Mechanical Massage Research Articles

990. Non-Invasive Gene Delivery to the Liver by Mechanical Massage

990. Non-Invasive Gene Delivery to the Liver by Mechanical Massage

Does Mechanical Massage of the Abdominal Wall After Colectomy Reduce Postoperative Pain and Shorten the Duration of Ileus? Results of a Randomized Study

The aim of this study was to determine the effectiveness of mechanical abdominal massage on postoperative pain and ileus after colectomy. We hypothesized that parietal abdominal stimulation could counteract induced pain and postoperative ileus, through common spinal-sensitive pathways, with nociceptive visceral messages. After preoperative randomization, 25 patients (age 52 ± 5 years) underwent active mechanical massage by intermittent negative pressure on the abdominal wall resulting in aspiration (Cellu M50 device, LPG, Valence, France), and 25 patients (age 60 ± 6 years) did not receive active mechanical massage (placebo group). Massage sessions began the first day after colectomy and were performed daily until the seventh postoperative day. In the active-massage group, amplitude and frequency were used, which have been shown to be effective in reducing muscular pain, whereas in the placebo group, ineffective parameters were used. Visual analogue scale (VAS) pain scores, doses of analgesics (propacetamol), and delay between surgery and the time to first passage of flatus were assessed. Types and dosages of the anesthetic drugs and the duration of the surgical procedure did not differ between groups. From the second and third postoperative days, respectively, VAS pain scores ( P < 0.001) and doses of analgesics ( P < 0.05) were significantly lower in patients receiving active massage compared to the placebo group. Time to first passage of flatus was also significantly shorter in the active-massage group (1.8 ± 0.3 days vs. 3.6 ± 0.4 days, P < 0.01). No adverse effects were observed. These results suggest that mechanical massage of the abdominal wall may decrease postoperative pain and ileus after colectomy. ( J Gastrointest Surg 2002;6:43–49.)

Analysis of the effects of deep mechanical massage in the porcine model.

Deep mechanical massage has been advocated as an alternative or adjunctive therapy for the contouring of subcutaneous fat and as a treatment for cellulite. We evaluated the effects of deep mechanical massage using two pig models. Yucatan pigs were divided into three groups (n = 4). One side of each body received 4, 10, or 20 treatments and the other side served as a control. Full-thickness tissue sections, including the underlying muscle, were harvested from identical treated and untreated regions. Examination of these regionally matched samples revealed an accumulation of dense, longitudinal collagen bands in the middle dermal and deep subdermal regions, which progressively increased with the number of treatments. Distortion and disruption of adipocytes was noted. In Yorkshire pigs, force-transducing balloon catheters were surgically placed between the deep subcutaneous tissue and muscle fascia. Catheters were inserted into two regions with different skin and subcutaneous tissue characteristics, the midflank and the hip. Standardized maneuvers were performed at suction settings 3, 5, 7, and 9 to record baseline tissue forces. Each maneuver carried a unique force signature. The measurement of tissue forces was repeated on the opposite side after 10 standardized treatment sessions. Analysis showed a significant reduction of measured forces at the midflank after the treatments. The actual force measured with each particular maneuver varied between different operators but not with different suction settings, suggesting that the technique of administering the treatments is the primary factor in creating the force within the tissue. This leads to the conclusion that deep mechanical massage is highly dependent on the individual operator of the device.

The mechanical massage of the abdomen decreases postoperative pain and ileus: A randomized study

The mechanical massage of the abdomen decreases postoperative pain and ileus: A randomized study

The mechanical massage of the abdomen decreases postoperative pain and ileus: A randomized study

The mechanical massage of the abdomen decreases postoperative pain and ileus: A randomized study

The effects of the modified intermittent sequential pneumatic device (MISPD) on exercise performance following an exhaustive exercise bout.

The Lymphapress, a pneumatic sequential intermittent device is recognized as one of the most effective conservative treatments for lymphoedema, due to its effective 'milking mechanism'. This led us to hypothesize that accelerated removal of fatigue-causing metabolites by mechanical massage could improve an athlete's performance capacity. We conducted trials with 11 men who exercised at a constant workload, on a cycle ergometer, until exhaustion. During a 20-min recovery period a new modified pneumatic sequential intermittent device (the MISPD) was applied to the subjects' legs. The men then performed a second constant load exercise bout. Cardiorespiratory parameters were measured during exercise and blood was withdrawn during recovery for the determination of lactate, pyruvate, ammonia, bicarbonate and pH. No difference was found in the blood levels of the 'fatigue causing metabolites' during passive recovery (PR) and recovery with the MISPD (MR). However, the MISPD effected a 45% improvement in the subjects' ability to perform the subsequent exercise bout. The accumulation of fluid in the interstitial space after exercise and its disappearance after the use of the MISPD offers one possible explanation for these results, although psychological effects cannot be discounted.

