Effects on Changes in Femoral Vein Blood Flow Velocity with the Use of Lower Extremity Compression for Critical Patients with Brain injury

Jung Sook Kim; Hye Jung Kim; Yun Hee Woo; Ji Young Lym; Chul Hyung Lee

doi:10.4040/jkan.2009.39.2.288

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Kim, Kim, Woo, Lym, and Lee: Effects on Changes in Femoral Vein Blood Flow Velocity with the Use of Lower Extremity Compression for Critical Patients with Brain injury

Original Article

Journal of Korean Academy of Nursing

Journal of Korean Academy of Nursing 2009; 39(2): 288-297.

Published online: 28 April 2009

DOI: https://doi.org/10.4040/jkan.2009.39.2.288

Effects on Changes in Femoral Vein Blood Flow Velocity with the Use of Lower Extremity Compression for Critical Patients with Brain injury

Jung Sook Kim¹, Hye Jung Kim², Yun Hee Woo², Ji Young Lym², Chul Hyung Lee³

¹Nursing Director, Intensive Care Unit, Samsung Medical Center Concurrent Professor, Sungkyunkwan University Graduate School of Clinical Nursing Science, Seoul, Korea.

²Nurse, Neurosurgical Intensive Care Unit, Samsung Medical Center, Seoul, Korea.

³Registered Vascular Technologist, Vascular Lab, Samsung Medical Center, Seoul, Korea.

Address reprint requests to: Kim, Hye Jung. Neurosurgical Intensive Care Unit, Samsung Medical Center, 50 Irwon-dong, Gangnam-gu, Seoul 135-710, Korea. Tel: 82-2-3410-3958, Fax: 82-2-3410-3983, monica1649@daum.net

Received 25 September 2008 Accepted 8 April 2009

Abstract

Purpose

This study was done to evaluate the mean venous velocity (MVV) response with knee and thigh length compression stockings (CS) versus intermittent pneumatic compression (IPC) devices in immobile patients with brain injuries.

Methods

We carried out a randomized controlled study. We analyzed both legs of a randomly chosen sample of 43 patients assigned to one of 4 groups (86 legs). The patients were sequentially hospitalized in the intensive care unit (ICU) in "S hospital" from November 2005 to December 2006. The base line and augmented venous velocity was measured at the level of the common femoral vein. We applied leg compression 42 times over 7 days (for 2 hours at a time at 2 hour intervals).

Results

There was a statistical difference among the 4 groups. The difference for the "IPC" group was more significant than the "CS" group.

Conclusion

These results indicate that the application of IPC can be considered as an effective method to prevent deep vein thrombosis for immobile patients with brain injury.

Keywords: Venous thrombosis, Blood flow velocity, Compression devices

Figures and Tables

Figure 1

Research design.

BT=body temperature; COC=circumference of calf; CS=compression stocking; EKG=electrocardiography; GC=general characteristics; GCS=glasgow coma scale; IPC=intermittent pneumatic compression; MAP=mean arterial pressure; MVV=mean venous velocity.

Table 1

Homogeneity Test for General Characteristics of Participants in the Four Groups (N=43)

^*Fisher Exact test; ^†Kruskal-Wallis test.

CS=compression stocking; IPC=intermittent pneumatic compression.

Table 2

Homogeneity Test for Risk Factor of Deep Vein Thrombosis in Patients in the Four Groups (N=43)

^*Fisher Exact test; ^†One-way ANOVA; ^‡Kruskal-Wallis test.

ABGA=arterial blood gas analysis; Abn=abnormal; CS=compression stocking; ECG=electrocardiograph; GCS=Glasgow coma scale; IPC=intermittent pneumatic compression; LES=lower extremity strength; MAP=mean arterial pressure; Nor=normal.

Table 3

Comparisons of Averages of 3 MVV Pre-Post Difference among Four Groups (N=86)

a=CS-knee (n=20); b=CS-thigh (n=24); c=IPC-knee (n=22); d=IPC-thigh (n=20).

CS=compression stocking; IPC=intermittent pneumatic compression; LSD=least significant difference; MVV=mean venous velocity; Q1=first quartile; Q3=third quartile.

Table 4

Comparisons of Difference in Mean Venous Velocity between CS Group and IPC Group after Intervention (N=86)

^*Wilcoxon's rank sum test; ^†t-test.

CS=compression stocking; IPC=intermittent pneumatic compression; MVV=mean venous velocity; Q1=first quartile; Q3= third quartile.

Notes

This study was financially supported by the research fund of Nursing department of Samsung Medical Center in 2006.

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