Intermittent Pneumatic Compression for Lymphoedema Therapy
What is Intermittent Pneumatic Compression?
Intermittent Pneumatic Compression (IPC) is an electronically driven pump that fills an inflatable garment (also known as a sleeve) with air. The garment is attached to the IPC pump and the garment is also fitted to the affected limb(s) prior to inflation. The IPC pump inflates and then deflates the IPC garment in a regular and usually sequential order. The IPC is generally set to deliver a certain amount of pressure for a set time. IPC devices are available with an inflatable single chamber or inflatable multi-chambers within the IPC garment.
IPC devices with multi-chambers are more widely used in lymphoedema treatment. The pressure and pressure sequences can be set to suit the individual’s treatment needs. The direction of flow, the starting point of the pressure and the time etc, can all be pre-set to make treatment as effective as possible. The IPC garments are available in different ‘styles’ (e.g. armsleeve) to accommodate different types of swelling.
How does Intermittent Pneumatic Compression work?
IPC aims to help improve lymphatic drainage and venous return. It works in a similar way to the principals of Manual Lymphatic Drainage (MLD). During MLD, the therapist’s hands create a therapeutic massage helping the lymph fluid return to the deeper lymphatics and in a similar way, the IPC creates a ‘mechanical’ massage helping the lymph fluid return to the deeper lymphatics. The IPC achieves this by inflating and deflating the chambers within the garments in a pressure ‘wave’. The ‘wave’ is a pattern of intermittent pressure following a sequence of steps and then the cycle is repeated. The pressures can be pre-set to a certain (safe and comfortable) level for each individual’s health and medical needs.
The pressures ranges vary depending on the model and the pump. For many treatments, the pressures are set around 30-50mmHg, but lower and/or higher pressures may also be used. A pressure above 80mmHg is generally not used as this is usually considered counter-productive as it may cause damage to the delicate lymphatics.
The decision on style of garment to be attached to the IPC varies according to the location of the swelling.
The IPC is only effective in the area where the garment sits on the limb. To try to avoid the risk of increased swelling above and/or below the garment, it is important to follow the advice from your healthcare professional.
How is Intermittent Pneumatic Compression used?
IPC is generally used as a component of lymphoedema management and not as a stand-alone treatment for lymphoedema. Unless directed by your healthcare professional, it is not intended to replace other components of your lymphoedema treatment plan. Such as, exercise and movement and compression therapy (garment, bandages wrap compression system etc).
It is also important that MLD or SLD is performed prior to (or during) the use of IPC. Generally, this is done beyond the top of the IPC garment to help prevent swelling building up above the IPC garment. Drainage is stimulated to try to avoid congestion that may lead to complications and reduce the benefits of IPC. Ask your healthcare professional for more information.
IPC treatment times vary but recommendations are usually between 30 – 60 minutes and twice daily. Compression therapy (such as garments, bandages and wrap compression systems) are not generally worn during the treatment but should ideally be put back on after the IPC treatment has finished.
Contra-indications for Intermittent Pneumatic Compression
Your healthcare professional will assess your suitability for IPC for lymphoedema treatment and will review/discuss the contra-indications. In general, IPC’s are not advisable:
- During an acute episode of cellulitis
- If you have an untreated or suspected blood clot (DVT)
- If you have been diagnosed with kidney or heart failure
- If you have advancing cancer that is obstructing lymph drainage at the root of the limb
- If you have significant loss of sensation in the affected limb
Speak to your healthcare professional
It is important that you receive a full and thorough assessment from a healthcare professional before using an IPC. An IPC can be a useful component during long-term management of lymphoedema but like any medication/treatment it may also cause problems, or prove ineffective, if not used appropriately. It is important to speak to your healthcare professional to determine if IPC is suitable for you.