Pulsatile Reperfusion After Cardiac Arrest Improves Neurologic Outcome

Cardiopulmonary bypass (CPB) using nonpulsatile flow (NPF) is advocated for refractory cardiac arrest. This study examined cerebral outcome after resuscitation with pulsatile flow (PF) versus NPF. Dogs arrested for 12.5 minute were reperfused with NPF (n = 11) using roller pump CPB or PF (n = 11) using mechanical biventricular cardiac massage. Pump flows were similar between groups; however early arterial pressures were greater during PF versus NPF, *p less than 0.05. Circulatory support was weaned at 60 minutes' reperfusion. Neurologic recovery of survivors (n = 16) was significantly better after PF versus NPF, *p = 0.01. The presence of brain lesions on magnetic resonance images did not significantly differ between groups at 7 days. Brain then were removed and regions examined for ischemic changes. Loss of CA1 pyramidal neurons was more severe after NPF versus PF, +p = 0.009. Ischemic changes were more frequent after NPF in the caudate nucleus (+p = 0.009) and watershed regions of the cerebral cortex (+p = 0.062), compared with PF. These results demonstrate that PF improves cerebral resuscitation when treating cardiac arrest with mechanical circulatory support (* = MANOVA with repeated measures, + = categorical data analysis.

An apparatus for applying a mechanical massage to rat hearts inside a wide‐bore NMR spectrometer

A device for applying mechanical massage to the isolated perfused rat heart inside a wide-bore NMR spectrometer was developed. This device exerts a squeezing pressure on a fibrillating heart placed inside a NMR spectrometer without interfering with the NMR measurements. It appears that the apparatus is important for obtaining reliable results in the postischemic reperfusion period.

Intermittent mechanical massage for the prevention of thromboembolism

Since 1977 we treated more than 7,000 out of 20,000 patients with risk of thromboembolic complications with intermittent pneumatic compression of the legs. Complications due to prophylaxis with heparin can so be avoided. Our statistical analysis makes it reasonable to use this physical method routinely for surgical in-patients. It is as effective as prophylaxis with heparin. The intermittent pneumatic compression is accepted by the patients and is more economical.

Biomedical aspects of cardiac massage in experiments and clinical practice.

Despite current successes in modern cardiology and heart surgery, the problem of restoring and maintaining cardiac function in cases of sudden arrest or ventricular insufficiency is still urgent. Different methods of mechanically assisting the heart and replacing its pumping function exist, and direct mechanical cardiac massage (DMCM) is one of the more important. Experimental results with dogs and calves on 2- to 4-h DMCM, cardiac massage lasting for up to 48 h, subsequent restoration of cardiac activity, and cardiac massage during experimentally induced myocardial infarction permitted clinical application in patients with myocardial infarction complicated by ventricular fibrillation. DMCM also permits extension of the possibilities of obtaining and transplanting donor organs. It is one of the variants for solving the problem of total and partial replacement of the pump function of the heart, and now makes it possible to solve some important problems in transplantation and cardiac resuscitation.

Abdominal Binding During Cardiopulmonary Resuscitation

To the Editor— Dr Chandra and colleagues conclude in their article "Abdominal Binding During Cardiopulmonary Resuscitation in Man" (1981; 246:351) that one of the reasons for the BP improvement in the patients in their study probably was a decrease in arterial perfusion in the abdomen and in the lower extremities. There are reasons to believe that this effect probably was one of the most important factors for the distinct hemodynamic effect in their study. In 1975, Dr Worsvorda and I1 studied the effect of external mechanical cardiac massage combined with ventilation and mechanical compression of the abdominal aorta using an automatic unit. The study subjects were ten patients experiencing cardiac arrest, and the systolic BP measured in the brachial arteries increased from 70.9 to 103.0 mm Hg (mean value for ten patients, P

Synchronous mechanical cardiac massage under conditions of auxiliary circulation

Synchronous mechanical cardiac massage under conditions of auxiliary circulation

Assistor for direct mechanical heart massage.

1. Direct mechanical heart massage using the assistor can maintain in a stable manner for a prolonged period both the frequency and the constrictive force, and can also regulate the durations of the systolic and diastolic phases.

Effect of biventricular mechanical massage after acetyl strophanthidin-induced ventricular fibrillation

Effect of biventricular mechanical massage after acetyl strophanthidin-induced ventricular fibrillation

Circulatory dynamics during manual and mechanical external massage in man.

