Intermittent pneumatic compression

Pants cuff with control unit

The intermittent pneumatic compression (IPC) is a physical measure in the compression treatment , wherein pressure is applied to the respective body region to be treated by an air-filled cuff. The pressure created by the cuff is generated by a connected pump at definable intervals and can be regulated as required. This form of therapy can be part of a complex physical decongestion therapy and is also known under the term apparatus intermittent compression (AIK).

Structure and functionality

Depending on the manufacturer, the IPK pressure cuffs can be equipped with one or more chambers, with multi-chamber systems being more common. The most common cuff shape is the leg cuff, followed by pant-shaped models. There are also cuffs for the arms or jacket-like products for use on the entire upper body. The basic functionality is common to all: An electronically controlled pump is used to feed air into the chambers, which are stored one behind the other or - depending on the system - overlapping within the cuff. The pressure initially builds up in the chamber furthest from the heart. Then the following chambers are gradually filled. The pressure thus arises from distal to proximal , which corresponds to the basic principle of every method of compression therapy, whether performed with bandages or with compression stockings . After a certain time, the pressure decreases evenly and builds up again after an interval. In most models, the pressure and the interval can be defined by the user and set on the electronic control of the pump.

IPK systems with several chambers and pressure levels

In the case of intermittent pneumatic compression, a distinction must be made between two basic systems: the one-stage system in which a single-stage control unit fills a cuff with one air chamber or all air chambers of a cuff with several chambers at the same time, or a multi-stage system in which a control unit builds up several pressure stages one after the other the air chambers of a cuff are filled one after the other. In the case of multi-stage systems , the type of filling and the pressure build -up depend on how many pressure stages the control unit has. If a control unit has 12 pressure levels, each chamber of a 12-chamber cuff can be filled individually. For example, if the control unit only has 6 stages, two chambers are always inflated at the same time when a 12-chamber cuff is connected.

Studies show that one-stage systems that fill one chamber are inferior to the multi-stage systems that gradually inflate several chambers (“sequential multi-chamber systems”) in terms of the therapeutic effect in patients with lymphedema. However, a significant reduction in the circumference of the affected extremities has been demonstrated for both principles.

commitment

The intermittent pneumatic compression (IPC) is at the post-thrombotic syndrome , during compression therapy in venous leg ulcers , for the treatment of venous or post-traumatic edema , of lymphedema or Ödemmischformen used. Other areas of application are diabetic foot syndrome or sensory disorders in hemiplegia . In thrombosis prophylaxis , the IPK supplements the basic measures, such as exercise and the donning of medical thrombosis prophylaxis stockings (MTPS) , as part of physical prophylaxis in patients with a medium or high risk of thrombosis.

Lymphatic drainage

The prefascial lymph drainage is strengthened by consistent compression, and the subfascial lymphatic transport increases. In the context of complex decongestion therapy, IPK can not replace manual lymphatic drainage and is used in combination with it. However, IPK is ineffective for lymphedema that is localized in the toes alone. The supportive use of IPK can reduce the frequency of manual lymphatic drainage treatment. However, IPK is ineffective for lymphedema that is localized in the toes alone. In the case of lipedema, it is possible to replace manual lymphatic drainage with IPK as a more economical solution.

Contraindications

The IPK is not used in cases of decompensated heart failure, phlebitis , erysipelas , trauma, neuropathies and severe and unadjustable hypertension .

literature

• Eberhard Rabe (Hrsg.): Apparative intermittent compression therapy (AIK). Viavital Verlag GmbH, Cologne 2003, ISBN 3-934371-29-9
• Kerstin Protz, Joachim Dissemond, Knut Kröger: Compression therapy An overview for the practice. Springer Verlag, Berlin a. a. 2016, ISBN 978-3-662-49743-2 .
• Stefanie Reich-Schupke, Markus Stücker: Modern Compression Therapy A practical guide. Viavital Verlag, Cologne 2013, ISBN 978-3-934371-50-7 .

Web links

• Guideline: Intermittent Pneumatic Compression (IPK or AIK). In: AWMF. in charge: German Society for Phlebology , 2018, accessed on March 13, 2020 . 
• S-3 guideline: prophylaxis of venous thromboembolism VTE. In: online download. AWMF , October 2015, accessed December 15, 2016 . 

Notes and individual references

1. ↑ C. Schwahn-Schreiber, S. Reich-Schupke, FX Breu, E. Rabe, I. Buschmann, W. Döller, G. Lulay, A. Miller, E. Valesky: S1 guideline intermittent pneumatic compression (IPK, AIK ) AWMF registration number: 037/007, page 9, point 8.3 Devices, recommendation 8, and page 10, 8.3.3 Terminology. (PDF) (No longer available online.) Archived from the original on May 4, 2018 ; accessed on May 3, 2018 . Info: The archive link was inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice.  
2. ↑ Eberhard Rabe (ed.): Apparative intermittent compression therapy (AIK). Viavital Verlag GmbH, Cologne 2003, ISBN 3-934371-29-9 , pp. 28-29.
3. ↑ Kerstin Protz, Joachim Dissemond, Knut Kröger: Compression therapy An overview for the practice. Springer Verlag, Berlin 2016, ISBN 978-3-662-49743-2 , p. 50
4. ↑ I care . Georg Thieme Verlag, Stuttgart 2015, ISBN 978-3-13-165651-3 , p. 421
5. ↑ Thomas Wild, Josef Auböck: Manual of wound healing: Surgical-dermatological guidelines for modern wound treatment. Springer-Verlag, Vienna 2007, ISBN 978-3-211-25212-3 , p. 177
6. ↑ Ulrich Herpetz: Edema and Lymph Drainage Diagnosis and Therapy. Schattauer, Stuttgart 2014, ISBN 978-3-7945-2912-4 , page 341
7. ↑ I care . Georg Thieme Verlag, Stuttgart 2015, ISBN 978-3-13-165651-3 , p. 422

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