JP2021533947A - Compression clothing - Google Patents

Abstract

The compression garment (1) has one abdominal active part (3) intended to surround the patient's abdomen and two lower active parts (4,) intended to surround one of the patient's lower limbs, respectively. 5) The three active parts (3, 4, 5) are provided, and each of the active parts (3, 4, 5) has a uniform positive pressure by the active part over the entire corresponding body part of the patient in the abdomen and lower limbs. It comprises at least one bladder (31, 41, 51) capable of filling the fluid so that The compression garment (1)-is positioned between the active part and the corresponding body part of the patient with respect to each active part (3, 4, 5), and the active part and the corresponding body of the patient. At least one interface pressure sensor (2) configured to measure pressure at the interface between the site and-one or more interface pressure sensors (2) in each active part (3, 4, 5). To maintain a predetermined interfacial pressure value for the active part based on the interfacial pressure measurement received by the receiving module for each active part and the receiving module configured to receive the interfacial pressure measurement from. It comprises a control unit comprising a drive module configured to control at least one injection device for injecting fluid into one or more fillable bladder (31, 41, 51) of the active portion. [Selection diagram] Fig. 1

Description

The present invention relates to compression garments intended to compress the patient's abdomen and the patient's lower limbs to compress the patient's body. In particular, the present invention relates to compression clothing for compressing the patient's body according to the "Lower Body Positive Pressure Load Method" (LBPP) principle to enable revascularization of the brain by mobilizing blood contained in the patient's lower body. .. The present invention further relates to a method of attaching such compression garments to a patient and a method of compressing the patient's body.

The "lower body positive pressure loading method" (LBPP) principle involves applying constant low pressure levels specifically in the range of 10-40 mmHg to the patient's abdomen and the patient's lower limbs, the pressure applied to the abdomen is applied to the lower limbs. Strictly less than pressure. This concept was initially developed to ensure proper volume distribution in the lower and upper aortic regions, especially for microgravity flight. LBPP has been reported to move blood from the lower body to the upper body, resulting in an increase in central cardiopulmonary blood volume.

WO 2008104861 (A1) discloses the use of LBPP to treat individuals suffering from vascular disorders affecting the upper part of the body, especially cerebrovascular disorders or eye disorders. This document describes the application of LBPP using anti-gravity pants or medical shock pants (MAST) as commercially available from LIFE SUPPORT PRODUCTS (St. Louis, Missouri, USA). Such shock pants are equipped with three independent air chambers that allow positive pressure to be applied to the patient's abdomen and both lower limbs, respectively. Each air chamber is connected to a pneumatic end, manually inflated using a pump, and a pressure gauge is provided in each air chamber to provide an instantaneous pressure value.

Shock pants have a rigid structure that makes it difficult to wear to bedridden patients such as those suffering from stroke or cerebrovascular accident (CVA) or patients suffering from quadriplegia. In addition, shock pants are generally available in one size, which is not suitable for all forms. However, if the patient's morphology does not fit the size of the shock pants, there is a risk that the pressure value indicated by the pressure gauge will not correspond to the pressure effectively applied to the patient's body part. This makes the pressure on the patient's body uncertain. Performing LBPP with shock pants also requires manual adjustment and monitoring of pressure over time to ensure that the pressure applied to the patient remains constant at each part of the body. It is a time-consuming task.

More specifically, the present invention proposes compression garments that allow uniform and constant pressure levels to be applied automatically, reliably and accurately to a patient's body part, thereby providing the above-mentioned drawbacks. Aim to overcome

To this end, the present invention is a compression garment for compressing the patient's body, one abdominal active area intended to surround the patient's abdomen, and one of the patient's lower limbs. Each has three active parts, two lower active parts intended to surround, each active part such that uniform positive pressure is applied by the active part to the entire corresponding body part of the patient in the abdomen and lower limbs. A compression garment with at least one bladder capable of filling the fluid.
-For each active part, measure the surface pressure at the interface between the active part and the patient's corresponding body part, positioned between the active part and the patient's corresponding body part. With at least one interface pressure sensor configured,
-Abdomen based on a receiving module configured to receive interface pressure measurements from one or more interface pressure sensors in each active part, and interface pressure measurements received by the receiving module for each active part. One or more of the active portions in order to maintain the predetermined interface pressure value for each active portion so that the predetermined interface pressure value for the active portion is strictly smaller than the predetermined interface pressure value for each lower active portion. A control unit with a drive module configured to drive at least one injection device for injecting fluid into a fillable bladder.
With respect to compression garments.

