Study On Prophylactic Effect Of Intermittent Pneumatic Compression For PICC Catheter-Related Thrombosis

Objective To investigate the prophylactic effect of intermittent pneumatic compression for PICC Catheter-related Thrombosis.To determine the most suitable pressure value on the upper extremity compression,and to compare the blood flow velocity on compression with doing handgrip.To evaluate the effect of intermittent pneumatic compression on the prevention of PICC-CRT in patients with PICC.Methods Firstly,131 patients with PICC were studied by self contrast method,we monitered axillary vein blood flow peak velocity in tranquility,upper extremity compression to 20mmHg/40mmHg/60mmHg(lmmHg=0.133kPa),and the comfort scores/Pulse oxygen saturation/complication.Secondly,71 patients with PICC were studied by self contrast method,we monitered axillary vein blood flow peak velocity in tranquility,upper extremity compression 40mmHg,and doing handgrip.At the same time,the relationship between the blood flow peak velocity caused by upper extremity compression and handgrip was discussed.Thirdly,66 patients were randomly divided into experimental group and control group.The experimental group does intermittent upper extremity compression,but the control group does handgrip exercise.The two prophylaxis were performed 24 hours after pucturing,twice a day for 28 days.The incidence/location/grading of PICC-CRT,and other related symptoms such as bleeding/bruising/pain were analyzed on the 1st,3rd,7th,14th,21st,and 28th days after pucturing.Results1.Axillary vein blood flow peak velocity in tranquility was 8.39cm/s,but it was 17.66cm/s,21.74cm/s5 23.84cm/s in compression on 20mmHg/40mmHg/60mmHg(P<0.05).There was statistically significant differences in every group except between 40mmHg and 60mmHg.When the pressure was 60mmHg,the degree of comfort was significantly decreased(P<0.05),and no decrease of pulse oxygen saturation and no conplications were found during the whole test(P>0.05).2.The vein blood flow peak velocity in tranquility was 7.61 cm/s,but it was 20.37 cm/s when doing handgrip exercise,and it was 23.37 cm/s in pressure to 40mmHg,The vein blood flow peak velocity 1s lower in tranquility than other groups(P<0.05).There was a linear positive correlation in the peak velocity of blood flow between compression on the upper extremity and doing handgrip(P<0.01).The correlation coefficient were 0.72.3.We involved 31 cases in the experimental group and 32 cases in the control group.The incidence of PICC-CRT in the experimental group was 12.9%,while that in the control group was 28.1%(P>0.05),and there was no significant difference in the location and grading of thrombosis too(P>0.05).Moreover,on the third day after pucturing,the incidence of blood leakage is higher in the experimental group(35.5%)than it 1s in the control group(12.5%).the incidence of bruising in the experimental group was 25.8%,which was significantly higher than that in the control group(3.13%)(P<0.05).There was no significant difference in the incidence of observation index.Conclusions 1.The optimum pressure value of upper extremity compression exercise was 40 mmHg.2.The blood flow velocity of upper extremity compression can reach the level of handgrip.There was a positive correlation between compression and handgrip on the blood flow velocity.3.The clinical prophylactic effect of intermittent upper extremity compression exercise on PICC-CRT is the same as that of doing handgrip exercise,but it may prolong the healing time of wound at PICC puncture point.