Compression, pneumatic intermittent

Authors: Prof. Dr. med. Peter Altmeyer, Prof. Dr. med. Martina Bacharach-Buhles

Last updated on: 29.10.2020

Synonym(s)

AIK; IPC; IPK

Definition
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Method for the application of alternating pneumatic pressures by means of apparatus, which is used for the prevention of thromboembolism, the decongestion therapy of venous and lymphological diseases and for influencing the arterial blood circulation.

General definition
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In principle, a distinction is made between two systems with regard to the application site, the so-called foot pump, which exerts intermittent compression on the plantar venous plexus, and the limb pump, which delivers pressure to the limb by means of double-walled treatment cuffs.

Foot pump: It consists of an air pulse generator and a "special shoe" over whose inflatable sole the compression is directed.
Extremities pump: Single or multi-chamber (up to 12 chambers), double-walled leg, arm, hip or trouser cuffs, which allow pressures of 12-200 mm Hg, depending on the model and pump. The single-chamber cuff can only be used intermittently, the multi-chamber cuffs can be used intermittently or sequentially (continuously from a distal to further proximal chambers).

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Indication
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Primary varicosis and secondary varicosis
Chronic venous insufficiency (extra/intrafascial)
venous leg ulcer
Thrombophlebitis and condition after thrombophlebitis
Phlebothrombosis and condition after phlebothrombosis
Lipedema with secondary lymphedema
Post-traumatic, postoperative, idiopathic edema (e.g. conditions following lymphadenectomy or radiation therapy)
Thrombosis prophylaxis
Congestion due to immobility (arthrogenic congestion syndrome, paresis and partial paresis of the limb)
Primary lymphedema (in addition to the complex physical decongestion therapy)
Secondary lymphedema (without proximal blockage in addition to the complex physical decongestion therapy)
Dependency Syndrome
Arterial occlusive disease with oedema (under strict control).

Undesirable effects
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Incorrect use can cause an increase in oedema proximal to the cuff in centrally located lymph drainage disorders. Excessive pressure can cause skin necrosis.

Contraindication
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Absolute contraindications:

Fresh myocardial infarction or currently fresh myocardial infarction
Decompensated heart failure
Pulmonary oedema
Cardiac and/or renal edema
Thrombophlebitis, thrombosis or suspected thrombosis
Erysipelas
Malignant lymphedema
fresh lower leg trauma.

Relative contraindications:

tumors in the proximal drainage area
Pain during AIK.

Note(s)
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According to the Universal Medical Device Nomenclature System (UMDNS), the intermittent devices are assigned the number 10-969, the sequential ones the number 16-387. In addition to the more complex hospital and practice devices, there are home devices that can be prescribed by a doctor. These devices are listed as aids in the official directory of aids (Bundesanzeiger, ed.: Federal Ministry of Justice) in product group 17 and have a multi-digit aid item number.

Notice! The costs for a home device are high: the monthly rental fee is approx. 10-15% of the new price of the device. For this reason, the cost units usually only allow short treatment periods, e.g. 3 months. Afterwards, a new treatment often has to be applied for or the necessity of treatment is checked by the MDK.

Literature
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Airaksinen O et al (1990) Elastic bandages and intermittent pneumatic compression for treatment of acute ankle sprains. Arch. Phys. Med. Rehabilitation. 71: 380-383
Armstrong DG, Nguyen HC (2000) Intermittent pneumatic compression promoted healing in foot infections. Arch Surg 135: 1405-1409
Bergan JJ et al (1998) A comparison of compression pumps in the treatment of lymphedema. J. Vasc Surg 32: 455-462
Delis KT et al (2000) Improving walking ability and ankle brachial pressure indices in symptomatic peripheral vascular disease with intermittent pneumatic foot compression: a prospective controlled study with one year follow-up. J Vasc Surg 31: 650-661
Wienert V et al (2005) Intermittent pnematic compression. Phlebology 34: 176-180