In the present invention, the interfacial pressure considered by the control unit for each active part (measured by at least one interfacial pressure sensor positioned between the active part and the corresponding body part of the patient) is the active part. Represents the pressure actually applied to the patient's corresponding body part, which contributes to the ability to automatically, reliably and accurately compress using the compression garments of the present invention. do. On the other hand, the pressure considered by the control unit for each active part was measured, in particular using a pressure gauge installed in the connection pipe between the bladder and the injection device for injecting fluid into the bladder. If only the filling pressure of each bladder in the active area, the bladder filling pressure is the pressure actually applied by the bladder to the patient's corresponding body part (depending on the degree of adjustment of the clothing around the patient's body). Since it is not expressed systematically, the control of the applied pressure is not reliable.

According to one feature, the control unit
-With respect to the abdominal active part, a first predetermined interfacial pressure value in the range of 10 to 20 mmHg, preferably about 10 mmHg.
-With respect to each of the two lower active portions, with a second predetermined interfacial pressure value in the range of 20-40 mmHg, preferably about 20 mmHg.
Is configured to maintain
The first predetermined interfacial pressure value for the abdominal active part is strictly smaller than the second predetermined interfacial pressure value for each lower active part.

Therefore, the compression garment of the present invention automatically applies pressure to the patient's body according to the "lower body positive pressure loading method" (LBPP) principle, enabling revascularization of the brain by mobilizing blood contained in the patient's lower body. It is configured to create a pressure gradient between one abdomen and the other lower limb. More specifically, the compression garments of the present invention allow revascularization of the brain in a passive manner by increasing circulating plasma volume. The control unit allows for automatic control of the interfacial pressure and servo-controls the injection of fluid into one or more bladder of each active part according to the interfacial pressure measurement and interfacial pressure set value. It enables and ensures that constant pressure is applied throughout the duration of the session without human intervention.

It should be noted that the treatment passband for the application of LBPP therapy should be in the range of 20-40 mmHg in the lower extremities and not more than 40 mmHg. More specifically, above 40 mmHg, the increase in preload (or cardiac filling pressure) is so great that it stimulates the sympathetic nervous system, which has a reflex effect on vasodilation of the large arterial highway. As a result, it has been found to result in vasodilation and decreased arterial blood pressure. This results in a decrease in cerebral perfusion, especially in patients suffering from stroke, as cerebral self-regulation is stopped by the stroke. Therefore, applying a pressure value above 40 mmHg to the lower limbs is harmful. Under these conditions, the compression garment of the present invention is configured to maintain a second predetermined interfacial pressure value of 40 mmHg or less for each of the two lower active portions.

According to one feature, the control unit receives measurements representing the patient's blood pressure (especially continuously acquired during a treatment session) and keeps the patient's blood pressure below a predetermined threshold, in particular. Each for injecting fluid into one or more fillable bladder in the lower active area to keep systolic blood pressure (SBP) strictly below 220 and diastolic blood pressure (DBP) strictly below 120. It is configured to control the injection device of.

According to one feature, the control unit receives measurements representing the patient's intracerebral blood flow (particularly obtained by the transcranial Doppler method) and changes the measurements representing intracerebral blood flow by compression clothing. It is configured to correlate with the pressure gradient applied to the patient's body part. This configuration advantageously allows the physician to select a treatment goal and, for example, aim for an average increase of 30% in intracerebral blood flow compared to, for example, at the beginning of a treatment session. Therefore, an alert can be generated when the treatment goal is reached, whereby the physician decides whether to continue the session depending on the functional results obtained.

