Jornal Vascular Brasileiro
https://jvascbras.org/article/doi/10.1590/S1677-54492008000400006
Jornal Vascular Brasileiro
Original Article

Eficácia da compressão pneumática intermitente (CPI) nos membros inferiores sobre o fluxo sanguíneo das veias femorais comuns

Efficacy of intermittent pneumatic compression (IPC) in lower limbs on the blood flow of common femoral veins

Marcondes Figueiredo; Patrícia Polizel Simão; Beethoven Marques Alves Pereira; Nilson Penha-Silva

http://dx.doi.org/10.1590/S1677-54492008000400006 J Vasc Bras, vol.7, n4, p.321-324, 2008
PDF
SciELO
Downloads: 5
Views: 2455

Resumo

CONTEXTO: A profilaxia do tromboembolismo venoso pode ser feita por métodos farmacológicos ou de forma mecânica, com o uso de meias antitrombo e compressão pneumática (CPI). A CPI é um método mecânico de profilaxia que merece melhor atenção da comunidade médica. OBJETIVO: Avaliar o efeito do uso de compressão pneumática intermitente (CPI) nos pés, pernas e coxas de adultos saudáveis sobre o fluxo sanguíneo nas veias femorais comuns. MÉTODOS: A amostra foi constituída de 10 voluntários (sete mulheres e três homens) adultos (20-40 anos), sem antecedente de tromboembolismo venoso. Após repouso (10 min) em decúbito dorsal, o fluxo sanguíneo era medido (três vezes) por ultra-sonografia vascular na veia femoral, a 1 cm acima da junção safeno-femoral, em ambos os membros, sem controle e com CPI no pé, perna e na coxa. A compressão (130 mmHg no pé e 45 mmHg na perna e na coxa) foi aplicada em ciclos de 11 segundos de compressão e 20-60 segundos de esvaziamento. As aferições de fluxo foram realizadas no pico de fluxo do ciclo de compressão. Os valores foram comparados por análise de variância (teste de Tukey), com p < 0,05 indicando diferença estatisticamente significante. RESULTADO: A utilização de CPI nos membros inferiores, esquerdo e direito, promoveu elevações percentuais relativas no fluxo venoso femoral de 37,6 e 70,8% (pés), 143,9 e 164,7% (pernas) e 132,6 e 128,9% (coxas), respectivamente. As variações foram estatisticamente significantes para as aplicações nas pernas e coxas. CONCLUSÃO: A CPI melhora o fluxo sanguíneo quando aplicada na perna ou na coxa.

Palavras-chave

Dispositivo de compressão pneumática intermitente, trombose venosa, ultra-sonografia, veia femoral

Abstract

BACKGROUND: Prophylaxis of venous thromboembolism, a very common post-surgical complication, can be made pharmacologically or via mechanical methods, such as the use of anti-thrombosis socks and intermittent pneumatic compression (IPC). IPC is a mechanical method of prophylaxis that deserves the attention of the medical community. OBJECTIVE: To evaluate the effect of IPC on the blood flow of common femoral veins in feet, legs and thighs of healthy adults. METHODS: The sample was comprised of 10 volunteers (seven females and three males), adults (20-40 years), without history of venous thromboembolism. After a rest period (10 min), with the patient in the supine position, blood flow was measured (three times) via vascular ultrasonography at the femoral vein, 1 cm above of the saphenofemoral junction, in both limbs, without (control) and with IPC in the patient"s foot, leg and thigh. Compression (130 mmHg on foot and 45 mmHg on leg and thigh) was applied at compression cycles of 11 seconds and emptying cycles of 20-60 seconds. Blood flow evaluations were performed at compression cycle peaks. Values were compared by analysis of variance (Tukey test), p < 0.05 indicating statistically significant difference. RESULTS: Use of IPC on the left and right lower limbs caused a percentage increase in the femoral blood flow of 37.6 and 70.8% (feet), 143.9 and 164.7% (legs), and 132.6 and 128.9% (thighs), respectively. Variations were statistically significant for application in legs and thighs. CONCLUSION: Use of IPC improves blood flow when applied in legs or thighs.

Keywords

Intermittent pneumatic compression, venous thrombosis, ultrasonography, femoral vein

References

Howard A, Howard DPJ, Davies AH. Introduction to venous thromboembolism and prophylaxis. Phlebology. 2006;21:1-10.

Nicolaides AN, Dupont PA, Desai S, Lewis JD, Douglas JN. Small doses of subcutaneous heparin in preventing postoperative deep venous thrombosis. Am Heart J.. 1974;87:261-3.

