Physical augmentation of cardiac output.
Explore the source record for details and available documents.
Cardiac Output, Low↗
SEARCH · Search PubMed
Results for “Gravity Suits”
Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.
Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.
Pneumatic compression hemodynamics in total hip arthroplasty.
A crossover study was performed to evaluate the effect of several pneumatic compression devices and active dorsoplantar flexion in 10 patients who underwent total hip arthroplasty. Using the Acuson 128XP/10 duplex ultrasound unit with a 5-MHz linear array probe, peak venous velocity and venous volume were assessed above and below the greater saphenous vein and common femoral vein junction. A computer generated randomization table was used to determine the order of the test conditions. The pneumatic compression devices evaluated included two foot pumps, one foot and calf pump, one calf pump, and three calf and thigh pumps. Statistical analyses included analysis of variance and analysis of variance with covariance between devices and patients. The covariates tested were the baseline measurements and the order in which the devices were tested. Differences between devices relate in part to the frequency and rate of inflation and the location and type of compression. Pulsatile calf and foot and calf pneumatic compression with a rapid inflation time produced the greatest increase in peak venous velocity, whereas compression of the calf and thigh showed the greatest increase in venous volume. Because patient and nursing compliance is essential to the success of mechanical prophylaxis for thromboembolic disease, the more simple, yet efficacious, devices that are easier to apply and less cumbersome appear to have a greater likelihood of success. In the active and alert patient, active dorsoplantar flexion should be encouraged.
Arthroplasty, Replacement, Hip↗
Effect of pneumatic trousers on pulmonary function.
Little information is available concerning the effect of pneumatic antishock trousers (PT) on pulmonary function. To examine this issue, we measured the effects of PT inflation on forced expired volumes, subdivisions of lung volumes, quasistatic lung compliance, single-breath diffusing capacity for carbon monoxide, and transdiaphragmatic pressure at resting lung volume in 10 healthy nonsmoking adults. All subjects were studied seated without PT, supine with PT uninflated, and supine with PT inflated to 100 mm Hg. When seated subjects assumed the supine position without PT inflation, significant reductions were found in the forced expired volume in 1 sec, in subdivisions of lung volume, total lung capacity (TLC), functional residual capacity (FRC), expiratory reserve volume (ERV) and in transdiaphragmatic pressure. However, PT inflation itself did not produce significant changes in any of the measured pulmonary indices except transdiaphragmatic pressure. We conclude that PT inflation in supine normovolemic individuals does not produce acutely significant alterations in lung function.
Adult↗
Regional blood flow during cardiopulmonary resuscitation in dogs.
We studied regional blood flow (QR) using radiolabeled microspheres in 12 anesthetized dogs during cardiopulmonary resuscitation (CPR). A circumferential vest and abdominal binder were used with a mechanical ventilator to deliver 30 simultaneous chest compressions and ventilations per minute. When this device was modified to increase aortic pressure (Pao) during compression and the aortic-to-right atrial pressure gradient (Pao-Pra) during relaxation, cerebral and myocardial QR increased significantly. These findings suggest that QR during CPR can be improved by augmenting perfusion-pressure gradients across the cerebral and coronary circulations.
Animals↗
Nonsurgical treatment of pelvic hemorrhage in obstetric and gynecologic patients.
Explore the source record for details and available documents.
Adult↗
Effect of intermittent pneumatic leg compression on intracranial pressure in brain-injured patients.
OBJECTIVE: To evaluate the effect of intermittent pneumatic leg compression on intracranial pressure and cerebral perfusion pressure in brain-injured patients. DESIGN: Prospective, sequential patient study. SETTING: Surgical/trauma ICU of a community hospital providing regional trauma care. PATIENTS: Twenty-four adult, brain-injured patients (mean Glasgow Coma Scale score = 6) who required hemodynamic and intracranial pressure monitoring. INTERVENTIONS: Placement of intermittent sequential pneumatic leg compression devices for prevention of venous thrombosis. MEASUREMENTS: Mean arterial pressure (MAP), heart rate, central venous pressure, and intracranial pressure were measured at baseline, and at 0, 10, 20, and 30 mins of intermittent pneumatic leg compression. Cerebral perfusion pressure was calculated as the difference between MAP and intracranial pressure. RESULTS: No significant changes in MAP, central venous pressure, or intracranial pressure occurred during the study interval. Calculated cerebral perfusion pressure remained unchanged. A total of 23 of 24 study patients had intracranial pressure controlled by hyperventilation or pharmacologic measures within the normal range at the time of study. CONCLUSION: Intermittent pneumatic leg compression results in no significant changes in intracranial pressure or cerebral perfusion pressure in stable, brain-injured patients who have intracranial pressure controlled by medical means.