By providing an interfacial pressure sensor for each of the three active parts, it is possible to control the pressure value effectively applied to the patient's abdomen and lower limbs, so that each interfacial pressure sensor is an active part. Is directly positioned between the patient and the corresponding body part of the patient. In particular, in the case of LBPP, the pressure applied to the abdomen preferably has a value in the range of 10 to 20 mmHg, preferably about 10 mmHg, and the pressure applied to each of the lower limbs preferably in the range of 20 to 40 mmHg. It preferably has a value of about 20 mmHg. Control using an interfacial pressure sensor further ensures that the applied pressure remains constant across each part of the patient's body throughout the duration of the compression session (especially in the case of LBPP, lasting about 90 minutes). do.

Preferably, each active part of the compression garment comprises a single fillable bladder to simplify the garment design. For each active part, the number and placement of interfacial pressure sensors provide pressure measurements that represent the pressure effectively applied to the patient's body part, while avoiding positioning of the sensor, especially to the bone part. Suitable for.

As an example, in one particular embodiment,
-The abdominal active part of the compression garment has three interfaces with an anterior central sensor intended to be positioned anterior to the center of the abdomen and two side sensors intended to be positioned on both sides of the abdomen. Equipped with a pressure sensor,
-Each lower active part of the compression garment is intended to be positioned on the calf, one or two lower sensors, especially the posterior lower sensor on the posterior surface of the calf, and in some cases on the inner surface of the calf. Medial lower sensor and two or three upper sensors intended to be positioned on the thigh, especially the posterior upper sensor on the posterior surface of the thigh, the medial upper sensor on the medial aspect of the thigh It comprises 3-5 interfacial pressure sensors, including a sensor, and optionally an anterior medial upper sensor on the anterior medial aspect of the thigh.

The size of each interfacial pressure sensor, more specifically the measured surface area, varies from sensor to sensor and can vary, especially depending on the position of the sensor. Thus, as an example, for the abdominal active area, the anterior central sensor may be selected to have a measured surface area that is greater than the measured surface area of the lateral sensor.

According to one aspect of the invention, for each fillable bladder, the volume for receiving the fluid is, in particular, by the fluid-impermeable flexible layer having a substrate of woven fabric and / or plastic material. Demarcated. Preferably, the material of the impermeable layer has elastic properties obtained, for example, by incorporating elastane into the material of the layer, or in the case of a layer containing a woven fabric, by weaving the woven fabric. Advantageously, the material of the impermeable layer is selected so that its outer surface, i.e. the outer surface of the bladder, can be washed.

In one embodiment, the fluid filling each bladder is air, so a flexible layer defining the volume of each bladder is applied into the bladder to apply the required positive pressure to the patient's body. It becomes airtight in a given pressure range that matches the air pressure. Such an airtight layer can be, in particular, a self-supporting layer or a layer of plastic material deposited on the substrate. In particular, the airtight layer has a woven or non-woven layer having a substrate of nylon, polypropylene, polyester, polyamide or cotton in particular and a substrate of polyurethane, silicone, polyvinyl chloride (PVC) or other plastic material in particular. It may be provided with an overlay with a coating layer. Preferably, the weight per unit area of the woven fabric layer is in the range of ^{150-250 g / m 2.} An example of a material that can be used to form an airtight layer within the scope of the invention includes a nylon knitted fabric layer with one side coated with a polyurethane coating layer. No air chamber is required as the bladder itself acts as an air chamber due to the airtightness of the flexible layers that form each of the bladder. This forms a flexible structure for each fillable bladder, improving the comfort of wearing compression garments and facilitating the wearing of compression garments to patients, including bedridden or paralyzed patients.

Advantageously, each active part deforms between a deployment configuration that allows attachment around the patient's corresponding body part and a regulatory configuration that is regulated around the patient's corresponding body part. It is a flexible part that can be formed. In the regulatory configuration, the active part has a tubular shape and the inner sidewall can apply positive pressure to the patient's body part.

According to one embodiment, the active parts are superposed on each other and are the first and second parts that are impermeable to the fluid and receive the fluid of each fillable bladder between them. A portion having a substrate of a woven fabric and / or a plastic material comprising a first portion and a second portion defining a volume for the woven fabric and / or a plastic material. In the regulatory configuration of the active part on the patient's corresponding body part, the first part is directed inward and the second part is directed outward. The first and second portions are advantageously connected to each other by the fluid impermeable peripheral seam or by any other fluid impermeable peripheral connection means.

