Peripheral hemodynamic effects of synchronizing intermittent compression with cardiac pulsation

Abstract

Intermittent pneumatic compression (IPC) is a noninvasive therapy choice for patients with peripheral arterial diseases, which typically inflates cuffs with a fixed compression period to facilitate peripheral perfusion. The fixed compression period ignores the synergistic effect between human cardiac pulsation and external intermittent compression, limiting the potential of IPC therapy. Meanwhile, existing IPC devices cannot directly assess peripheral perfusion in the target lower limb to provide feedback for adjusting treatment parameters and improving therapeutic efficacy. This work develops a cardiac cycle-synchronous IPC prototype, featuring an innovative flexible perfusion sensor module that enables real-time synchronization of compression with local blood perfusion distribution. By continuously monitoring peripheral perfusion distribution, the system adjusts compression timing based on real-time data, offering enhanced therapeutic efficacy compared to traditional fixed-period IPC treatments. We compare the therapeutic efficacy between an asynchronous mode and three cardiac cycle-synchronous modes. The results of on-body experiments show that the systole synchronous mode outperforms other modes, significantly improving the peripheral perfusion index (PPI) and augmentation index compared to the resting state. On the control side, the PPI had no significant difference between rest and treatment phase, which suggests that IPC treatment would not damage the peripheral blood perfusion on other body parts. The developed cardiac cycle-synchronous IPC prototype demonstrates that a good synchronization between the compression and the cardiac cycle might bring better therapeutic efficacy. The proposed prototype and the exploration of cardiac cycle-synchronous IPC therapy strategies are conducive to the development of non-invasive and intelligent therapies.