Exploring intermittent pneumatic compression parameters to optimize venous peak velocity and flow duration

Abstract

Deep vein thrombosis (DVT) is a significant risk in patients with prolonged immobility. Intermittent pneumatic compression devices (IPCDs) are recommended for DVT prevention, yet optimal compression parameters remain poorly defined. This proof-of-concept pilot study evaluated the hemodynamic impact of varying IPCD compression pressures and sequences in healthy volunteers simulating lower-limb immobilization, using a programmable prototype with adjustable settings. Twelve participants underwent continuous Doppler ultrasound measurement of peak systolic velocity (PSV) in the common femoral vein during three compression modes: simultaneous 30 mmHg, simultaneous 50 mmHg, and sequential 30 mmHg. All modes significantly increased PSV compared to resting baseline (per-participant means, n = 12, paired t-tests). Simultaneous 30 mmHg produced the highest and most consistent augmentation (mean PSV 40.06 ± 1.53 cm/s; 90% increase from baseline; t(11) = 29.1, p < 0.0001, Cohen’s d = 8.39). Simultaneous 50 mmHg showed significant but more variable augmentation (30.45 ± 6.33 cm/s; t(11) = 4.26, p = 0.001), with a dipping phenomenon in five participants consistent with possible venous occlusion at higher pressures. Sequential 30 mmHg produced the longest augmented flow duration (mean 4.49 s versus 1.85 s for simultaneous 30 mmHg), suggesting greater total venous volume displacement despite lower peak velocity. These findings provide a hemodynamic foundation for IPCD parameter optimization, with clinical validation in patient populations required before implementation.