According to one advantageous feature, each interfacial pressure sensor is firmly anchored to the inner wall of the active part, i.e., a wall intended to be directed at the patient's corresponding body part. In particular, the interfacial pressure sensor may be housed in a compartment provided on the inner wall of the active portion for containment purposes. Alternatively, the interfacial pressure sensor may be firmly anchored to the inner wall of the active portion by any other suitable means, especially by sewing or gluing.

Advantageously, each fillable bladder of the compression garment comprises at least one filling end piece designed to be connected to a fluid infusion device. For each fillable bladder, the compression garment further comprises at least one filling pressure sensor, such as a pressure gauge, for sensing the pressure as the bladder is filled with fluid. In particular, for each fillable bladder, the filling pressure sensor may be installed in the connecting pipe between the filling end piece of the bladder and the corresponding fluid injection device. Advantageously, the compression garment comprises an automatic servo control means between one or more filling pressure sensors and one or more interfacial pressure sensors in each active portion. In particular, one or more fill pressure sensors in each active area have an automated servo control system with the fill pressure sensor to apply constant controlled pressure to each of the patient's body parts throughout the duration of the compression session. It may be connected to a control unit so that it can be installed between the active part and the interfacial pressure sensor. In the case of LBPP, the principle involves blood mobilization in the lower body, which must be constant, controlled and self-regulating to compensate for the loss, while being too high to prevent adverse effects. It doesn't become. Such constant and controlled recruitment of blood requires constant, controlled, and automatically regulated pressure on each body part of the patient throughout the duration of the session.

Within the scope of the invention, the infusion device for injecting fluid into one or more fillable bladder of each active part of the compression garment is a pump, or a compressed air supply system such as that available in hospitals. possible. In one advantageous embodiment, the infusion device for injecting fluid into one or more fillable bladder of each active part of the compression garment allows the use of the compression garment during patient transfer, portable. It is a type device. In one embodiment, the infusion device for injecting fluid into one or more fillable bladder of each active portion of the compression garment is a portable pump incorporated in the garment.

According to one advantageous embodiment, each interfacial pressure sensor is a pneumatic sensor that is hermetically connected to the measurement module, especially by means of a flexible tube. The use of such a pneumatic sensor has the advantage of limiting the electronics that must be embedded directly in the active portion of the compression garment. In particular, the pneumatic sensor can be a sensor as disclosed in WO 2009072011 (A1), which receives a predetermined amount of injected air in the internal volume corresponding to a known positive pressure. Provided, for example, a cushion having a flexible polymer casing made of silicone. The measuring module comprises a pressure gauge and an air injection piston that communicate with each other and with the pneumatic sensor. The measurement module of each sensor is configured to transmit the interfacial pressure measurement value to the receiving module of the control unit. This data transmission may be performed by any means, especially by wired connection means, or by wireless connection means such as Bluetooth® or WiFi. Advantageously, the measurement module of each pressure sensor is incorporated in the housing of the control unit.

Alternatively, each interfacial pressure sensor can be an electronic sensor, in particular a sensor that measures the force applied to the surface at the interface between the active part and the corresponding body part of the patient, from that force the interfacial pressure. Is calculated. Each electronic sensor is configured to transmit the interface pressure value to the receiving module of the control unit. This data transmission is preferably performed by a wireless connection means such as Bluetooth or WiFi.

According to one aspect of the invention, each active part forms the most desirable shape of the patient's corresponding body part and compresses the patient's corresponding body part as most effectively and most uniformly as possible. Provided are regulatory means for regulating the active part around the patient's corresponding body part so that it can be.

According to one feature, for each active part, the regulatory means can apply the active part to the patient's corresponding body part when filling the or each fillable bladder of the active part. It has a patterning element of an active part.

The patterning element of each active portion can pattern the active portion in a filled state so that the active portion is pressed against the corresponding body part of the patient and a controlled and predictable surface pressure is applied to the site. As a result, this prevents a "buoy" effect when filling each active part, so that the active part swells without applying a controlled and uniform pressure to the patient's body part. Become.

