Hemodynamic alterations in venous blood flow produced by external pneumatic compression.

Venous stasis associated with prolonged bed rest can enhance the risk of deep venous thrombosis (DVT). Pneumatic compression of the lower extremities can reduce this risk by preventing venous stasis. When selecting a method of leg compression for their patients, physicians must chose between two distinctly different types of compression devices. One device applies pressure with a single-chambered sleeve to the below knee region while the other applies pressure in a sequential gradient fashion from the ankle to the thigh. The current prospective study was designed to evaluated the ability of two such devices to increase blood flow in the profunda femoral vein. Venous blood flow velocity, compression time, and vein diameter were measured in nine normal experimental subjects using an Accuson duplex-Doppler before, during and after leg compression. Compression with the single-chambered device produced a significant rise in venous blood flow velocity; however, this could not be maintained and our results indicate a higher average velocity was achieved with the sequential gradient device. The sequential gradient device also moved a greater volume of blood and achieved a higher average blood flow rate. The time between deflation of the sleeve and return of a phasic respiratory signal was greater after compression with the sequential gradient device. These results suggest that sequential gradient compression produces the type of hemodynamic alterations needed to reduce the risk of DVT by achieving a sustained increase in venous blood flow and more completely emptying of the veins in the leg.