Introduction.High prevalence of cardiovascular diseases, [1] implies continuous improvement of noninvasive physical techniques particularly perfectioning of compression therapy techniques, [3]. Intermittent pneumatic compression (IPC)widely used thought multipurpose physical rehabilitation in vascular surgery, dermatologic surgery, and sport medicine. Compressiontherapy (CT) is an established treatment method with very low rate of complicationsin research various facets of vascular and skeletal muscle physiology, [4].Purpose.The study was aimed to evaluate of intermittent pneumatic compression hemodynamic effects on the lower extremities and identify the effectiveness external pressure parameter of value 40 mm Hg.Methods.The study was included healthy 25 volunteers, 17+ years of age. The research shows that the mean physiological pressure in the superficial lymphatic vessel in the lower limb is 10–12 mmHg, then the external pressure (on skin) is 30–40 mmHg. Therefore, only greater external pressure can stimulate lymph drainage. In our research, used average pressures of 40 mmHg, and the procedure time limit at 20 minutes were applied. Outcome was considered succeed if blood pressure was dropped during and after procedure by increasing the expelled blood volume flow during a given period. To investigate the hemodynamic parameters after IPC, impedance cardio-vasography (ICVG) was implied.Results.A summary of the 20-minute testing with IPC of 40 mm hg pressure indicators in the chambers led to the following outcomes. Indications diastolic pressure significant were decrease for about 5-10 min of the procedure (p˂0,05) and by 15-20 minutes in recovery period, (p˂0,01). This phenomen may be attributted in changing the physiological milieu of the lymphatic system through compression application, a mechanism necessary to promote fluid uptake and alleviate limb swelling. However, there is evidence to suggest tissue fluid transport is not associated with transport of macromolecules (i.e., protein) from the interstitial tissue, [12,13,14]. Data suggest that the reactivity of blood pressure under the action IPC on the lower extremities with an intensity of 40 mm Hg maximizes endothelial shear stress. Rapid inflation stimulates the endothelium to release nitric oxide, which in turn inhibits platelet aggregation and platelet and monocyte adhesion. This indicates that the shear stress produced by IPC induces changes in endothelial cell function producing adaptation of blood vessels, resulting in clinical effects that can be measured, including improved arterial perfusion. Would be assumed that, depending on the compression parameters, the procedure time also depends if it was supposed to achieve an effect on the central hemodynamics. In case study, the recommended is that with an increase in cuff pressure, the recommended time should within 20 minutes or less. And vice versa - to achieve a lesser effect on central hemodynamics - the compression in the cuffs should be reduced to values less than 40 mm Hg and, accordingly, the procedure time should be increased.61 ISSN 2076-5835. Вісник Черкаського університету. 2022. No1Originality.To identify the effectiveness external pressure parameter of value 40 mm Hg.Conclusion.Applying IPC devices for hypertension prevention is gradually becoming a standard second-order therapy, particularly for patients with a high risk bleeding. However, a number of questions remain with regard for determining a more accurate time of inflation and deflation in the chambers of IPC devices are required and pressure parameters to its optimal use. The literature overview suggests that IPC improved hematologic and hemodynamic effects, maximizes endothelial shear stress and emptying of venous blood from the lower extremities are likely major contributors.Key words: timing; hemodynamics; lower extremity; intermittent pneumatic compression; cardio-vasography impedance; parameters.
Intermittent pneumatic compression (IPC) widely used in the therapy of preventing the formation of blood clots, improving the oxygenation of peripheral tissues. IPC is an established method in the therapy of post-operative recovery and in geriatrics and sports medicine. The purpose of our study was to determine functional changes in heart rate variability (HRV) and peripheral hemodynamics during exposure to lowintensity IPC depending on different types of regulation of the autonomic nervous system. We investigated 62 participants in age of 18-22 years. Testing sessions that included pressure of 40 mmHg and 20-minute period of temporary occlusion of the lower extremities was performed by intermittent pneumatic compression with Recovery Pump PRX device (“Mego Aftek AC Ltd”, Israel). During the procedure exposure and recovery period, arterial blood pressure was recorded with Korotkov’s auscultative method by mercury tonometer (“Dr. Frei”A-10, Switzerland). Heart Rate was monitored using a Cardio Trainer Polar H9 (“Polar Electro Oy”, Finland). For monitoring hemodynamic changes, impedance cardiography (ICG) method (“ХАІ-medica”, Kharkiv, Ukraine) was applied by 15 s. Based on the spectrum power values in the range of 0.15–0.4 (HFnorm), 3 groups of volunteers were determined using sigma deviations. Group 1 included 29 volunteers with an advantage of the sympathetic link of regulation of the autonomic nervous system (the background HFnorm was less than 40 nu). Group 2 included 19 persons with a normotonic type of autonomic nervous system regulation (HFnorm from 40 to 60 nu). Group 3 included 14 individuals with predominance of the parasympathetic link of the autonomic nervous system (HFnorm above 60 nu). In conclusion, IPC treatment in groups 1 and 2 inhibited the sympathetic activation, increased the blood flow in the large femoral arteries and tone of small arteries. In group 3, the blood outflow from the lower extremities was predominance, the blood flow volume and speed decreased. Therefore, we conclude effectivity of the low intensity IPC using. Also, HRV and peripheral hemodynamics depend on the types of regulation of the autonomic nervous system.
The purpose of our study was to determine changes in central hemodynamics under the condition of exposure to low-intensity IPC on the lower limbs in individuals with different types of regulation of the autonomic nervous system. The group of 62 participants in age of 18-22 years were investigated. Testing session that included pressure of 40 mmHg and 20-minute period of temporary occlusion of the lower extremities was performed by intermittent pneumatic compression with Recovery Pump PRX device (“Mego Aftek AC Ltd”, Israel). Before, during the exposure and recovery period of the procedure arterial blood pressure was recorded with Korotkov’s auscultative method by mercury tonometer (“Dr.Frei”A-10, Switzerland). For monitoring hemodynamic changes impedance cardiography (ICG) method was applied (“ХАІ-medica”, Kharkiv, Ukraine), by 15 sec. Based on the spectrum power values in the range of 0.15-0.4 (HFnorm), which was calculated according to the formula HFnorm = HF/(HF+LF)∙100%, 3 groups of volunteers were determined by method of sigma deviations. The 1st group included 29 people with a predominance of the sympathetic link of regulation of the autonomic nervous system, HF norm at rest is less than 40 nu. The 2nd - 19 people with a normotonic type of regulation, HFnorm from 40 to 60 nu. The 3rd - 14 people with a predominance of the parasympathetic link, HF norms higher than 60 nu. It has been established that in persons of the 1st group blood pressure maintenance is a result of complex neurohumoral interactions, in the 3rd group - due to vascular components. The decrease in the heart rate and cardiac index in the 1st and 2nd groups is caused by a decrease in venous return to the heart, and in the 3rd group - by contractile function of the heart. The proven impact of non-invasive IPC on peripheral blood circulation improving supports the concept of orthostatic tolerance. Future long-term studies are needed to evaluate the further long-term efficacy of IPC, safety and tolerability of this approach in clinical practice.
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