The effect of graduated compression stockings on blood velocity in the deep venous system of the lower limb in the postnatal period

Jamieson, Rosalind; Calderwood, Carmelita; Greer, I. A.

doi:10.1111/j.1471-0528.2007.01421.x

Cited by 33 publications

(28 citation statements)

References 6 publications

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“…In addition, the lower surface-to-volume ratio in large veins and the reduced effectiveness of surface-bound coagulation inhibitors 48 must also be considered. Our analysis (shear rates were calculated here from the vein diameter and flow rate values measured by Jamieson et al 47 ) of published data 47 shows that the shear rate in the common femoral vein is increased by Ϸ50% by gradient compression stockings, a result that is consistent with this hypothesis. Although shear rate can be estimated by dividing the velocity of blood flow by the diameter of a blood vessel, assuming a circular, noncompressible tube, 33 the actual shear rate in blood vessels in vivo may be more difficult to calculate because of Figure 5.…”

Section: Discussionsupporting

confidence: 79%

“…4,46 Although various anticoagulants contribute to the prevention of venous thromboembolism, 2 increased blood flow rate and velocity are usually interpreted as possible mechanisms by which compression stockings prevent DVT. 16,47 However, we hypothesize that shear rate may be a better predictor of initiation of coagulation than volumetric flow rate or flow velocity, because a considerable amount of coagulation is initiated on or near vessel walls, and the flow velocity approaches zero on the vessel walls. In this respect, large veins may be more risky because, for a given flow rate or flow velocity, their shear rates are disproportionately low.…”

Section: Discussionmentioning

confidence: 99%

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Threshold Response of Initiation of Blood Coagulation by Tissue Factor in Patterned Microfluidic Capillaries Is Controlled by Shear Rate

Shen

Kastrup

Liu

et al. 2008

ATVB

111

115

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Objective-Blood flow is considered one of the important parameters that contribute to venous thrombosis. We quantitatively test the relationship between initiation of coagulation and shear rate and suggest a biophysical mechanism to understand this relationship. Methods and Results-Flowing human blood and plasma were exposed to cylindrical surfaces patterned with patches of tissue factor (TF) by using microfluidics. Initiation of coagulation of normal pooled plasma depended on shear rate, not volumetric flow rate or flow velocity, and coagulation initiated only at shear rates below a critical value. Initiation of coagulation of platelet-rich plasma and whole blood showed similar behavior. At constant shear rate, coagulation of plasma also showed a threshold response to the size of a patch of TF, consistent with our previous work in the absence of flow. Conclusion-Initiation of coagulation of flowing blood displays a threshold response to shear rate and to the size of a surface patch of TF. Combined with the results of others, these results set the range of shear rates that limit initiation of coagulation by small surface areas of TF and by shear activation of platelets. This range fits the relatively narrow range of physiological shear rates described by Murray's law. T his article analyzes initiation of coagulation of blood flowing over a patch presenting tissue factor (TF) in the regime where platelets are not activated by shear alone. TF is the primary stimulus for initiation of coagulation in vivo. [1][2][3] We demonstrate that initiation of coagulation displays a threshold response to shear rate and to the size of the patch of TF, and we suggest a biophysical mechanism that explains these threshold phenomena. While low blood flow and endothelial damage are known risk factors for coagulation, 4 the precise effects of blood flow on the initiation of coagulation are not fully characterized, possibly because of the difficulty in experimentally decoupling the effects of volumetric flow rate, flow velocity, and shear rate.The effects of flow and shear rate on the activation of coagulation factors have been studied previously, 5-12 but whether high or low shear rates promote initiation of coagulation remains unclear. Intuitively, high blood flow and shear rates may promote coagulation by increasing the rate of delivery of coagulation proenzymes to sites of vascular damage. Indeed, high shear rates have been shown to increase the generation of factor Xa from surfaces coated with the TF and factor VIIa complex (TF-VIIa). 11 Moreover, high shear rates increase the potential for shear activation of platelets. 13,14 On the other hand, numeric simulations have predicted that low blood flow could promote initiation by reducing the removal of activated coagulation factors from surfaces of TF-VIIa, 15 and, clinically, stasis and low blood flow are considered risk factors for deep vein thrombosis (DVT). 16 Low shear rates have also been found to increase fibrin deposition and appearance of fibrin monomers, indicating that l...