In a particular example of LBPP, the particular patterning of the compression garment of the present invention ensures that the required pressure value is applied in a reliable and controlled manner, i.e., advantageously in the range of 10-20 mmHg, preferably about. It is possible to apply a pressure of 10 mmHg to the abdomen, preferably in the range of 20-40 mmHg, preferably a pressure of about 20 mmHg to each lower limb.

If each active part of the compression garment comprises a single fillable bladder, the presence of each active part patterning element forms the patient's corresponding body part upon filling of the active part fillable bladder. However, it is even more important to apply pressure evenly to the lower active part, which has a particularly large filling volume.

According to one feature, for each active part of the compression garment, the patterning element comprises at least one sculptural line, in particular a seam, of a layer defining the fluid receiving volume of each fillable bladder of the active part. This requires molding of the active part in the filled state to form the shape of the patient's corresponding body part. Overall, the patterning element comprises an active part ridge pattern in which the active part can be applied to or pressed against the patient's corresponding body part when filling the or each fillable bladder of the active part. .. The ridge pattern can be a sculptural seam or heat fusion of a fabric-based and / or plastic material-based flexible layer that forms one or more bladder of the active portion.

The regulatory means is the most desirable shape of the patient's corresponding body part and the compression around the patient's corresponding body part so that the pressure can be applied most effectively and evenly as much as possible. Designed to regulate each active part of clothing. In a controlled configuration, the active portion generally has a tubular shape.

According to one feature, the regulatory means comprises a closing element of the active part, preferably the perimeter of the active part around the patient's corresponding body part in a form that fits over the entire length of the tubular active part. Allows adjustment. According to one particular embodiment, the closure element comprises at least a pair of gripping strips comprising a first strip provided with a hook and a second strip provided with a loop, which are of active portions. It extends over the entire length. Alternatively, or with it, the closure element may include multiple tightening strap clip systems that are distributed throughout the length of the active area.

According to one feature, the lower active portion of the compression garment is connected to the abdominal active portion to facilitate the attachment of the garment to the patient's body. According to one feature of the invention, each lower active portion is located at the opposite end of the abdominal active portion, in order to adapt the length of the lower active portion to the length of the patient's corresponding lower limb. It has multiple segments that can be folded over. Similarly, the abdominal active part may have multiple segments at one end that can be folded over each other in order to adapt the length of the abdominal active part to the length of the patient's abdomen. Preferably, for each active portion, with the segments folded over each other, the fillable bladder portion corresponding to the folded segment is not filled with fluid. To further enhance the suitability of compression garments for each patient's morphology, the presence of segments that can be folded or rolled up can be combined with the provision of different garment sizes, such as S, M, L, XL sizes.

According to one aspect of the invention, at least one of the lower active portions of the compression garment surrounds the patient's thigh and exerts a tightening force therein when the lower active portion is in place around the patient's lower limbs. It has an inner tightening element that can be added. Therefore, the medial tightening element can act as a tourniquet and cause venous obstruction in the patient's thigh. Preferably, the inner tightening element is a cuff intended to inflate to standard pressure (50 mmHg). The application of venous occlusion in the thigh of a patient using a medial tightening element to assess mobilizable blood volume (or "venous bed") is the change in volume of the lower extremities caused by this occlusion and release of the occlusion. Combined favorably with measurements.

If the estimated mobilizable blood volume is 0 or less than a predetermined value, infusion of liquid (especially 500 mL saline) into the venous network is performed prior to the compression session using the compression garments of the present invention. obtain.

Various plethysmography techniques are used to measure changes in lower limb volume, especially measuring changes in air pressure in the lower active part of compression garments that form, for example, an air-filled sleeve around the patient's lower limbs. Therefore, air plethysmography can be used. More specifically, the implementation principle is as follows. The medial tightening element surrounding the patient's thigh swells to cause venous obstruction in the patient's thigh, and thus the patient's lower extremities swell due to the obstruction of venous return, after which the thigh tourniquet is released. The patient's lower extremities restore their initial volume as venous return resumes normal flow. Changes in lower limb volume provide an estimate of mobilizable fluid volume, including lymph and venous blood. Advantageously, the compression garment of the present invention not only allows venous occlusion to be obtained by the medial tightening element of the lower active portion, but also the lower active portion of the compression garment that forms a sleeve around the patient's lower limbs. By direct use and by measuring the volume of air in this sleeve before and after the application of venous occlusion, the volume of the lower limbs at rest and the volume of the lower limbs minutes after the application of venous occlusion by air plethysmography It also makes it possible to measure the difference between.

