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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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                                                                                                                                                                             2
                                              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.
 3
                                                                                                                                                                                                         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
                                                                                                                                                                                                                                                             5
                                                                                                                                                                                                         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
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