The Hemodynamic Effect and Safety of Intermittent Sequential Pneumatic Compression Leg Sleeves in Patients with Congestive Heart Failure

Background: Pneumatic leg sleeves are widely used following prolonged operations for prevention of venous stasis. In healthy volunteers they increased cardiac function. We evaluated the hemodynamic effects and the safety of intermittent sequential pneumatic leg sleeves (ISPC) in patients with chronic congestive heart failure (CHF).

Methods: We studied 19 patients with systolic left ventricular dysfunction and CHF. ISPC, each with 10 air cells, was operated by a computerized compressor, exerting 2 cycles/min. Hemodynamic and echocardiographic parameters were measured before, during and after ISPC activation.

Results: The baseline mean left ventricular ejection fraction was 29±9.2%, median 32%, range 10% to 40%. Cardiac output (4.26 to 4.83 l/min, p=0.008) and stroke volume (56.1 to 63.5 ml, p=0.029) increased significantly following ISPC activation, without a reciprocal increase in heart rate, and declined with sleeve de-activation. Systemic vascular resistance (SVR) decreased significantly (1,520 to 1,216 dynes-sec/cm⁵, p=0.0005), and remained lower than baseline level throughout the study. There was no detrimental effect on diastolic function and no adverse clinical events, despite increased pulmonary venous return.

Conclusions: ISPC in patients with chronic CHF does not exacerbate symptoms and transiently improves cardiac output through an increase in stroke volume and a reduction in SVR.