According to one advantageous feature, the compression garment comprises a protective cloth that can be changed with each use of the garment, the protective cloth being the inner wall of one or each active part of the garment, i.e. the active part is the patient. Removably secured to the wall of the active part facing inward in a configuration regulated around the corresponding body part of. The protective cloth acts as a "second skin" and prevents the patient's skin from being irritated by contact with the active part. The protective cloth also prevents the active part from becoming dirty. Preferably, the protective cloth is placed in tension on the inner wall of each active area and is held in tension by any suitable means such as a gripping strip or other means. More specifically, it is important to avoid wrinkles on the protective cloth within the scope of the compression session (especially LBPP). An example of a woven fabric suitable for use as a protective fabric is a microfiber woven fabric having a weight per unit area in the range of ^{40-170 g / m 2.}

The present invention is further a method of attaching the above-mentioned compression garment to a patient.
-Steps in which each active part of the unfolded compression garment is positioned facing the patient's corresponding body part,
-Steps in which each active part of the compression garment in the unfolded configuration is moved to a regulated configuration that is regulated around the patient's corresponding body part,
-For each active part, from each interface pressure sensor of the active part to each fillable bladder of the compression garment until a measurement obtained that is substantially equal to the predetermined interface pressure value for the active part. It relates to a mounting method, including a step of filling with fluid.

For patients who can wear compression garments only in the supine position, the method of wearing compression garments as described above is
-The step where the compression garment is placed on the bed with each of the active parts in the unfolded configuration,
-The step in which the patient is laid on his back on the compression garment, with each body part of the patient positioned on the corresponding active part of the garment.
-Steps in which each active part of the compression garment in the unfolded configuration is moved to a regulated configuration that is regulated around the patient's corresponding body part,
-For each active part, from each interface pressure sensor of the active part to each fillable bladder of the compression garment until a measurement obtained that is substantially equal to the predetermined interface pressure value for the active part. Includes a step in which the fluid is filled.

The invention further comprises three active parts, one abdominal active part intended to surround the patient's abdomen and two lower active parts intended to surround one of the patient's lower limbs, respectively. Each part is a compression garment with at least one bladder capable of filling fluid so that uniform positive pressure is applied by the active part to the entire corresponding body part of the patient in the abdomen and lower limbs, each active part. At least one interface configured to measure the pressure at the interface between the active part and the patient's corresponding body part in a positioned state between the active part and the patient's corresponding body part. A predetermined pressure value including a first predetermined pressure value applied to the patient's abdomen and a second predetermined pressure value applied to each of the patient's lower limbs for a predetermined duration using a compression garment equipped with a pressure sensor. It is a method of compressing the patient's body according to the protocol of
-Steps in which each active part of the unfolded compression garment is positioned facing the patient's corresponding body part,
-Steps in which each active part of the compression garment in the unfolded configuration is moved to a regulated configuration that is regulated around the patient's corresponding body part,
-For each active part, compression clothing until a measurement obtained from each interface pressure sensor of the active part substantially equal to a predetermined pressure value applied to the patient's body part corresponding to the active part. With the steps of filling each fillable bladder with fluid,
-For each active part for a given duration, the interfacial pressure measurements received for each active part are at least one for injecting fluid into one or more fillable bladder of the active part. Used as a reference for driving one infusion device, thereby substantially equal to a predetermined pressure value applied to the patient's body part corresponding to the active part, from each interface pressure sensor of the active part. Concerning compression methods, including steps to maintain measurements.

According to one embodiment of the compression method, the or each fluid infusion device is automatically driven using a control unit.

