![]() 12 This is not the purpose of compression therapy. Pressure over 40 mm Hg raises the load on the heart through an elevation of the intra-auricular and pulmonary capillary pressure. As such, occlusion of the superficial venous network should be obtained at a compression of about 40 mm Hg, and it can be expected that the application of higher pressures will not further empty the superficial venous network. 9– 11 During pressure application, patients are usually in a supine position and the pressure in the superficial veins can be assumed not to exceed 20 mm Hg. ![]() Generally, pressures in a relatively wide range between 30 and 100 mm Hg are used. The optimal pressure for lymphatic drainage to which each chamber of a sequential pressure device is inflated is not clear and may depend on the application of the pressure cuff. Methods such as the application of pressure on a limb that are necessary for efficient emptying of the venous or lymphatic system without increasing the heart load or damaging the vascular parenchym 8 are not defined and are in need of scientific foundation and standardization. 7 We contend that this lack of agreement is probably due to the lack of references concerning optimal pressure values and how to apply compression. Not all authors agree on whether compression therapy, called “pressotherapy” in some parts of the world, should be part of the treatment. 2, 3 Pneumatic compression devices are sometimes used as part of the treatment of peripheral edema of venous-lymphatic origin as are techniques for manual drainage via the use of multilayer bandages. 1 Besides pharmacological treatments, physical treatments range from elastic or inelastic bandaging, use of elastic stockings, manual treatment by physical therapists, or sequential compression therapy using pneumatic devices. It can result in substantial impairment and psychological morbidity. Because the measured pressures were far beyond the pressure level indicated by the controller, it is recommended that pneumatic compression devices be used at much lower target pressures (<30 mm Hg) than those applied in clinical practice.īreast cancer, Compression therapy, Deep venous thrombosis, Lymphedema, Mastectomy, TherapyĪrm edema is a complication in approximately 40% (according to US National Cancer Institute data) of patients who undergo axillary radiation and surgery as breast cancer treatment. The discrepancy between the target pressure, indicated by the controller, and the pressure measured inside the cuff chambers undermines the therapeutic control and efficacy of the pneumatic compression devices. For the 80-mm cylindrical model, for instance, pressure in this chamber reached 54, 98, 121, and 141 mm Hg, respectively, instead of the 30, 60, 80, and 100 mm Hg indicated by the controller. Cuff chamber interaction led to P chamber and P interface values in the most distal (first inflated) chamber that were up to 80% higher than the target pressure. There was some effect of model diameter and shape, with the smaller curvatures yielding the highest P interface. Our data indicated that, overall, P interface is of the same order of magnitude as P chamber. We studied the time course of P chamber and P interface during the inflation sequence and the effect of local curvature on P interface. In this study, we used 3 cylindrical (60-, 80-, and 100-mm-diameter) model limbs and 1 ellipsoidal model of the arm to test a commercially available pressure controller using “target pressures,” indicated by the controller, of 30, 60, 80, and 100 mm Hg. The purpose of this study was to investigate (1) the relationship between cuff chamber pressure (P chamber) and the pressure on the cuff-skin interface (P interface) and (2) the mechanical interaction of cuff chambers and consequences for device control. Pneumatic compression devices, used as part of the therapeutic strategy for lymphatic drainage, often have cuffs with multiple chambers that are inflated sequentially.
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