Blood Pressure↗
Managing trauma patients in the prehospital setting: applying mother nature's principles.
Explore the source record for details and available documents.
Adult↗
Hypertonic saline infusion in hemorrhagic shock treated by military antishock trousers (MAST) in awake sheep.
OBJECTIVES: To determine the effect of military antishock trousers (MAST) combined with hypertonic saline in controlled hemorrhagic shock in an awake sheep model. DESIGN: Prospective, randomized, controlled study. SETTING: University research laboratory. SUBJECTS: Healthy adult sheep (21 to 33.5 kg) were studied in four experimental groups. INTERVENTIONS: Sheep underwent cannulation of the jugular vein and the carotid artery. An indwelling catheter was also inserted into their bladders. Mean arterial, pulmonary arterial, pulmonary artery occlusion, and central venous pressures, cardiac and stroke volume indices, systemic and pulmonary vascular resistances, PaO2 and PaCO2, and serum lactate and hemoglobin concentrations were measured at baseline, after induction of hemorrhagic shock, and subsequently during resuscitative treatments of normal saline, MAST, hypertonic saline, and the combination of MAST and hypertonic saline. MEASUREMENTS: Controlled hemorrhagic shock was induced by arterial bleeding of 40 mL/kg in all animals. The sheep were randomized into four groups. In group 1 (n = 5), controlled hemorrhagic shock was treated by 5 mL/kg sodium chloride 0.9% (isotonic saline). In group 2 (n = 6), controlled hemorrhagic shock was treated by 5 mL/kg sodium chloride 7.5% (hypertonic saline). In group 3 (n = 5), controlled hemorrhagic shock was treated by MAST inflated to 40 mm Hg followed by 5 mL/kg sodium chloride 0.9%. In group 4, controlled hemorrhagic shock was treated by MAST (40 mm Hg) followed by 5 mL/kg of hypertonic saline. MAIN RESULTS: Arterial bleeding was followed by significant decreases in mean arterial pressure (87 +/- 1 to 41 +/- 4 mm Hg; p < .001), cardiac index (4.6 +/- 0.4 to 2.0 +/- 0.2 L/min/m2; p < .001), and urine output (102 +/- 30 to 13.0 +/- 7 mL/hr; p < .001), and an increase in systemic vascular resistance (1517 +/- 130 to 2601 +/- 370 dyne.sec/cm5; p < .001). MAST inflation in group 3 increased systemic vascular resistance to 3018 +/- 399 dyne.sec/cm5 (p < .05) and mean arterial pressure to 79 +/- 5 mm Hg (p < .05), while cardiac index, urine output, and lactate concentration remained unchanged. Infusion of hypertonic saline after MAST inflation (group 4) resulted in an increase in mean arterial pressure to 99 +/- 4 mm Hg (p < .001), an increase in cardiac index to 4.1 +/- 0.4 L/min/m2 (p < .001), an increase in urine output to 221 +/- 93 mL/hr (p < .001), and a decrease in systemic vascular resistance to 1847 +/- 175 dyne.sec/cm5 (p < .005). CONCLUSIONS: In hemorrhagic shock, the combination of MAST and hypertonic saline increases mean arterial pressure, improves cardiac output and tissue perfusion during the application of MAST, and also prolongs for > 2 hrs the short beneficial effect of hypertonic saline on mean arterial pressure.
Animals↗
Fluid balance and acute cardiovascular failure.
