title: Pneumatic thigh compression reduces calf volume and augments the venous return.
abstract: OBJECTIVE
  Reactive hyperaemia following thigh compression increases arterial inflow and venous outflow. The net effect can be measured by changes in calf volume quantified using air-plethysmography. The objective was to investigate the effect of thigh compression on venous return.
  
  
  METHODS
  The right legs of 19 consecutive volunteers (14 male), median age 31 (25-56) years, were studied in the supine position using air-plethysmography. The clinical, etiological, anatomical, pathophysiological (CEAP) class was C0. A thigh-cuff, 12 cm wide, was inflated in increments of 10 mmHg, from 0 to 80 mmHg. After each inflation step, the calf volume increased to a plateau and was recorded. At 80 mmHg, the thigh-cuff was deflated suddenly with the calf volume decreasing until baseline. Calf volume changes were recorded and stored for analysis.
  
  
  RESULTS
  There was a stepwise increase in the venous volume of the calf with each incremental rise in thigh-cuff pressure up to 80 mmHg (p < .0005, Friedman). The median (interquartile range) increase in venous volume from 0 to 80 mmHg was 87 (65-113) mL (p < .0005, Wilcoxon). The volume change below the original baseline following thigh-cuff release was -16 (-12 to -25) mL (p < .0005, Wilcoxon).
  
  
  CONCLUSIONS
  Once optimised, intermittent pneumatic compression of the thigh may have a therapeutic role in augmenting the venous return and reducing leg swelling in patients.
authors.affiliation: Josef Pflug Vascular Laboratory, Ealing and Northwick Park Hospitals and Imperial College, London, UK c.lattimer09@imperial.ac.uk.
authors.forename: Christopher R
authors.initials: CR
authors.lastname: Lattimer
authors.affiliation: Josef Pflug Vascular Laboratory, Ealing and Northwick Park Hospitals and Imperial College, London, UK.
authors.forename: Evi
authors.initials: E
authors.lastname: Kalodiki
authors.affiliation: Josef Pflug Vascular Laboratory, Ealing and Northwick Park Hospitals and Imperial College, London, UK.
authors.forename: Mustapha
authors.initials: M
authors.lastname: Azzam
authors.affiliation: Josef Pflug Vascular Laboratory, Ealing and Northwick Park Hospitals and Imperial College, London, UK.
authors.forename: George
authors.initials: G
authors.lastname: Geroulakos
mesh_terms: D000328:Adult; D001783:Blood Flow Velocity; D005260:Female; D006801:Humans; D048228:Intermittent Pneumatic Compression Devices; D008297:Male; D010865:Pilot Projects; D011446:Prospective Studies; D013848:Thigh / Q000098:blood supply*
keywords: Venous return; air-plethysmography; calf volume; compression; thigh compression; venous flow; venous outflow