Research Article
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The Effects of Body Mass Index on Efficacy of Intermittent Pneumatic Compression

Year 2020, Volume: 73 Issue: 2, 107 - 112, 31.08.2020

Abstract

Objectives: The aim of our study was to compare the efficacy of intermittent pneumatic compression on venous hemodynamics in individuals with different body mass indexes (BMIs).

Materials and Methods: The study included a total of 48 healthy volunteers. The participants were classified into three groups according to their BMIs as <24.9 kg/m2
(group I), 25-29.9 kg/m2 (group II), and >30 kg/m2 (group III). The measurements of pulse, arterial blood pressure and oxygen saturation were made, and venous ultrasonography was performed by the investigator. The measurements were repeated at the 30th minute of intermittent pneumatic compression. Vena femoralis communis (common femoral vein) (VFC) vein flow dynamics were evaluated 1-1.5 cm proximal to the junction of the VFC and great saphenous vein.

Results: The increases observed in the peak systolic flow rates of both right and left VFC in groups I and II were found to be significantly higher compared to those observed in group III at the 30th minute of intermittent pneumatic compression application. (p<0.001, p=0.012, and p=0.049, respectively)

Conclusion: We demonstrated that intermittent pneumatic compression application increased the femoral venous flow; however, this effect changed among individuals with different BMIs. We believe that BMI should be considered as an independent risk factor in patients for whom venous thromboembolism prophylaxis has been planned, which is frequently encountered in emergency units, and that providing the same effect in individuals with different physical properties is important in planning the prophylaxis.

