Multiple blood flow surges during intermittent pneumatic compression: The origins and their implications

Abstract

Intermittent pneumatic compression (IPC) therapy has been used to enhance peripheral blood flow for prevention and rehabilitation of ischemic-related vascular diseases. A novel phenomenon has been reported that multiple blood flow surges appeared in the skin blood flow signal during each compression, but its mechanism has not been fully revealed. This study aimed to gain insights into the origins of these blood flow surges through experiment and biomechanical modeling methods. Foot skin blood flow (SBF) signals of 13 healthy adults (23.8 ± 0.5 yr old, 7 males) and air cuff pressure signals were recorded during IPC. Lumped parameter modeling and wavelet analysis were adopted to investigate the multiple blood flow surges (named as Peak₁, Peak₂ and Peak₃). The results of the simulated Peak₁ and Peak₂ were in good agreements with the experiment results, suggesting that IPC could enhance foot SBF not only by deflation, but also by inflation. Statistical analysis demonstrated that high frequency compression with more frequent occurrence of Peak₁ and Peak₂ lead to significantly higher (Friedman test, p < 0.001) time-averaged SBF enhancement than the traditional mode. In addition, wavelet analysis showed that the major frequency component of the Peak₃ (0.059 Hz) was within the range of the vascular myogenic activity, suggesting a vascular regulation process triggered by intravascular pressure changes. Our study provide new insights into the mechanism of how IPC enhance foot SBF.

Keywords: Blood flow enhancement; Intermittent pneumatic compression; Lumped parameter model; Microcirculation; Wavelet analysis.