Tables
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Device designation	Device features	Manufacturer	Manufacturer address
Hydropress 100	Single-chamber alternating pressure device, 6-watt power, air pressure continuously adjustable between 30-100 mm Hg, intermittent pressure behaviour	FMT	FMT Medizintechnik GmbH, Postfach 14 44, D-96005 Bamberg Phone: 0951-51166, Fax: 0951-51167
Flowtron Hydroven 3	Single-chamber alternating pressure device, air pressure 30-100 mm Hg continuously adjustable, pressure regulator and pressure gauge; full-leg, half-leg, full-arm and half-arm cuffs available in various sizes	HNE	HNE Huntleigh Nesbit Evans Healthcare GmbH, Im Hülsenfeld 19, 40721, Hilden, Phone: 02103-9711-0, Fax: 02103-9711-80
Turbo-Press-Plus 5000	Single-chamber alternating pressure device, 10-Watt power, air pressure continuously adjustable between 30-100 mm Hg, with and without pressure gauge	Tettamed	Tettamed Vertrieb med. Geräte GmbH, Kopernikusstr. 13a, Gewerbepark, 50126 Bergheim; Phone: 02271-4984-0, Fax: 02271-4984-17
Vasoflow mini	Single-chamber alternating pressure device, 10-watt power, air pressure 30-90 mm Hg, continuously adjustable, two cuffs can be connected simultaneously, treatment cycle 3 min./6 min.; whole leg cuffs in two sizes as well as arm cuffs available	Bösl	BÖSL Medizintechnik GmbH, Charlottenburger Allee 13, 52068 Aachen, Germany, Phone: 0241-90077-0, Fax: 0241-90077-10

