Effects Of Different Treatment Pressures Of Arteriovenous Foot Pump On Lower Extremity Hemodynamics In ICU Patients

Objective: This study explored the changes of lower extremity arteriovenous and cardiac hemodynamic parameters before and after the action of different treatment pressures of arteriovenous foot pump in ICU patients,and to explore the optimal pressure ranges for arteriovenous foot pump applications.Methods: A total of 21 ICU patients who met the inclusion criteria were selected,and all patients received foot pump pressure therapy of 80 mmHg,130 mmHg and 180 mmHg,which were divided into 80 mmHg group,130 mmHg group and 180 mmHg group according to different inflation pressures,and the following hemodynamic indexes of all included patients before and after the use of the foot pump were collected by color Doppler ultrasound and compared within or between groups.Arterial hemodynamic indexes: systolic peak blood flow velocity(PSV),end-diastolic minimum blood flow velocity(EDV),time mean peak blood flow velocity(TAP),pulsatile index(PI),resistance index(RI),and blood flow(Q).Venous hemodynamic indexes: systolic peak blood flow velocity(PSV),time average peak blood flow velocity(TAP),and blood flow(Q).Cardiac function indicators: left ventricular ejection fraction(EF),left ventricular output(CO),heart rate(HR),systolic blood pressure(SBP),diastolic blood pressure(DBP),and mean arterial pressure(MAP).Results:1.Arterial hemodynamic indexes: in the intra-group comparison,popliteal artery PSV,EDV,TAP,and Q increased under the pressure of the three foot pumps compared with using before,and the differences were statistically significant(all P<0.01);PI and RI decreased at 80 mmHg compared with using before,and the differences were statistically significant(all P<0.05);femoral artery PSV,TAP,and Q increased under the three pressures compared with using before,the differences were statistically significant(all P<0.05);and the femoral artery EDV under 130 mmHg increased compared with using before,and PI decreased compared with using before,and the difference was statistically significant(all P<0.05).Compared with the groups,popliteal PSV,TAP,and Q were significantly higher than 80 mmHg under pressure of 180 mmHg,and the differences were statistically significant(all P<0.05),and there were no significant differences between80 mmHg and 130 mmHg,130 mmHg and 180 mmHg pressure.There were no significant differences in EDV,PI and RI between the three groups(all P>0.05),and there were no significant differences in the hemodynamic parameters of the femoral artery between the three groups(all P>0.05).2.Venous hemodynamic indexes: In the intra-group comparison,popliteal vein and femoral vein PSV,TAP,and Q increased significantly compared with the three pressures before using(all P<0.05).Compared with the groups,the popliteal vein PSV and Q were significantly higher than 80 mmHg at 130 mmHg and 180 mmHg pressures(all P<0.05),there was no significant difference between 130 mmHg and 180 mmHg(P>0.05);TAP was not statistically different between the three groups(P>0.05),and femoral vein PSV was significantly higher than 80 mmHg and 130 mmHg at 180 mmHg pressure,the differences were statistically significant(all P<0.01);there was no significant difference between80 mmHg and 130 mmHg,and there was also no statistical differences between TAP and Q(all P>0.05).3.Cardiac function indicators: in the intra-group comparison,SBP only increased significantly at 130 mmHg foot pump pressure compared with using before(P<0.05),and CO increased compared with pre-use pressure under all three pressures(average blood flow increased by 9.61%,14.32%,13.13%,respectively),the differences were statistically significant(all P<0.05).There were no statistically significant differences in the before and after comparisons of the remaining index groups.There were also no statistically significant differences between the groups.Conclusions:1.Arteriovenous foot pump therapy increased cardiac output,lower extremity arteriovenous blood flow velocity and blood flow in ICU patients.2.Based on this experimental equipment,130 mmHg is the best pressure to improve hemodynamics.