Abstract This paper reports the changes that occurred in left atrial pressure during closed chest cardiac massage in three patients. The effects of prolonged external massage with a mechanical resuscitator on systemic arterial pressure and oxygenation are also described. The implications of these observations and means of improving current methods of external cardiac massage are discussed. It is reported that the mechanical resuscitator has several advantages over manual cardiac massage.

Preservation of cadaver organs with the use of a heart massage unit.

The new biventricular cardiac assister designed to compress selectively both ventricles of the brain-death dog was evaluated. The parameters determined in the present investigation were cardiac output, aortic pressure, pulmonary arterial pressure, blood gases, blood pH, serum glucose and body temperature. In the brain-death dogs, the cardiac output and the aortic pressure were kept relatively well, but the blood pressure was about 20 per cent lower than that of the non brain-death dogs with ventricular fibrillation, in which blood supply to the brain was intact and EEG was normal. The pulmonary hypertension was not noted, but various changes in blood pH, blood gases, serum glucose and body temperature may have been due to absence of brain function. The lung, heart, liver and kidney can be preserved in situ under mechanical cardiac massage with the use of our new cardiac assister, set in thorax of the brain-death dogs after cardiac arrest. In cases where organ preservation was done at room temperature, each organ can be kept for 6–8 hours in good condition for organ transplantation. But thereafter hypoxic changes were noted in these organs, particularly in liver and kidney, but less in lung and heart. The usefulness of our new cardiac assister for preservation of liver and kidney is at the present time limited to 6 to 8 hours and that for lung preservation is limited to 12 hours at room temperature.

Mechanical Ventricular Assistance in Man

Mechanical cardiac massage by a pneumatic device which fits over the ventricles of the heart was studied in six patients with cardiac arrest who failed to respond to conventional means of resuscitation. Adequate arterial blood pressure, full peripheral pulses, respiratory efforts, small reactive pupils, reasonable cardiac output, and a low venous pressure were obtained for as long as four hours. In a 48-year-old patient ventricular fibrillation did not respond to external or internal massage and defibrillation in 35 minutes, and there was no ECG activity. With this instrument the circulation was supported for an hour (blood pressure 135/50). Defibrillation was then possible, and the patient survived for six days, dying of her primary disease process, which was unrelated to the heart. These studies are being continued and indicate that this approach may be helpful for cardiac resuscitation, for prolonged circulatory support, and for maintaining the circulation in potential donors for organ transplantation.

Manual vs Mechanical External Cardiac Massage

To the Editor:— I would like to comment on your report ( 196 , April 4, 1966, adv p 36), comparing manual and mechanical external cardiac massage. We have been engaged in a study of mechanical resuscitation aids, and both our methods and our results differ from the one reported. Much of our data derive from direct on-line recording, which takes place automatically during clinical resuscitation of humans. Our experience in using instrumented manikins for trials suggests that the substantial difference in weight, measurable phenomena, physical results derived, and completely different psychological response to the manikin make this an ineffective comparison method. Effective studies cannot be carried out on most animals because of differences in anatomy of the mediastinum and thorax. Manually lever-operated plungers possess all of the disadvantages of manual and mechanical external cardiac massage with the advantages of neither. Some are more time-consuming and difficult to set up than pneumatically

Stopping atonic postpartum hemorrhage with "metrohemostat" by V.E. Rogovin

The fight against postpartum atonic bleeding is carried out using mechanical (massage of the uterus, pressing the aorta, tamponade of the uterine cavity), thermal (ice on the uterine region) and pharmacological (pituitrin, ergotine, etc.), which are usually used in combination with one another. When it is not possible to stop bleeding by the listed measures, they resort to amputation or extirpation of the uterus. However, it is not always possible to perform the operation in a timely manner, especially in rural conditions, as a result of which maternal mortality from postpartum hemorrhage is high.

Physical medicine in management of patients with postmastectomy lymphedema.

Lymphedema affecting the upper extremity after radical operations on the breast was studied in 220 patients. Limb volumes measured by displacement of water made it possible to assess the results of treatment. The treatment program here described consisted of a period of some days in a department of physical medicine and rehabilitation, followed by a period of home treatment which was usually prolonged. During the first period manual and mechanical massage were used, in addition to isometric exercises and spiral bandaging. During the second period the patient carried out certain instructions, especially involving exercise, bandaging, and elevation of the extremity. The results were sometimes only palliative, but the objective data as well as the reactions of the patients show that this program generally reduced the discomfort and disability caused by the lymphedema.