References

  • 1. Andersson T, Soderberg S. Incidence of acute pulmonary embolism, related comorbidities and survival; analysis of a Swedish national cohort. BMC Cardiovasc Disord. 2017;17:155.
  • 2. Guyatt GH, Norris SL, Schulman S, et al. Methodology for the development of antithrombotic therapy and prevention of thrombosis guidelines: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest. 2012;141:53S-70S.
  • 3. Coleman DM, Obi A, Henke PK. Update in venous thromboembolism pathophysiology, diagnosis, and treatment for surgical patients. Curr Probl Surg. 2015;52:233-259.
  • 4. Virchow RLK. Gesammelte Abhandlungen zur wissenschaftlichen Medicin. Frankfurt: Meidinger; 1862.
  • 5. Wolberg AS, Aleman MM, Leiderman K, et al. Procoagulant activity in hemostasis and thrombosis: Virchow’s triad revisited. Anesth Analg. 2012;114:275-285.
  • 6. Labropoulos N, Cunningham J, Kang SS, et al. Optimising the performance of intermittent pneumatic compression devices. Eur J Vasc Endovasc Surg. 2000;19:593-597.
  • 7. Malone MD, Cisek PL, Comerota AJ, et al. High-pressure, rapid-inflation pneumatic compression improves venous hemodynamics in healthy volunteers and patients who are post-thrombotic. J Vasc Surg. 1999;29:593- 539.
  • 8. Kohro S, Yamakage M, Sato K, et al. Intermittent pneumatic foot compression can activate blood fibrinolysis without changes in blood coagulability and platelet activation. Acta Anaesthesiol Scand. 2005;49:660-664.
  • 9. Sutkowska E, Wozniewski M, Gamian A, et al. Intermittent pneumatic compression in stable claudicants: effect on hemostasis and endothelial function. Int Angiol. 2009;28:373-379.
  • 10. Effect of intermittent pneumatic compression on disability, living circumstances, quality of life, and hospital costs after stroke: secondary analyses from CLOTS 3, a randomised trial. Lancet Neurol. 2014;13:1186- 1192.
  • 11. Chibbaro S, Cebula H, Todeschi J, et al. Evolution of Prophylaxis Protocols for Venous Thromboembolism in Neurosurgery: Results from a Prospective Comparative Study on Low-Molecular-Weight Heparin, Elastic Stockings, and Intermittent Pneumatic Compression Devices. World Neurosurg. 2018;109:e510-e516.
  • 12. Dennis M, Sandercock P, Graham C, et al. The Clots in Legs Or sTockings after Stroke (CLOTS) 3 trial: a randomised controlled trial to determine whether or not intermittent pneumatic compression reduces the risk of post-stroke deep vein thrombosis and to estimate its cost-effectiveness. Health Technol Assess. 2015;19:1-90.
  • 13. Kakkos SK, Caprini JA, Geroulakos G, et al. Combined intermittent pneumatic leg compression and pharmacological prophylaxis for prevention of venous thromboembolism in high-risk patients. Cochrane Database Syst Rev. 2008: CD005258.
  • 14. Classification and grading of chronic venous disease in the lower limbs. A consensus statement. Ad Hoc Committee, American Venous Forum. J Cardiovasc Surg (Torino) 1997;38:437-441.
  • 15. Andrews B, Sommerville K, Austin S, et al. Effect of Foot Compression on the Velocity and Volume of Blood-Flow in the Deep Veins. British Journal of Surgery. 1993;80:198-200.
  • 16. Yamashita K, Yokoyama T, Kitaoka N, et al. Blood flow velocity of the femoral vein with foot exercise compared to pneumatic foot compression. J Clin Anesth. 2005;17:102-105.
  • 17. Nguyen NT, Cronan M, Braley S, et al. Duplex ultrasound assessment of femoral venous flow during laparoscopic and open gastric bypass. Surgical Endoscopy and Other Interventional Techniques. 2003;17:285-290.
  • 18. Proctor MC, Greenfield LJ, Wakefield TW, et al. A clinical comparison of pneumatic compression devices: the basis for selection. J Vasc Surg. 2001;34:459-463.
  • 19. Koo KH, Choi JS, Ahn JH, et al. Comparison of clinical and physiological efficacies of different intermittent sequential pneumatic compression devices in preventing deep vein thrombosis: a prospective randomized study. Clin Orthop Surg. 2014;6:468-475.
  • 20. Morris RJ. Intermittent pneumatic compression - systems and applications. J Med Eng Technol. 2008;32:179-188.
  • 21. Morris RJ, Griffiths H, Woodcock JP. Analysis of the operation of the SCD Response intermittent compression system. J Med Eng Technol. 2002;26:111-116.
  • 22. Bickel A, Shturman A, Grevtzev I, et al. The physiological impact of intermittent sequential pneumatic compression (ISPC) leg sleeves on cardiac activity. Am J Surg. 2011;202:16-22.
  • 23. Fanelli G, Zasa M, Baciarello M, et al. Systemic hemodynamic effects of sequential pneumatic compression of the lower limbs: a prospective study in healthy volunteers. J Clin Anesth. 2008;20:338-342.
  • 24. Albert NM, Hail MD, Li J, et al. Equivalence of the bioimpedance and thermodilution methods in measuring cardiac output in hospitalized patients with advanced, decompensated chronic heart failure. Am J Crit Care. 2004;13:469-479.
  • 25. Bickel A, Shturman A, Sergeiev M, et al. Hemodynamic effect and safety of intermittent sequential pneumatic compression leg sleeves in patients with congestive heart failure. J Card Fail. 2014;20:739-746.
  • 26. Chen LE, Liu K, Qi WN, et al. Role of nitric oxide in vasodilation in upstream muscle during intermittent pneumatic compression. J Appl Physiol (1985). 2002;92:559-566.
  • 27. Liu K, Chen LE, Seaber AV, et al. Intermittent pneumatic compression of legs increases microcirculation in distant skeletal muscle. J Orthop Res. 1999;17:88-95.

Vücut Kitle İndeksinin Aralıklı Pnömatik Kompresyon Etkililiği Üzerindeki Etkileri

Year 2020, Volume: 73 Issue: 2, 107 - 112, 31.08.2020

Abstract

Amaç: Çalışmamız aralıklı pnömatik kompresyonun, farklı vücut kitle indeksine (VKİ) sahip bireylerde venöz hemodinamiye olan etkilerinin karşılaştırılmasını amaçlamaktadır.

