Acute oxygenation changes on ischemic foot of a novel intermittent pneumatic compression device and of an existing sequential device in severe peripheral arterial disease

BMC Cardiovascular Disorders

Paolo Zamboni²  Nino Basaglia³  Francesco Mascoli¹  Roberto Manfredini⁴  Nicola Lamberti¹  Simona Mandini¹  Michele Felisatti¹  Anna Maria Malagoni²  Fabio Manfredini¹ 

[1] Vascular Diseases Center, University of Ferrara, Ferrara, Italy;Program Pathophysiology of Vascular Peripheral System and Day Surgery, S. Anna Hospital University, Ferrara, Italy;Department of Rehabilitation Medicine, S. Anna Hospital University, Ferrara, Italy;Clinica Medica, Department of Medical Sciences, University of Ferrara, Ferrara, Italy

关键词: Critical limb ischemia;    Perfusion;    Peripheral vascular disease;    Near-infrared spectroscopy;    Intermittent pneumatic compression devices;   

Others  :  855234
DOI  :  10.1186/1471-2261-14-40

 received in 2013-11-14, accepted in 2014-03-27,  发布年份 2014

【 摘 要 】

Background

Intermittent pneumatic compression (IPC) improves haemodynamics in peripheral arterial disease (PAD), but its effects on foot perfusion were scarcely studied. In severe PAD patients we measured the foot oxygenation changes evoked by a novel intermittent IPC device (GP), haemodynamics and compliance to the treatment. Reference values were obtained by a sequential foot-calf device (SFC).

Methods

Twenty ischemic limbs (Ankle-Brachial Index = 0.5 ± 0.2) of 12 PAD patients (7 male, age: 74.5 ± 10.8 y) with an interval of 48 ± 2 hours received a 35 minute treatment in supine position with two IPC devices: i) a Gradient Pump (GP), which slowly inflates a single thigh special sleeve and ii) an SFC (ArtAssist^®, ACI Medical, San Marcos, CA, USA), which rapidly inflates two foot-calf sleeves. Main outcome measure: changes of oxygenated haemoglobin at foot (HbO_2foot) by continuous near-infrared spectroscopy recording and quantified as area-under-curve (AUC) for periods of 5 minutes. Other measures: haemodynamics by echo-colour Doppler (time average velocity (TAV) and blood flow (BF) in the popliteal artery and in the femoral vein), patient compliance by a properly developed form.

Results

All patients completed the treatment with GP, 9 with SFC. HbO_2foot during the working phase, considered as average value of the 5 minutes periods, increased with GP (AUC 458 ± 600 to 1216 ± 280) and decreased with SFC (AUC 231 ± 946 to −1088 ± 346), significantly for most periods (P < 0.05). The GP treatment was associated to significant haemodynamic changes from baseline to end of the treatment (TAV = 10.2 ± 3.3 to 13.5 ± 5.5 cm/sec, P = 0.004; BF = 452.0 ± 187.2 to 607.9 ± 237.8 ml/sec, P = 0.0001), not observed with SFC (TAV = 11.2 ± 3.4 to 11.8 ± 4.3 cm/sec; BF = 513.8 ± 203.7 to 505.9 ± 166.5 ml/min, P = n.s.). GP obtained a higher score of patient compliance (P < 0.0001).

Conclusions

A novel IPC thigh device, unlike a traditional SFC device, increased foot oxygenation in severe PAD, together with favourable haemodynamic response and high compliance to the treatment under the present experimental conditions.

【 授权许可】

   
2014 Manfredini et al.; licensee BioMed Central Ltd.

【 图 表 】

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