Explore the source record for details and available documents.
Adenosine Triphosphate↗
Prospective randomized comparison of two types of pressure therapy garments.
A prospective randomized study was undertaken to compare compliance efficacy and cost of the elastic nylon pressure garment (Jobst Institute, Inc., Toledo, Ohio) with the cotton elastic pressure garment (Tubigrip, SePro Healthcare Inc., Montgomeryville, Penn.). Of 110 patients enrolled, 54 received Jobst pressure garments and 56 received Tubigrip pressure garments. Time spent in pressure-therapy garments was the same for both groups. Comparable clinical results were achieved with either Tubigrip or Jobst garments. A significantly greater percentage of patients were compliant with Tubigrip pressure-garment therapy than with Jobst pressure-garment therapy. The cost of the Tubigrip garments was significantly lower than that of Jobst garments. These data suggest that the use of elasticized cotton pressure garments results in significantly better patient compliance, a lower cost, and equal therapeutic efficacy when compared with the elasticized nylon pressure garments.
Adolescent↗
Compliance and durability in pressure garments.
This study examined the pressure volumetric characteristics (compliance) of Jobst (Jobst Institute, Toledo, Ohio), Barton-Carey (Barton-Carey Co., Perrysburg, Ohio), and Tubigrip (SePro Healthcare Inc., Moorestown, N.J.) pressure garments for arms after repeated saturation with lubricating substances and repeated washing/drying cycles. The three treatment groups were each composed of one sleeve from each of the manufacturers and were subjected to 20 washing/drying cycles. In addition, the sleeves in treatment groups 2 and 3 were saturated with cocoa butter and Lubriderm moisturizer, respectively, before each cycle. Circumferential measurements were taken on the proximal forearm of the sleeve at varying degrees of pressure with a Grafco standard sphygmomanometer (Graham Field Inc., Hauppauge, N.Y.) and a Gulick anthropometric tape measure (Creative Engineering, Plymouth, Mich.). Measurements were taken initially and after every fifth washing/drying cycle. Analysis of variance revealed significant results for the main effects and some interactions at the 0.01 level. Overall results showed little change in the Jobst and Barton-Carey garments, whereas the Tubigrip garments displayed an inconsistent pattern.
Burns↗
Color pressure garments versus traditional beige pressure garments: perceptions from the public.
Social acceptance of patients with burns may be affected by the color of the pressure garment they wear. The purpose of this study was to ask students (n = 712), health care providers (n = 354), and the public (n = 250) their perceptions of beige versus color pressure garments. It was assumed that beige pressure garments have negative connotations and that colored pressure garments have positive connotations. Data were collected from subjects after they viewed beige, pink, and blue pressure garments. Items on the instrument contained bipolar word pairs rated on a 5-point scale; a rating of 1 indicated positive feelings, and a rating of 5 indicated negative feelings. Cronbach's alpha reliability for the instrument was 0.85, indicating a high internal consistency among items. Paired t test indicated a significant difference between the subjects' perceptions of the beige garments versus their perceptions of the color garments (t = -44.82, p = 0.000) among all subjects (n = 1259). Results indicate that positive feelings toward color garments may lead to social acceptance of the patient with burns, which in turn could increase the patient's self-esteem.
Adult↗
The effect of mechanical compression on chronic hand edema after burn injury: a preliminary report.
Chronic hand edema after wound healing is a troublesome condition to treat in patients with burns. Stagnant edema can cause fibrosis, which impedes rehabilitation and may lead to deformity. Although favorable results have been reported with mechanical compression used in acute injuries, no literature was found on the effects of compression for the treatment of chronic hand-burn edema. Five male patients with nine chronically edematous burned hands were subject to mechanical compression at 55 mm Hg pressure. A single-cell unit was used for a 30-minute treatment at 4:1 treatment ratio. Goniometric and volumetric hand measurements were recorded both before and after treatment. Although patients expressed a subjective feeling of improvement, no statistical difference was found in finger joint range of motion nor in hand volume when comparing pretreatment and posttreatment measurements. Many different treatment protocols exist in the literature and are discussed.