Gereç ve Yöntem: Çalışmaya sağlıklı gönüllülerden olmak üzere toplam 48 birey dahil edildi. Çalışmaya alınan gönüllüler, hesaplanan VKİ’leri <24,9 kg/m2 olan (grup I), 25-29,9 kg/m2 arasında olan (grup II) ve >30 kg/m2 (grup III) olan olmak üzere üç gruba ayrıldı. Nabız, arteriyel kan basıncı ile oksijen satürasyonu ölçümleri ve venöz ultasonografi incelemeleri çalışmayı yürüten araştırmacı tarafından yapıldı. Aralıklı pnömatik kompresyon uygulamasının 30. dakikasında ölçümler tekrarlandı. Vena femoralis communis (ortak femoral ven) (VFC) çapı ve venöz akım dinamiği, VFC’nin büyük safen venle bileşkesinin 1-1,5 cm proksimalinden değerlendirildi.

Bulgular: Grup I ve grup II’de olan bireylerin, aralıklı pnömotik kompresyon uygulamasının 30. dakikasında, sağ ve sol VFC tepe sistolik akım hızlarının artışı, grup III’de olan bireylerin, sağ ve sol vena femoralis communis tepe sistolik akım hızlarının artışına oranla istatistiksel olarak anlamlı yüksek bulundu (sırasıyla, p<0,001, p=0,012, p=0,049).

Sonuç: Aralıklı pnömatik kompresyon uygulamasının femoral venöz akışı arttırdığını; ancak bu etkinin farklı VKİ’lere sahip bireyler arasında değiştiğini gösterdik. VKİ’nin, acil servislerde sıklıkla karşılaşılan, venöz tromboembolizm profilaksisi planlanlanan hastalar için bağımsız bir risk faktörü olarak düşünülmesi gerektiğine ve farklı fiziksel özeliklere bireylerde aynı etkiyi sağlamasının önemli olduğu kanaatindeyiz.

