title: Intermittent pneumatic foot compression can activate blood fibrinolysis without changes in blood coagulability and platelet activation.
abstract: BACKGROUND
  Intermittent pneumatic foot compression (IPC) is a useful technique for prophylaxis of peri-operative venous thromboembolism. The aim of this study was to determine the effect of IPC on blood coagulation/fibrinolysis and platelet function using a blood viscometer (Sonoclot) and a platelet aggregation monitor (WBA analyzer(TM)), respectively. Using the same blood samples, serum levels of tissue-type plasminogen activator (t-PA), thrombomodulin (TM) and activated protein C (APC) were also measured.
  
  
  METHODS
  The soles and legs of each subject (n = 8) were compressed for 3 s (130 mmHg) at a 0.3-Hz interval using an IPC device. Parameters were measured 2 min before and at the end of 60-min compression.
  
  
  RESULTS
  Parameters of the Sonoclot time-to-peak were shortened and clot retraction rate was increased significantly by IPC, whereas the other parameters did not change. These results indicate that IPC can activate blood fibrinolysis but not coagulability. A parameter of the WBA analyzer PATI (platelet aggregatory threshold index) did not change, indicating that IPC cannot activate platelet function per se. The concentration of t-PA decreased slightly but significantly. A decrease in the concentration of t-PA can lead to activation of fibrinolysis. Other humoral parameters did not change, indicating that IPC has no effect on endothelial function. Although neither blood coagulability nor platelet function were affected by IPC, fibrinolytic activity increased slightly, probably by activation of t-PA function.
  
  
  CONCLUSIONS
  IPC is useful for prophylaxis for thromboembolism by activation of blood fibrinolysis as well as inhibition of blood stasis.
authors.affiliation: Department of Anesthesiology, Sapporo Medical University School of Medicine, South 1 West 16, Chuo-ku, Sapporo, Hokkaido 060-8543, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Kohro
authors.forename: M
authors.initials: M
authors.lastname: Yamakage
authors.forename: K
authors.initials: K
authors.lastname: Sato
authors.forename: J-I
authors.initials: JI
authors.lastname: Sato
authors.forename: A
authors.initials: A
authors.lastname: Namiki
mesh_terms: D020016:Activated Protein C Resistance; D000328:Adult; D001777:Blood Coagulation / Q000502:physiology*; D001809:Blood Viscosity / Q000502:physiology; D003018:Clot Retraction; D042783:Endothelial Cells / Q000473:pathology; D005260:Female; D005342:Fibrinolysis / Q000502:physiology*; D005528:Foot / Q000098:blood supply*; D006801:Humans; D007432:Intraoperative Period; D008297:Male; D015539:Platelet Activation / Q000502:physiology*; D011312:Pressure / Q000009:adverse effects; D012039:Regional Blood Flow / Q000502:physiology; D013923:Thromboembolism / Q000097:blood / Q000188:drug therapy; D018180:Thrombomodulin / Q000097:blood; D010959:Tissue Plasminogen Activator / Q000378:metabolism
chemical_list: D018180:Thrombomodulin; D010959:Tissue Plasminogen Activator