Prospective Randomized Controlled Trial to Analyze the Effects of Intermittent Pneumatic Compression on Edema Following Autologous Femoropopliteal Bypass Surgery

Background: Patients who undergo autologous femoropopliteal bypass surgery develop postoperative edema in the revascularized leg. The effects of intermittent pneumatic compression (IPC) to treat and to prevent postreconstructive edema were examined in this study. Methods: In a prospective randomized trial, patients were assigned to one of two groups. All patients suffered from peripheral arterial disease, and all were subjected to autologous femoropopliteal bypass reconstruction. Patients in group 1 used a compression stocking (CS) above the knee exerting 18 mmHg (class I) on the leg postoperatively for 1 week (day and night). Patients in group 2 used IPC on the foot postoperatively at night for 1 week. The lower leg circumference was measured preoperatively and at five postoperative time points. A multivariate analysis was done using a mixed model analysis of variance. Results: A total of 57 patients were analyzed (CS 28; IPC 29). Indications for operation were severe claudication (CS 13; IPC 13), rest pain (10/5), or tissue loss (7/11). Revascularization was performed with either a supragenicular (CS 13; IPC10) or an infragenicular (CS 15; IPC 19) autologous bypass. Leg circumference increased on day 1 (CS/IPC): 0.4%/2.7%, day 4 (2.1%/6.1%), day 7 (2.5%/7.9%), day 14 (4.7%/7.3%), and day 90 (1.0%/3.3%) from baseline (preoperative situation). On days 1, 4, and 7 there was a significant difference in leg circumference between the two treatment groups. Conclusions: Edema following femoropopliteal bypass surgery occurs in all patients. For the prevention and treatment of that edema the use of a class I CS proved superior to treatment with IPC. The use of CS remains the recommended practice following femoropopliteal bypass surgery

É possível determinar a economia de corrida através do teste progressivo até a exaustão? Is possible to predict running economy using maximal incremental exercise test?

O objetivo do presente estudo foi verificar a possibilidade de se estimar a economia de corrida (EC) a partir do coeficiente angular gerado pela relação VO2 vs. intensidade de testes progressivos até a exaustão (EC INCLINA). Para tanto, 16 corredores de provas de longa duração (idade 32 ± 7 anos, massa corporal 70,0 ± 6,7 kg, estatura 173,3 ± 5,0 cm, <img src="/img/revistas/rbefe/v24n3/v1_dot.jpg" align=absmiddle>O2máx 57,9 ± 5,8 ml·kg-1·min-1) foram submetidos a um teste incremental e a dois testes de cargas constantes (12 km·h-1 e a intensidade de 90% do segundo limiar ventilatório) para a mensuração da EC. Foram detectadas correlações fracas entre o EC INCLINA e a EC estabelecida a 12 km·h-1 (r = 0,49; p = 0,054) e na intensidade de 90% do segundo limiar ventilatório (r = 0,55; p = 0,027). Além disso, o EC INCLINA também estava negativamente correlacionado com a concentração sanguínea de lactato (r = -0,75; p = 0,001) e a razão de troca respiratória (r = -0,80; p < 0,001) mensuradas ao final no teste progressivo. Portanto, esses achados sugerem que, embora a sua aplicação para determinar a EC seja limitada, o EC INCLINA pode ser um parâmetro alternativo empregado para o diagnóstico da aptidão de corredores de provas de longa duração devido a sua relação com o metabolismo anaeróbio.<br>The purpose of the present study was to investigate the association between running economy (RE) and the slope of the regression line obtained as the individual relationship between oxygen uptake and the corresponding intensity in the incremental test (EC INCLINA). Sixteen recreational long-distance runners (age 32 ± 7 years, body mass 70,0 ± 6.7 kg, height 173.3 ± 5.0 cm, VO2max 57.9 ± 5.8 ml·kg-1·min-1) performed a progressive incremental test and two submaximal workload tests (at 12 km·h-1 and 90% second ventilatory threshold) to determine the RE. There was significant correlation between EC INCLINA and RE measured at 12 km·h-1 (r = 0.49; p = 0.054) and at 90% second ventilatory threshold (r = 0.55; p = 0.027). In addition, EC INCLINA also was negatively correlated with peak blood lactate (r = -0.75; p = 0.001) and peak respiratory exchange rate (r = -0.80; p < 0.001). These findings suggest that EC INCLINA would be an alternative parameter employed to determine the endurance performance in recreational long-distance runners