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to Four Currently Available Intermittent Pneumatic Compression Devices
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Karen K. Giuliano, PhD, RN, FAAN, MBA ; Kristen Parmelee ; Jeff Schwegman
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Associate Professor (Joint), University of Massachusetts Amherst, College of Nursing & Institute for Applied Life Sciences, Amherst MA ; RF Health, Fishers IN
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Results (N=20)
Introduction
Participant Demographics (N=20)
Conclusions
In the US, DVTs are a leading cause of preventable hospital death,
• A broad range of subjects (N=20) were successfully recruited
affecting 350,000-900,000 patients with an estimated 60,000-100,000
representing a variety of age, BMI, gender, and leg sizes.
annual deaths.
DVTs are the fifth most common reason for hospital
1,2
• Peak flow velocity over baseline measurements were significantly
readmission, the third most frequent complication of total joint
higher for the MAC System in 3 out of 4 comparisons.
replacement (TJR), and are associated with an estimated annual cost
• While not significantly different, the Arjo Huntleigh Flowtron
of $10 billion.
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ACS900 (SD= 3.4) had more measurement variability in peak flow
velocity over baseline than the MAC System (SD=1.9).
DVT prophylaxis in patients with limited mobility includes the use of
• The MAC System had a significantly faster rise time to peak flow
anticoagulant medications and mechanical compression of the lower
than all other comparison devices.
Significance testing using Kruskal-Wallis with post-hoc Mann -
limbs. For effective DVT prophylaxis using mechanical compression,
• The differences in both peak flow velocity over baseline and rise
Whitney U found the MAC System had a significantly higher peak
enhanced blood flow in the common femoral vein of at least three
time to peak between the MAC System and the other devices is
flow velocity over baseline as compared to Kendall SCD 700,
times over baseline and a short rise time to peak flow are Femoral Blood Flow for DVT Prophylaxis: A Comparison of a Novel Non-Pneumatic Device
particularly important. 4 ActiveCare+S.F.T., and Circul8. No significant difference was found easily seen in the shape of sample blood flow curves.
between the MAC System and Arjo Huntleigh Flowtron ACS900. • The MAC System was the only device to achieve the target peak
Purpose flow velocity over baseline in every BMI group.
Compare femoral vein blood flow enhancement during external Replicating blood flow from ambulation
MAC Moves Blood. TM Subject 10: Blood flow Curve Sample for each Device The MAC System had more Clinical Implications
mechanical compression between the novel, non-pneumatic RF
Health Movement and Compressions (MAC System ) and four
measurements (Figure 1) in the
Conclusions:
Peer-Reviewed Evidence currently available intermittent pneumatic compression devices: target range of > 3 than any of • Consistency in achieving enhanced blood flow in excess of 3x over
700, Arjo Huntleigh Flowtron®
Cardinal Health Kendall SCD
TM
Commonly used intermittent
ACS900, Zimmer Biomet ActiveCare+S.F.T.®, and Ortho8 Circul8. the other comparison devices. baseline is important for the prevention of deep vein thrombosis. 4
pneumatic compression (IPC) • Commonly used intermittent pneumatic compression (IPC) devices
Original Research Aim devices require bladders and require bladders and tubes that hinder mobility and have a
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negative impact on adherence with recommended use.
tubes that compress the leg at
a slower rate. The movement
Using Doppler ultrasound, measure and compare common femoral Significance testing using • The MAC System is a mobile system that remained in place during
of air using millimeters of
ABSTRACT vein peak blood flow velocity, rise time to peak flow and calculated Kruskal-Wallis/post-hoc ambulation and provided more consistent external mechanical
peak flow velocity over baseline for five mechanical compression RF Health MAC System Mann -Whitney U found compression in the desired range as compared to all comparison
mercury (mmHg) to gauge
Background: devices in a group of subjects with varied leg sizes. that the MAC System had devices.