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Section: Discussionsupporting

confidence: 79%

Section: Discussionmentioning

confidence: 99%

Threshold Response of Initiation of Blood Coagulation by Tissue Factor in Patterned Microfluidic Capillaries Is Controlled by Shear Rate

Shen

Kastrup

Liu

et al. 2008

ATVB

111

115

View full text Add to dashboard Cite

show abstract

“…GCS are commonly used as a thromboprophylaxis adjunct in pregnancy and postpartum, while IPCD can be used during and after caesarean section. A small Scottish study found a reduction in lumen size of the common femoral vein and increase in blood velocity after application of GCS in the immediate postnatal period after vaginal delivery (Jamieson et al, 2007). Despite the general lack of evidence for their use in pregnancy, the RCOG advises the use of GCS in postpartum women where there are three or more risk factors present (Nelson-Piercy et al, 2009).…”

Section: Mechanical Thromboprophylaxismentioning

confidence: 99%

The prevention of pregnancy‐related venous thromboembolism

2014

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SummaryPregnancy-related venous thromboembolism (VTE) remains one of the leading causes of maternal mortality and morbidity in the developed world. There is a lack of high-level data surrounding the use of thromboprophylaxis in pregnancy. In the UK, following the publication of the first Royal College of Obstetricians and Gynaecologists (RCOG) guideline for VTE prophylaxis during pregnancy and the puerperium in 2004, a fall in maternal deaths secondary to VTE was observed during the subsequent triennium (2006)(2007)(2008). For the first time since 1985, VTE was no longer the most common cause of maternal death. Low-molecular-weight-heparin (LMWH) is generally the agent of choice for thromboprophylaxis in this setting, and is considered safe and efficacious. The accurate risk stratification of women in order to allow the targeted provision of thromboprophylaxis is challenging. A number of international guidelines support risk assessment for pregnancyrelated VTE and the provision of LMWH for those who are deemed at sufficiently high risk. This review describes the importance of VTE in pregnancy and the puerperium, the part played by different risk factors and the role of thromboprophylaxis in this group of patients.

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“…50 In a Cochrane review of nine randomly controlled studies, 3% (n ¼ 598) who received GCS with prophylaxis developed DVT compared to 14% (n ¼ 595) in the control group. When compression stockings were used without anticoagulation, seven randomly controlled studies revealed 15% (n ¼ 536) developed DVT versus 29% (n ¼ 491) of the control group.…”

Section: Mechanical Prophylaxismentioning

confidence: 99%

DVT Prevention for the Obese Patient: Evidence-Based Nursing Interventions

Maiocco

2008

Bariatric Nursing and Surgical Patient Care

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Obesity is a risk factor for deep vein thrombosis (DVT), and as obesity increases, DVT rates will also elevate. The purpose of this article is to assist nurses in correctly selecting evidence-based interventions found effective in preventing DVT formation. To promote full understanding of this disease process, pathophysiologic changes associated with obesity will be linked with current research-based therapies of anticoagulation, compression therapy, and mobilization. A call for future research is proffered in multiple areas, to include assessment, determination of interventional effectiveness, and establishment of outcome measurements for both surgical and medical obese populations.

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The effect of graduated compression stockings on blood velocity in the deep venous system of the lower limb in the postnatal period

Cited by 33 publications

References 6 publications

Threshold Response of Initiation of Blood Coagulation by Tissue Factor in Patterned Microfluidic Capillaries Is Controlled by Shear Rate

Threshold Response of Initiation of Blood Coagulation by Tissue Factor in Patterned Microfluidic Capillaries Is Controlled by Shear Rate

The prevention of pregnancy‐related venous thromboembolism

DVT Prevention for the Obese Patient: Evidence-Based Nursing Interventions

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