ЗМІНИ ГЕМОДИНАМІКИ ПРИ ДІЇ ОБ’ЄМНОГО ПНЕВМОПРЕСИНГУ НА ЛІМФАТИЧНУ СИСТЕМУ

Abstract

Introduction.High prevalence of cardiovascular diseases, [1] implies continuous improvement of noninvasive physical techniques particularly perfectioning of compression therapy techniques, [3]. Intermittent pneumatic compression (IPC)widely used thought multipurpose physical rehabilitation in vascular surgery, dermatologic surgery, and sport medicine. Compressiontherapy (CT) is an established treatment method with very low rate of complicationsin research various facets of vascular and skeletal muscle physiology, [4].Purpose.The study was aimed to evaluate of intermittent pneumatic compression hemodynamic effects on the lower extremities and identify the effectiveness external pressure parameter of value 40 mm Hg.Methods.The study was included healthy 25 volunteers, 17+ years of age. The research shows that the mean physiological pressure in the superficial lymphatic vessel in the lower limb is 10–12 mmHg, then the external pressure (on skin) is 30–40 mmHg. Therefore, only greater external pressure can stimulate lymph drainage. In our research, used average pressures of 40 mmHg, and the procedure time limit at 20 minutes were applied. Outcome was considered succeed if blood pressure was dropped during and after procedure by increasing the expelled blood volume flow during a given period. To investigate the hemodynamic parameters after IPC, impedance cardio-vasography (ICVG) was implied.Results.A summary of the 20-minute testing with IPC of 40 mm hg pressure indicators in the chambers led to the following outcomes. Indications diastolic pressure significant were decrease for about 5-10 min of the procedure (p˂0,05) and by 15-20 minutes in recovery period, (p˂0,01). This phenomen may be attributted in changing the physiological milieu of the lymphatic system through compression application, a mechanism necessary to promote fluid uptake and alleviate limb swelling. However, there is evidence to suggest tissue fluid transport is not associated with transport of macromolecules (i.e., protein) from the interstitial tissue, [12,13,14]. Data suggest that the reactivity of blood pressure under the action IPC on the lower extremities with an intensity of 40 mm Hg maximizes endothelial shear stress. Rapid inflation stimulates the endothelium to release nitric oxide, which in turn inhibits platelet aggregation and platelet and monocyte adhesion. This indicates that the shear stress produced by IPC induces changes in endothelial cell function producing adaptation of blood vessels, resulting in clinical effects that can be measured, including improved arterial perfusion. Would be assumed that, depending on the compression parameters, the procedure time also depends if it was supposed to achieve an effect on the central hemodynamics. In case study, the recommended is that with an increase in cuff pressure, the recommended time should within 20 minutes or less. And vice versa - to achieve a lesser effect on central hemodynamics - the compression in the cuffs should be reduced to values less than 40 mm Hg and, accordingly, the procedure time should be increased.61 ISSN 2076-5835. Вісник Черкаського університету. 2022. No1Originality.To identify the effectiveness external pressure parameter of value 40 mm Hg.Conclusion.Applying IPC devices for hypertension prevention is gradually becoming a standard second-order therapy, particularly for patients with a high risk bleeding. However, a number of questions remain with regard for determining a more accurate time of inflation and deflation in the chambers of IPC devices are required and pressure parameters to its optimal use. The literature overview suggests that IPC improved hematologic and hemodynamic effects, maximizes endothelial shear stress and emptying of venous blood from the lower extremities are likely major contributors.Key words: timing; hemodynamics; lower extremity; intermittent pneumatic compression; cardio-vasography impedance; parameters.