local EPrints ID: 72740
URI: http://eprints.soton.ac.uk/id/eprint/72740
ISSN: 1061-1711
PURE UUID: 10404820-bb26-4934-8559-9629e0ffca75
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Date deposited: 23 Feb 2010
Last modified: 08 Jan 2022 05:24
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Author:
DJ Warwick
Author:
K Dewbury
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