INTERMITTENT COMPRESSION THERAPY.pptx

A brief Knowledge about IPC devices.

1. INTERMITTENT COMPRESSION THERAPY Dr. Jasjyot Kaur Sabharwal (PT)

2. INTRODUCTION Also known as: intermittent pneumatic compression (IPC). Intermittent pneumatic compression devices consist of a sleeve that fits over the leg and attaches to a pump. Various pneumatic pumps with different specifications are available. Since the early 1950s, pneumatic compression systems have been used in the management of swelling. Over the past decades, the technology has improved substantially.  The initial pneumatic compression pumps were single chamber non-segmented, nonprogrammable, pumps providing a single uniform compression to the limb. 

3. Intermittent pneumatic compression devices come with either single-chamber or multi-chamber sleeves. The multi-chamber sleeve provides sequential compression that “milks” the fluid from distal to proximal, whereas the single-chamber sleeve inflates and deflates all at once.  The multi-chamber sequential compression has been shown to be more effective in achieving venous return than the single-chamber compression. For patients with venous insufficiency these devices are generally applied for 30-60 minutes twice per day at pressures of 30-50 mm Hg.

4. CHARACTERISTIC OF IPC DEVICES Non-segmental- Single cuff that expands (inflation) and contracts (deflation) applying pressure against the limb. No manual control over pressure distribution(inbuilt cycle). No pressure gradient exists. Not optimal for lymphedema management Adjustable pressure range 1-100mmHg (therapeutic range 25-30mmHg) Pre-set inflation/deflation cycle. Multi-Chamber segmented without manual control Commonly have 3-4 chambers which inflate sequentially from distal to proximal until all are inflated and then all deflate together. May have limited pressure programming options and are not independently adjustable. May be constructed so that each chamber has the same pressure and pressure gradient is achieved by virtue of the limb contours. These pumps can treat one or two legs or arms simultaneously.

5. MECHANISM Intermittent pneumatic compression (IPC) devices are inflatable sleeves. The inflating and deflating movement of the IPC device supports your circulation. Healthy movement of blood in the body prevents blood clots from forming. When the sleeves compress, it helps the blood move through your body to your heart. When they relax, oxygen-rich blood flows to your leg arteries. The sleeves also help your body release substances that can prevent clots.

6. INDICATIONS Intermittent pneumatic compression devices may be used to relieve edema and may promote healing in patients with venous ulcerations. Lymphedema. Post surgery- cancer. Venous insufficiency. Post traumatic edema. Dysfunction of the muscle pump like- intermittent claudication discomfort leg fatigue.

7. APPLICATION The pressure used should not exceed the patient’s diastolic blood pressure. Maximum pressure ranges used for treating the upper extremity are 40-60 mm Hg and 60-100 for the lower extremity. C over the area to be treated with stockinette. Make sure there are no wrinkles as this can cause high pressure areas and subsequent bruising. Encourage the patient to perform gentle ROM exercises (wiggle fingers or toes) during the off time. Instruct the patient to notify you if pain or a “tingling” feeling occurs.

8. CONTRAINDICATION Septic phlebitis Abscesses Advanced peripheral neuropathy Cardiac insufficiency Confirmed allergy to compression material. Active infection Recent skin graft Compartment syndrome Gangrene Known or suspected deep vein thrombosis or pulmonary embolism

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