A Novel Clinical Test for Setting Intermittent Pneumatic Compression Parameters Based on Edema Fluid Hydromechanics in the Lymphedematous Calf

Abstract

Abstract

Background:

Long-term observations confirm lasting effects and lack of complications of intermittent pneumatic compression (IPC) therapy. So far, no test has been designed that would provide data necessary for setting pressure and time parameters of the IPC device to obtain optimum decrease in limb volume.

Aim:

To design a test providing data on decrease of circumference under the inflated chamber in time depending on the applied compression pressure.

Methods:

One chamber was placed above the ankle joint and inflated to 120 mmHg in order to occlude tissue fluid backflow during inflation of the proximally located test chamber. The latter was inflated sequentially to 50, 80, 100, and 120 mmHg, for 1–3 minutes each. Calf circumference changes were recorded continuously using the plethysmographic strain gauges placed under and proximally to the inflated chamber.

Results:

Four different types of the recorded circumference change curves were observed during inflation of the test chamber. The first was decrease under and increase proximally to the inflated chamber, another showed decrease under the inflated chamber and little change proximally, the third small decrease under the chamber but increase proximally, and the fourth no change under and proximally. Depending on the steepness of the obtained curves, pressures and timing of IPC device were increased to values bringing about edema fluid mobilization.

Conclusions:

The two-chamber inflation-deflation test provides plethysmographic data on the circumference changes during calf IPC, time necessary to obtain optimum decrease of circumference, and an insight into tissue elasticity. These data are useful for setting the compression devices at levels bringing about a decrease in limb swelling as well as may be of prognostic value with respect to the efficacy of long-term use of IPC.