References

  • 1. Andersson T, Soderberg S. Incidence of acute pulmonary embolism, related comorbidities and survival; analysis of a Swedish national cohort. BMC Cardiovasc Disord. 2017;17:155.
  • 2. Guyatt GH, Norris SL, Schulman S, et al. Methodology for the development of antithrombotic therapy and prevention of thrombosis guidelines: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest. 2012;141:53S-70S.
  • 3. Coleman DM, Obi A, Henke PK. Update in venous thromboembolism pathophysiology, diagnosis, and treatment for surgical patients. Curr Probl Surg. 2015;52:233-259.
  • 4. Virchow RLK. Gesammelte Abhandlungen zur wissenschaftlichen Medicin. Frankfurt: Meidinger; 1862.
  • 5. Wolberg AS, Aleman MM, Leiderman K, et al. Procoagulant activity in hemostasis and thrombosis: Virchow’s triad revisited. Anesth Analg. 2012;114:275-285.
  • 6. Labropoulos N, Cunningham J, Kang SS, et al. Optimising the performance of intermittent pneumatic compression devices. Eur J Vasc Endovasc Surg. 2000;19:593-597.
  • 7. Malone MD, Cisek PL, Comerota AJ, et al. High-pressure, rapid-inflation pneumatic compression improves venous hemodynamics in healthy volunteers and patients who are post-thrombotic. J Vasc Surg. 1999;29:593- 539.
  • 8. Kohro S, Yamakage M, Sato K, et al. Intermittent pneumatic foot compression can activate blood fibrinolysis without changes in blood coagulability and platelet activation. Acta Anaesthesiol Scand. 2005;49:660-664.
  • 9. Sutkowska E, Wozniewski M, Gamian A, et al. Intermittent pneumatic compression in stable claudicants: effect on hemostasis and endothelial function. Int Angiol. 2009;28:373-379.
  • 10. Effect of intermittent pneumatic compression on disability, living circumstances, quality of life, and hospital costs after stroke: secondary analyses from CLOTS 3, a randomised trial. Lancet Neurol. 2014;13:1186- 1192.
  • 11. Chibbaro S, Cebula H, Todeschi J, et al. Evolution of Prophylaxis Protocols for Venous Thromboembolism in Neurosurgery: Results from a Prospective Comparative Study on Low-Molecular-Weight Heparin, Elastic Stockings, and Intermittent Pneumatic Compression Devices. World Neurosurg. 2018;109:e510-e516.
  • 12. Dennis M, Sandercock P, Graham C, et al. The Clots in Legs Or sTockings after Stroke (CLOTS) 3 trial: a randomised controlled trial to determine whether or not intermittent pneumatic compression reduces the risk of post-stroke deep vein thrombosis and to estimate its cost-effectiveness. Health Technol Assess. 2015;19:1-90.
  • 13. Kakkos SK, Caprini JA, Geroulakos G, et al. Combined intermittent pneumatic leg compression and pharmacological prophylaxis for prevention of venous thromboembolism in high-risk patients. Cochrane Database Syst Rev. 2008: CD005258.
  • 14. Classification and grading of chronic venous disease in the lower limbs. A consensus statement. Ad Hoc Committee, American Venous Forum. J Cardiovasc Surg (Torino) 1997;38:437-441.
  • 15. Andrews B, Sommerville K, Austin S, et al. Effect of Foot Compression on the Velocity and Volume of Blood-Flow in the Deep Veins. British Journal of Surgery. 1993;80:198-200.
  • 16. Yamashita K, Yokoyama T, Kitaoka N, et al. Blood flow velocity of the femoral vein with foot exercise compared to pneumatic foot compression. J Clin Anesth. 2005;17:102-105.
  • 17. Nguyen NT, Cronan M, Braley S, et al. Duplex ultrasound assessment of femoral venous flow during laparoscopic and open gastric bypass. Surgical Endoscopy and Other Interventional Techniques. 2003;17:285-290.
  • 18. Proctor MC, Greenfield LJ, Wakefield TW, et al. A clinical comparison of pneumatic compression devices: the basis for selection. J Vasc Surg. 2001;34:459-463.
  • 19. Koo KH, Choi JS, Ahn JH, et al. Comparison of clinical and physiological efficacies of different intermittent sequential pneumatic compression devices in preventing deep vein thrombosis: a prospective randomized study. Clin Orthop Surg. 2014;6:468-475.
  • 20. Morris RJ. Intermittent pneumatic compression - systems and applications. J Med Eng Technol. 2008;32:179-188.
  • 21. Morris RJ, Griffiths H, Woodcock JP. Analysis of the operation of the SCD Response intermittent compression system. J Med Eng Technol. 2002;26:111-116.
  • 22. Bickel A, Shturman A, Grevtzev I, et al. The physiological impact of intermittent sequential pneumatic compression (ISPC) leg sleeves on cardiac activity. Am J Surg. 2011;202:16-22.
  • 23. Fanelli G, Zasa M, Baciarello M, et al. Systemic hemodynamic effects of sequential pneumatic compression of the lower limbs: a prospective study in healthy volunteers. J Clin Anesth. 2008;20:338-342.
  • 24. Albert NM, Hail MD, Li J, et al. Equivalence of the bioimpedance and thermodilution methods in measuring cardiac output in hospitalized patients with advanced, decompensated chronic heart failure. Am J Crit Care. 2004;13:469-479.
  • 25. Bickel A, Shturman A, Sergeiev M, et al. Hemodynamic effect and safety of intermittent sequential pneumatic compression leg sleeves in patients with congestive heart failure. J Card Fail. 2014;20:739-746.
  • 26. Chen LE, Liu K, Qi WN, et al. Role of nitric oxide in vasodilation in upstream muscle during intermittent pneumatic compression. J Appl Physiol (1985). 2002;92:559-566.
  • 27. Liu K, Chen LE, Seaber AV, et al. Intermittent pneumatic compression of legs increases microcirculation in distant skeletal muscle. J Orthop Res. 1999;17:88-95.
There are 27 citations in total.

