title: Hemodynamic effect and safety of intermittent sequential pneumatic compression leg sleeves in patients with congestive heart failure.
abstract: BACKGROUND
  Pneumatic leg sleeves are widely used after prolonged operations for prevention of venous stasis. In healthy volunteers they increase cardiac function. We evaluated the hemodynamic effects and safety of intermittent sequential pneumatic compression (ISPC) leg sleeves in patients with chronic congestive heart failure (CHF).
  
  
  RESULTS
  We studied 19 patients with systolic left ventricular dysfunction and CHF. ISPC leg sleeves, each with 10 air cells, were operated by a computerized compressor, exerting 2 cycles/min. Hemodynamic and echocardiographic parameters were measured before, during, and after ISPC activation. The baseline mean left ventricular ejection fraction was 29 ± 9.2%, median 32%, range 10%-40%. Cardiac output (from 4.26 to 4.83 L/min; P = .008) and stroke volume (from 56.1 to 63.5 mL; P = .029) increased significantly after ISPC activation, without a reciprocal increase in heart rate, and declined after sleeve deactivation. Systemic vascular resistance (SVR) decreased significantly (from 1,520 to 1,216 dyne-s/cm5; P = .0005), and remained lower than the baseline level throughout the study. There was no detrimental effect on diastolic function and no adverse clinical events, despite increased pulmonary venous return.
  
  
  CONCLUSIONS
  ISPC leg sleeves in patients with chronic CHF do not exacerbate symptoms and transiently improve cardiac output through an increase in stroke volume and a reduction in SVR.
authors.affiliation: Department of Surgery, Western Galilee Medical Center, Nahariya, Israel; Faculty of Medicine of the Galilee, Bar Ilan University, Israel.
authors.forename: Amitai
authors.initials: A
authors.lastname: Bickel
authors.affiliation: Department of Cardiology, Western Galilee Medical Center, Nahariya, Israel; Faculty of Medicine of the Galilee, Bar Ilan University, Israel.
authors.forename: Alexander
authors.initials: A
authors.lastname: Shturman
authors.affiliation: Department of Anesthesiology, Western Galilee Medical Center, Nahariya, Israel.
authors.forename: Michael
authors.initials: M
authors.lastname: Sergeiev
authors.affiliation: Department of Anesthesiology, Western Galilee Medical Center, Nahariya, Israel; Faculty of Medicine of the Galilee, Bar Ilan University, Israel.
authors.forename: Shimon
authors.initials: S
authors.lastname: Ivry
authors.affiliation: Department of Surgery, Western Galilee Medical Center, Nahariya, Israel; Faculty of Medicine of the Galilee, Bar Ilan University, Israel.
authors.forename: Arieh
authors.initials: A
authors.lastname: Eitan
authors.affiliation: Department of Cardiology, Western Galilee Medical Center, Nahariya, Israel; Faculty of Medicine of the Galilee, Bar Ilan University, Israel. Electronic address: shaul.atar@gmail.com.
authors.forename: Shaul
authors.initials: S
authors.lastname: Atar
mesh_terms: D000368:Aged; D002302:Cardiac Output; D004452:Echocardiography / Q000379:methods; D005260:Female; D006333:Heart Failure / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology; D006339:Heart Rate; D006439:Hemodynamics; D006801:Humans; D048228:Intermittent Pneumatic Compression Devices; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic; D017063:Outcome Assessment, Health Care; D014655:Vascular Resistance; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology
keywords: Laparoscopy; pneumatic sleeves; surgery; transthoracic echocardiography