Effect of intermittent pneumatic leg compression on intracranial pressure in brain-injured patients.

OBJECTIVE To evaluate the effect of intermittent pneumatic leg compression on intracranial pressure and cerebral perfusion pressure in brain-injured patients. DESIGN Prospective, sequential patient study. SETTING Surgical/trauma ICU of a community hospital providing regional trauma care. PATIENTS Twenty-four adult, brain-injured patients (mean Glasgow Coma Scale score = 6) who required hemodynamic and intracranial pressure monitoring. INTERVENTIONS Placement of intermittent sequential pneumatic leg compression devices for prevention of venous thrombosis. MEASUREMENTS Mean arterial pressure (MAP), heart rate, central venous pressure, and intracranial pressure were measured at baseline, and at 0, 10, 20, and 30 mins of intermittent pneumatic leg compression. Cerebral perfusion pressure was calculated as the difference between MAP and intracranial pressure. RESULTS No significant changes in MAP, central venous pressure, or intracranial pressure occurred during the study interval. Calculated cerebral perfusion pressure remained unchanged. A total of 23 of 24 study patients had intracranial pressure controlled by hyperventilation or pharmacologic measures within the normal range at the time of study. CONCLUSION Intermittent pneumatic leg compression results in no significant changes in intracranial pressure or cerebral perfusion pressure in stable, brain-injured patients who have intracranial pressure controlled by medical means.