Details

Primary Language English
Subjects General Surgery
Journal Section Research Article
Authors

Merve Ekşioğlu 0000-0003-0108-9855

Nahit Arda Demirkan 0000-0001-6238-7712

Ahmet Burak Oğuz 0000-0001-8796-7529

Ömer Arda Çetinkaya 0000-0001-9135-8224

Behnan Gülünay 0000-0002-8201-6924

Müge Günalp Eneyli This is me

Publication Date August 31, 2020
Published in Issue Year 2020 Volume: 73 Issue: 2

Cite

APA Ekşioğlu, M., Demirkan, N. A., Oğuz, A. B., … Çetinkaya, Ö. A. (2020). The Effects of Body Mass Index on Efficacy of Intermittent Pneumatic Compression. Ankara Üniversitesi Tıp Fakültesi Mecmuası, 73(2), 107-112.
AMA Ekşioğlu M, Demirkan NA, Oğuz AB, Çetinkaya ÖA, Gülünay B, Günalp Eneyli M. The Effects of Body Mass Index on Efficacy of Intermittent Pneumatic Compression. Ankara Üniversitesi Tıp Fakültesi Mecmuası. August 2020;73(2):107-112.
Chicago Ekşioğlu, Merve, Nahit Arda Demirkan, Ahmet Burak Oğuz, Ömer Arda Çetinkaya, Behnan Gülünay, and Müge Günalp Eneyli. “The Effects of Body Mass Index on Efficacy of Intermittent Pneumatic Compression”. Ankara Üniversitesi Tıp Fakültesi Mecmuası 73, no. 2 (August 2020): 107-12.
EndNote Ekşioğlu M, Demirkan NA, Oğuz AB, Çetinkaya ÖA, Gülünay B, Günalp Eneyli M (August 1, 2020) The Effects of Body Mass Index on Efficacy of Intermittent Pneumatic Compression. Ankara Üniversitesi Tıp Fakültesi Mecmuası 73 2 107–112.
IEEE M. Ekşioğlu, N. A. Demirkan, A. B. Oğuz, Ö. A. Çetinkaya, B. Gülünay, and M. Günalp Eneyli, “The Effects of Body Mass Index on Efficacy of Intermittent Pneumatic Compression”, Ankara Üniversitesi Tıp Fakültesi Mecmuası, vol. 73, no. 2, pp. 107–112, 2020.
ISNAD Ekşioğlu, Merve et al. “The Effects of Body Mass Index on Efficacy of Intermittent Pneumatic Compression”. Ankara Üniversitesi Tıp Fakültesi Mecmuası 73/2 (August2020), 107-112.
JAMA Ekşioğlu M, Demirkan NA, Oğuz AB, Çetinkaya ÖA, Gülünay B, Günalp Eneyli M. The Effects of Body Mass Index on Efficacy of Intermittent Pneumatic Compression. Ankara Üniversitesi Tıp Fakültesi Mecmuası. 2020;73:107–112.
MLA Ekşioğlu, Merve et al. “The Effects of Body Mass Index on Efficacy of Intermittent Pneumatic Compression”. Ankara Üniversitesi Tıp Fakültesi Mecmuası, vol. 73, no. 2, 2020, pp. 107-12.
Vancouver Ekşioğlu M, Demirkan NA, Oğuz AB, Çetinkaya ÖA, Gülünay B, Günalp Eneyli M. The Effects of Body Mass Index on Efficacy of Intermittent Pneumatic Compression. Ankara Üniversitesi Tıp Fakültesi Mecmuası. 2020;73(2):107-12.