Device designation	Device features	Manufacturer	Manufacturer address
Vein Walker	Multi-chamber pressure device, 3 air chambers, air pressure 30-100 mm Hg continuously adjustable, two cuffs with zipper	Globalmind	GLOBALMIND consumer electronics GmbH, Havighorster Weg 2, 21031 Hamburg, Germany, Phone: 040-73921-40, Fax: 040-73921-18
Vasoflow 100 Gradient	Multi-chamber alternating pressure device with 3 air chambers, gradient pressure build-up, air pressure 0-80 mm Hg continuously adjustable, treatment cycle fixed. The three air chambers of a treatment cuff are filled with air one after the other during a compression cycle, starting distally. Chamber 1 with 100%, chamber 2 with 80% and chamber 3 with 60% of the set treatment pressure. All chambers remain filled with air until the last chamber has reached the desired pressure. Then air escapes from all chambers simultaneously, and after a pause time the inflation cycle starts again.	Bösl	BÖSL Medizintechnik GmbH, Charlottenburger Allee 13, 52068 Aachen, Germany, Phone: 0241-90077-0, Fax: 0241-90077-10
Lympha-mat 300 Gradient	Multi-chamber alternating pressure device with 12 overlapping air chambers, gradient pressure build-up, air pressure continuously adjustable from 0-100 mm Hg, treatment cycle fixed. The twelve overlapping air chambers of a treatment cuff are filled with air one after the other during a compression cycle, starting distally: chamber 1 to 4 with 100%, chamber 5 to 8 with 80% and chamber 9 to 12 with 60% of the previously set treatment pressure. All chambers remain filled until the last one has reached the desired pressure. After that, the air escapes from all chambers simultaneously and after a pause time the inflation cycle starts again.	Bösl	BÖSL Medizintechnik GmbH, Charlottenburger Allee 13, 52068 Aachen, Germany, Phone: 0241-90077-0, Fax: 0241-90077-10
HYDROPRESS 300 Sequential	Multi-chamber alternating pressure device, air pressure infinitely variable from 30-100 mm Hg, pressure frequency adjustable, the pressure time regulation from 5 sec. - 2 min. (infinitely variable) 2 cuffs connectable	FMT	FMT Medizintechnik GmbH, Postfach 14 44, D-96005 Bamberg Phone: 0951-51166, Fax: 0951-51167
COMPRIFLOW SYSTEM 7500	Multi-chamber alternating pressure device, air pressure continuously adjustable up to 0-100 mm Hg, 3 air chambers	BSN-JOBST	BSN-JOBST GmbH, Beiersdorfstr. 1, 46446 Emmerich, Phone: 02822-607-100, Fax: 02822-607-195
Lympha Press Mini Switch	Multi-chamber alternating pressure device, air pressure 20-100 mm Hg continuously adjustable, max. 12 overlapping air chambers, safety tested, 2 cuffs can be connected. Accessories: Cuffs for different body areas in different lengths and sizes (therefore also suitable for compression therapy, e.g. on partially amputated limbs).	Villa Sana GmbH & Co.	Villa Sana GmbH & Co. medical products KG, Hauptstr. 10, 91798 Weiboldshausen, Phone: 09141-8546-0, Fax: 9141-8546-26
Lympha-Press Mini Timer	Multi-chamber alternating pressure device, continuously adjustable 12-chamber pressure system: air pressure 20-100 mm Hg continuously adjustable, max. 12 overlapping air chambers, timer, 2 cuffs can be connected. Accessories: Cuffs for different body areas in different lengths and sizes.	Villa Sana GmbH & Co.	Villa Sana GmbH & Co. medizinische Produkte KG, Hauptstr. 10, 91798 Weiboldshausen, Phone: 09141-8546-0, Fax: 9141-8546-26
Lympha-Wave	Multi-chamber alternating pressure unit with adjustable 12-chamber pressure system with wave-shaped decongestion cycle. According to the manufacturer especially suitable for the treatment of arm lymphedema and ulcerations. Air pressure 20-100 mm Hg continuously adjustable, max. 12 overlapping air chambers, timer, wave-shaped decongestion cycle; 2 cuffs can be connected. Accessories: Cuffs for different body areas in different lengths and sizes	Villa Sana GmbH & Co.	Villa Sana GmbH & Co. medical products KG, Hauptstr. 10, 91798 Weiboldshausen, Phone: 09141-8546-0, Fax: 9141-8546-26
HYDROPRESS 600 Sequential No. 3650	Multi-chamber alternating pressure device, air pressure 30-150 mm Hg continuously adjustable, pressure frequency adjustable, 2 cuffs can be connected, 6 air chamber connections. Gradient pressure gradient. The 6 chambers of the treatment cuff are successively filled with air. The gradual build-up of pressure creates a pressure wave which removes excess fluid in the tissue. Cuffs for whole and half leg in different lengths/sizes and for the hip.	FMT	FMT Medizintechnik GmbH, Postfach 14 44, D-96005 Bamberg Phone: 0951-51166, Fax: 0951-51167
Vasoflow 200 Gradient	Multi-chamber alternating pressure device with 3 air chambers, gradient pressure build-up, air pressure continuously adjustable from 0-100 mm Hg, treatment cycle variable, timer, connection for 2 leg cuffs	Bösl	BÖSL Medizintechnik GmbH, Charlottenburger Allee 13, 52068 Aachen, Germany, Phone: 0241-90077-0, Fax: 0241-90077-10
Phlebo Press	Multi-chamber alternating pressure device, 4 air chambers, pressure approx. 20-80 mm Hg continuously adjustable, interval pause adjustable, safety tested, 2 cuffs can be connected. Accessories: Leg cuffs in 3 sizes	Villa Sana Ltd.	Villa Sana GmbH & Co. medical products KG, Hauptstr. 10, 91798 Weiboldshausen, Phone: 09141-8546-0, Fax: 9141-8546-26
HYDROPRESS 1200 sequential	Multi-chamber alternating pressure device (12-chamber), air pressure continuously adjustable from 30-100 mm Hg, pressure frequency adjustable, pressure build-up and pressure reduction time: individually adjustable, 2 cuffs can be connected. Gradient pressure gradient. Similar to medical compression stockings, the pressure decreases ? from distal to proximal. The twelve chambers of the treatment cuff are successively filled with air. The gradual build-up of pressure creates a pressure wave which removes excess fluid in the tissue. Cuffs for whole leg, whole arm and trouser cuffs	FMT	FMT Medizintechnik GmbH, Postfach 14 44, D-96005 Bamberg Phone: 0951-51166, Fax: 0951-51167
Flowtron Hydroven 12	Multi-chamber alternating pressure device (12-chamber), air pressure continuously adjustable from 15-120 mm Hg, pressure frequency adjustable, two cuffs can be connected, sequential and peristaltic mode. Accessories: Cuffs for legs and arms in different versions. Operation with one or two cuffs as well as with one or three chamber cuffs.	HNE	HNE Huntleigh Nesbit Evans Healthcare GmbH, Im Hülsenfeld 19, 40721, Hilden, Phone: 02103-9711-0, Fax: 02103-9711-80