pressure has historically
A study published by the Journal of Vascular Surgery using Doppler ultrasound to been the standard to which a significantly faster rise • The MAC System’s non-pneumatic technology consistently
time to peak flow as
achieved clinical goals for blood flow enhancement in a varied
a compression’s efficacy is
measure and compare common femoral vein response to mechanical compression Materials & Methods compared to all other sample of subjects.
found that efficacy of industry-leading devices in moving blood varied in a group of measured. devices.
subjects with diverse leg sizes. • Volunteer participants were recruited from the Indianapolis, IN
geographical area. The MAC System’s mechanism References
of compression involves an
Methods: • 21 participants were successfully recruited: participant 1 served
as the pilot test subject, and the other 20 provided data for
alternative means of squeezing
This novel method of evaluating compression efficacy is directly based on femoral s. by using a motorized system Cardinal Health Kendall SCD700 Arjo Huntleigh Flowtron ACS900 1. Makic MB, Rauen C, Watson R, Poteet AW. Examining the evidence to guide practice: challenging
analysi
practice habits. Crit Care Nurse. 2014;34(2):28-45; quiz 46.
vein response and thus validates the indication for moving blood. • Leg size measurements were taken using a non-contact leg 2. CDC. Venous thromboembolism (blood clots). 2017; https://www.cdc.gov/ncbddd/dvt/data.html
that remains in place on the
measurement device, the LEGREADER XT5 by Sigvaris. Accessed July 17, 2018.
lower leg before, during and
3. CDC. Venous thromboembolism (blood clots): Healthcare-associated venous thromboembolism.
Results: • Due to the mobile and tubeless design, the MAC System was 2016; https://www.cdc.gov/ncbddd/dvt/ha-vte.html Accessed May 6, 2018.
after ambulation. MAC provides
measured when applied and re-measured following 500 walked
The MAC System was the only device to achieve the target peak flow velocity over adaptive forces to give a more 4. Labropoulos N, Oh DS, Golts E, Kang SS, Mansour MA, Baker WH. Improved venous return by
elliptical, sequential and seamless air-cell compression. Int Angiol. 2003;22(3):317-321.
steps while wearing the system to determine slippage.
baseline in every BMI group. MAC also had a significantly faster rise time to peak consistent external mechanical Table 6 shows the mean peak flow velocity over baseline for each 5. Giuliano, K, Hatch, C., Pozzar, R**. (2019). Thrombophylaxis after hospitalization for joint
flow than all other comparison devices. • Doppler ultrasound on the right leg by a vascular certified 5 device by BMI group. Target values are highlighted in green and replacement surgery. Journal for Healthcare Quality.
compression without air.
ultrasound technician was used to measure (1) peak blood flow Zimmer Biomet Ortho8 Circul8 values below target are highlighted in red. Funding
Both corded and cordless devices were included in the study giving further velocity and (2) rise time to peak flow on device. ActiveCare+S.F.T.
• Each participant received remuneration for their participation in
indication that not all squeezes are the same in terms of femoral vein response. The MAC System met the goal of less than 1 inch of movement after
the study. Contact ambulation in 100% of measurements; 75% of measurements found Research reported in this poster was supported by the National Heart, Lung And
no movement. Blood Institute of the National Institutes of Health under Award Number
Karen K. Giuliano, PhD, RN, FAAN, MBA R44HL132624. The content is solely the responsibility of the authors and does
kkgiuliano@umass.edu not necessarily present the official views of the National Institutes of Health.
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Table 6: Mean Peak Flow Velocity over Baseline by BMI Group
Table 1 shows the mean
peak flow velocity for each MAC Kendall SCD Arjo Huntleigh ActiveCare
device by BMI group. Target BMI Group N System 700 Flowtron ACS900 +S.F.T Circul8
values highlighted in green
and values below in red.
Under 18.5 2 3.8 2.7 2.3 2.3 1.9
18.5-24.9 5 4.1 2.8 5 3.3 1.8
25-29.9 7 4.2 3.8 5.6 2.8 2.1
30+ 6 5.3 3.7 5.5 2.8 1.8
10 MOVEMENT AND COMPRESSIONS SYSTEM 11