Document Detail


Peristaltic Pneumatic Compression of the Legs Reduces Fluid Demand and Improves Hemodynamic Stability during Surgery: A Randomized, Prospective Study.
MedLine Citation:
PMID:  21307764     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND:: Perioperative fluid restriction might be beneficial in specific clinical settings. In this prospective, randomized and blinded study, we assessed whether peristaltic pneumatic compression of the legs can support restrictive fluid management strategies by reducing intraoperative fluid demand and improving hemodynamic stability. METHODS:: Seventy patients scheduled for minor surgery were randomly assigned to receive either intraoperative peristaltic pneumatic compression or placebo compression. Both groups received fluid therapy according to a goal-directed protocol with a crystalloid base rate of 2 ml · kg · h and bolus infusions of 250 ml crystalloids triggered by hypotension, tachycardia, or high Pleth Variability Index. RESULTS:: Patients treated with peristaltic pneumatic compression received less intravenous fluid: median (interquartile range) 286 (499) versus 921 (900) ml (P < 0.001), resulting in a median difference of 693 ml (95% CI, 495-922 ml) and a median difference of 8.4 ml/kg (95% CI, 5.3-11.5 ml; P < 0.001). After the anesthesia induction phase, median overall infusion rates were 12.2 (14.1) ml · kg · h in the control group and 1.9 (0.4) ml · kg · h in the pneumatic peristaltic compression group (P < 0.001). Among patients treated with pneumatic peristaltic compression, the median cumulative time of hypotension was shorter (0 [12.5] vs. 22.6 [22.8] min; P = 0.002), fewer hypotensive events were recorded (39 vs. 137; P = 0.001), and median lowest individual systolic pressure was higher (92 [8] vs. 85 [16] mmHg; P = 0.002). CONCLUSIONS:: This study demonstrates that peristaltic pneumatic compression of the legs significantly improves hemodynamic stability and reduces fluid demand during minor surgery.
Authors:
Nicholas Kiefer; Judith Theis; Gabriele Putensen-Himmer; Andreas Hoeft; Sven Zenker
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-2-8
Journal Detail:
Title:  Anesthesiology     Volume:  -     ISSN:  1528-1175     ISO Abbreviation:  -     Publication Date:  2011 Feb 
Date Detail:
Created Date:  2011-2-10     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  1300217     Medline TA:  Anesthesiology     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
*Staff Anesthesiologist, †Student, ‡Attending Anesthesiologist, §Professor, Chair, ∥Staff Physician, Department of Anesthesiology and Intensive Care Medicine, University of Bonn, Germany.
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