Adult↗
Compliance with pressure garment use in burn rehabilitation.
Pressure garment use is recommended 23 to 24 hours a day for hypertrophic scar control after a burn injury. Compliance with this treatment has not been documented. A 52-question survey was administered to 101 adult outpatient burn survivors to rate compliance with this program. The average compliance of each patient was assessed. The framework of the Health Belief Model was used to identify the patients' beliefs and factors reported to interfere with compliance. Strategies patients believed to enhance garment use were identified. Forty-one percent of the patients reported total compliance. The difficulties with garment use such as discomfort and activity limitations appeared to promote low compliance. The primary strategies patients believed would enhance compliance were seeing outcome pictures of scars and having contact with other survivors. This step toward identifying compliance rates and factors that affect them will guide the health care worker in techniques to facilitate adherence to the scar management program.
Adult↗
A new tool to measure pressure under burn garments.
This article introduces a new tool to measure the pressure that is under pressure garments. The Iscan (Tekscan, Inc.) system uses a patented ultra-thin (0.007 inch) sensor with multiple sensing locations that sample continuously at 100 times per second. It is noninvasive, convenient, and quick. The study had two parts. First, we established the validity and reliability of the device. Next, garment/scar interface pressures were measured on new garments with use of the Iscan system. Four garment types were studied, with 10 measurements made in each group: Isotoner gloves (Smith & Nephew Roylan, Inc.); custom-fit pressure gloves; Tubigrip forearm sleeves (Seton Health Care Group); and custom-fit pressure forearm sleeves. Mean garment/scar interface pressures were 18 +/- 2 mm Hg for the Isotoner glove, 34 +/- 5 mm Hg for the custom-fit pressure glove, 20 +/- 7 mm Hg for the Tubigrip sleeve, and 35 +/- 6 mm Hg for the custom-fit sleeve. We concluded that the Iscan system can be used to measure pressure under pressure garments accurately and reliably, and that custom-fit hand and forearm garments provide more pressure than Isotoner gloves or Tubigrip sleeves.
Bandages↗
Do custom-fitted pressure garments provide adequate pressure?
Pressure garment therapy has become the worldwide standard of care for the prevention and treatment of hypertrophic scars. There are many reports in the literature on pressure garment therapy but few studies state the amount of pressure actually provided. The purpose of our study was to determine the amount of pressure applied to the scar/garment interface by custom-fitted pressure garments. The Iscan (Tekscan, Inc.) system was used to document scar/garment interface pressures of 144 new custom-fitted pressure garments. Average pressure readings for garments for the anterior thigh, anterior trunk, abdomen, buttocks, posterior trunk, posterior thigh, and arm were less than 22 mm Hg. Average pressure readings for the dorsal hand, leg, forearm, and dorsal foot were more than 28 mm Hg, with smaller relative standard deviations. The pressure readings varied greatly between garments in this group, frequently resulting in standard deviations that were higher than the pressure readings. The data show that despite precise fitting techniques, pressure garments do not provide a consistent amount of pressure at the scar/garment interface. This means that studies that report results of pressure therapy, but do not verify the amount of pressure applied, are of limited value. Precise determination of pressure "dose" must be made before the efficacy of pressure garment therapy can be determined objectively.
Burns↗
Skeletal and dental disturbances in children after facial burns and pressure garment use: a 4-year follow-up.
Pressure garment use alters facial growth during rehabilitation after a facial burn injury. We previously studied 3 children with full facial burns and 3 children with partial facial burns who wore pressure garments for 1 year, and we found that maxillary horizontal growth and mandibular anterior-inferior growth are inhibited during the time of pressure garment use. The purpose of this follow-up study was to prospectively document skeletal and dental changes after pressure garment use was discontinued. We found that although the growth and development of the facial bones seem to return to normal, lasting changes remain. The use of pressure garments after skin grafting is still recommended. However, it is also recommended that an orthodontist be included in the team of burn care specialists for children with facial burns to monitor facial and dental development. Close attention to facial development during and after pressure garment use is necessary to maintain normal dental and facial relationships.
Burns↗