Venous Hemodynamics After Total Hip Arthroplasty: A Comparison Between Portable vs Stationary Pneumatic Compression Devices and the Effect of Body Position.

ABSTRACT

BACKGROUND: Improvements in device design have allowed for portable pneumatic compression devices (PPCDs). However, portability results in smaller pumps that move less blood. Additionally, although patients often stand when wearing PPCDs, few studies have evaluated the hemodynamic effects of PCDs while standing. METHODS: A crossover study was performed to compare a PPCD (ActiveCare+S.F.T.; Medical Compression Systems, Or Akiva, Israel) to a stationary pneumatic compression device (SPCD) (VenaFlow; DJO Global, Carlsbad, CA) on hemodynamics in supine and standing positions among 2 cohorts composed of 10 controls and 10 total hip arthroplasty patients. Differences in baseline peak venous velocity (PVV), PVV with each PCD, and delta PVV with each PCD were assessed. A multivariate analysis was performed to examine differences between cohorts, devices, and position. RESULTS: In both positions, the SPCD demonstrated a larger change in PVV when compared to the PPCD (P < .001). The total hip arthroplasty group had a greater delta PVV while standing when considering both PCDs together (P < .001). When considering both cohorts, delta PVV was greater while standing, only when the SPCD was used (P < .001). There was no difference between standing and supine positions when the PPCD was used. CONCLUSION: The SPCD demonstrated a greater capacity to increase PPV in the supine and standing positions. The SPCD generated greater values of PVV and delta PVV in the standing position. Although these results demonstrate a difference between devices, it is important to establish the PVV necessary to prevent VTE before one is considered more effective.