Intermittent Compression Therapy Overview

Study Notes

Rationale for using ICT to manage peripheral edema: ICT facilitates venous return, reducing swelling.
Treatment procedures for upper/lower extremities: Includes parameters used in administering ICT. (7D21)
Referral criteria for compression garments: Criteria for determining when a compression garment is needed.
Physiological effects, treatment goals, indications, contraindications, and precautions of elastic bandaging: (7D21)
Appropriate application of elastic bandaging: Based on criteria from informal skills check rubric (7D21, 7D23c, 7D23g)

A type of compression therapy used for chronic or acute edema and venous insufficiency.
Contraindicated for arterial disease, particularly severe PAD.
Mixed arterial and venous disease: IPC accelerates positive outcomes.
Importance in preventing/treating venous leg ulcers: Improves perfusion to enhance wound healing.
Edema inhibits wound healing: By affecting tissue perfusion and delaying wound healing.
IPC as an adjunct to manual lymphatic drainage (MLD): Helpful in facilitating venous return.

Cost range: From several hundred to several thousand dollars for advanced units.
Types/Complexity: Single-chambered to 12 or more chambers (cells)
Sequential compression: Inflatio, creating pressure from distal to proximal to move fluids and improve edema.
Pressure Levels: Lower for upper extremities (40-60 mmHg), higher for lower (80-90 mmHg).
Sequential Compression Devices (SCDs) are another name for IPC.

Inflatable sleeves or boots intermittently force air into them.
Pressure gradient: Encourages interstitial fluid return to venous/lymphatic vessels.
Pump effect: Acts like a pump, moving fluids back toward the heart..

Varying treatment times: 2 hours on, 30 minutes off, or extended treatment(18 hrs on, 9 hr off) for specific cases or patient conditions (low mobility, post-surgery.)
Compression pressure: Generally in between patient's DBP and SBP.
Specific pressure values: UE: 40-60mmHg; LE: 80-90mmHg.

Severe arterial insufficiency: Causes additional arterial occlusion and potential ischemia.
Presence of thrombus: Can cause emboli and potential harm.
Anticoagulated patients: Increased bleeding risk.
Patients with local cancer/malignancy: Potential infection concerns
Acute inflammation/infection (lymphangitis): Obstructs lymphatic channels.

Materials/styles: Variety of custom and off-the-shelf garment styles available.
Varying pressure: Fabric pressure levels: Low (12-25mm Hg) to higher (30-40 mm Hg).
Measurement and fitting: Measuring for custom-made garments is important for ideal fit and support.
Usage: Can be used for patients who have trouble applying tighter garments independently..
Duration of use: Generally last 3-6 months, then need to be replaced.
Potential discomfort: May be uncomfortable at first, but more comfortable materials are available.

Venous wounds: High working pressure, low resting, for calf pump effects.
Arterial wounds: No or minimal compression in close collaboration with the appropriate practitioner
Neuropathic wounds: Compression is contingent on blood flow and an ABI evaluation.
Lymphedema: Short-stretch compression—worn 24hours—followed by graduated increased compression(20-30mmhG- 30-40 mm Hg) for limb-reduction goals.