Kalodiki EP, Hoppensteadt DA, Nicolaides AN. Deep venous thrombosis prophylaxis with low molecular weight heparin and elastic compression in patients having total hip replacement: A randomised controlled trial. Int Angiol. 1996;15:162-8.

Howard A, Zaccagnini D, Williams A. A protocol of low molecular weight heparin and antiembolic stockings abolishes deep vein thrombosis in low and moderate-risk patients and reduces it in high-risk surgical patients. Br J Surg. ;90:73-73.

Nicolaides AN, Fernandes e Fernandes J, Pollock AV. Intermittent sequential pneumatic compression of the legs in the prevention of venous stasis and postoperative deep venous thrombosis. Surgery. 1980;87:69-76.

Nicolaides AN, Miles C, Hoare M, Jury P, Helmis E, Venniker R. Intermittent sequential pneumatic compression of the legs and thromboembolism-deterrent stockings in the prevention of postoperative deep venous thrombosis. Surgery. 1983;94:21-5.

Kakkos SK, Daskalopoulou SS, Daskalopoulos ME, Nicolaides AN, Geroulakos G. Review on the value of graduated elastic compression stockings after deep vein thrombosis. Thromb Haemost. 2006;96:441-5.

Urbankova J, Quiroz R, Kucher N, Goldhaber SZ. Intermittent pneumatic compression and deep vein thrombosis prevention in postoperative patients. Thromb Haemost. 2005;94:1181-5.

Hills NH, Pflug JJ, Jeyasingh K, Boardman L, Calnan JS. Prevention of deep vein thrombosis by intermittent pneumatic compression of calf. Br Med J. 1972;1:131-5.

Flam E, Berry S, Coyle A, Dardik H, Raab L. Blood-flow augmentation of intermittent pneumatic compression systems used for prevention of deep vein thrombosis prior to surgery. Am J Surg. 1996;171:312-5.

Kakkos SK, Griffin M, Geroulakos G, Nicolaides AN. The efficacy of new portable sequential compression device (SCD express) in preventing venous stasis. J Vasc Surg. 2005;42:296-303.

Kakkos SK, Nicolaides AN, Griffin M, Geroulakos G. Comparison of two intermittent pneumatic compression systems: a hemodynamic study. Int Angiol. 2005;24:330-5.

Maffei FH, Rollo HA. Trombose venosa profunda dos membros inferiores. Doenças vasculares periféricas. 2001:1363-86.

Morris RJ, Woodcoock JP. Evidence-based compression: prevention of stasis and deep vein thrombosis. Ann Surg. 2004;239:162-71.

Chen AH, Frangos SG, Kilaru S, Sumpio BE. Intermittent pneumatic compression devices: physiological mechanisms of actions. Eur J Endovasc Surg. 2001;21:383-92.

Delis KT, Slimani G, Hafez HM, Nicolaides AN. Enhancing venous out flow in the lower limb with intermittent pneumatic compression: A comparative haemodynamic analysis on the effect of foot vs. calf vs. foot and calf compression. Eur J Vasc Endovasc Surg. 2000;19:250-60.

Keith SL, McLaughlin DJ, Anderson FA Jr. Do graduated compression stockings and pneumatic boots have an additive effect on the peak velocity of venous blood flow?. Arch Surg. 1992;127:727-30.

European Venous Forum: International Surgical Thrombosis Forum; International Union of Angiology; Union Internationale de Phlébologie. Prevention and treatment of venous thromboembolism. International Consensus Statement (guidelines according to scientific evidence). Int Angiol. 2006;25:101-61.

Nutescu EA. Assessing, preventing, and treating venous thromboembolism: evidence-based approaches. Am J Health Syst Pharm. 2007;64:S5-13.

Engelhorn ALV, Garcia ACF, Cassou AF, Birckholz L, Engelhorn CA. Profilaxia da trombose venosa profunda: estudo epidemiológico em um hospital escola. J Vasc Bras. 2002;1:97-102.

Garcia ACS, Souza BV, Volpato DE. Realidade do uso da profilaxia para trombose venosa profunda: da teoria à prática. J Vasc Bras. 2005;4:35-41.

Stratton MA, Anderson FA, Bussey HI. Prevention of venous thromboembolism: adherence to the 1995 American College of Chest Physicians consensus guidelines for surgical patients. Arch Intern Med. 2000;160:334-40.

Sociedade Brasileira de Angiologia e Cirurgia Vascular (SBACV)"> Sociedade Brasileira de Angiologia e Cirurgia Vascular (SBACV)">
5ddd45d30e8825f74a1da3e9 jvb Articles
Links & Downloads
1677-7301 (Electronic)
J Vasc Bras ©2024 All rights reserved.

J Vasc Bras

Share this page
Page Sections