According to one embodiment of the compression method, the predetermined protocol is LBPP treatment, in this case.
-The first predetermined pressure value applied to the patient's abdomen is in the range of 10-20 mmHg, preferably about 10 mmHg.
-A second predetermined pressure value applied to each of the patient's lower limbs is in the range of 20-40 mmHg, preferably about 20 mmHg.
-The first predetermined pressure value for the abdominal active part is strictly smaller than the second predetermined pressure value for each lower active part.
-The predetermined duration is about 90 minutes.

According to one embodiment, the compression method is a vein in one of the patient's lower limbs prior to the step of filling each fillable bladder of the compression garment with fluid to apply a predetermined pressure value to the patient's body part. It comprises the step of measuring mobilizable blood volume, including applying the obstruction and measuring the volume change of the lower extremities due to the obstruction and the release of the obstruction by plethysmography.

According to one feature, venous occlusion is applied to the patient's lower limbs by one medial tightening element of the lower active portion of the compression garment, wherein the medial tightening element is defined by the lower active portion around the patient's corresponding lower limbs. When in position, it can surround the patient's thigh and apply a tightening force to it.

According to one feature, the measurement of lower limb volume change due to lower limb obstruction and release of the obstruction measures the change in air pressure in the lower active part of the compression garment forming an air-filled sleeve around the patient's lower limb. By doing so, it is done by air plethysmography.

According to one feature, if the measured mobilizable blood volume is below a predetermined threshold, before applying a predetermined pressure value to the patient's body part with compression clothing to increase the mobilizable blood volume. Is infused with saline into the patient's venous network.

The features and advantages of the present invention will become apparent from the following description of embodiments of the compression garments and compression methods of the invention, which are shown by way of reference only by way of illustration.

It is a front view of the compression garment which concerns on 1st Embodiment of this invention. It is a rear view of the compression garment of FIG. It is a front view of the compression garment of FIG. 1 in which the active part is in the developed configuration. FIG. 3 is an enlarged cross-sectional view taken along the plane IV-IV of FIG. FIG. 1 is a front view of the compression garment of FIG. 1 attached to a patient and connected to an air infusion device. It is the same figure as FIG. 1 of the compression garment which concerns on the 2nd Embodiment of this invention. It is the same figure as FIG. 5 of the compression garment which concerns on the 3rd Embodiment of this invention, and is the figure which omitted the air injection device for more easy-to-see. It is a rear view of the compression garment of FIG. 7.

As shown in FIGS. 1-5, the compression garment 1 of the first embodiment has three active parts, i.e., one abdominal active part 3 intended to surround the patient's abdomen A. and a two lower active part (4, 5) to which is respectively intended to surround one of the leg or lower leg L _1, L ₂ of the patient. Each of the active portions 3, 4, and 5 of the compression garment 1 is a flexible woven fabric portion made of an airtight material. In particular, in this example, the airtight material of each of the active portions 3, 4, and 5 includes a nylon knitted fabric layer whose one side is coated with a polyurethane coating layer. To facilitate the attachment of the compression garment 1 to the patient's body, the two lower active portions 4, 5 are connected to the abdominal active portion 3 by a joining element 9 (particularly an elastic woven strip). Each active portion 3, 4, 5 surrounds a substantially planar unfolded configuration shown in FIG. 3 that allows attachment around the patient's corresponding body part and the corresponding part of the patient's body. It can be deformed to and from the tubular configuration shown in FIG. 1, FIG. 2, or FIG. 5, which is adjustable around the corresponding part of the body.

As shown for the active portion 5 in the cross-sectional view of FIG. 4 (it is understood that the active portions 3 and 4 have a cross section similar to that of the active portion 5), each active portion 3 of the compression garment 1 is used. 4, 5 superimpose the inner woven fabric portions 33, 43, 53 intended to face the patient's body side and the outer woven fabric portions 34, 44, 54 intended to face outward. All of these parts are made from airtight material as described above. For each of the active portions 3, 4, 5 the inner woven fabric portions 33, 43, 53 and the outer woven fabric portions 34, 44, 54 made of airtight material are similarly airtight peripheral seams 32, 42, 52. Connected by. Therefore, for each of the active portions 3, 4, and 5 of the compression garment 1, the airtight bladder 31, 41, 51 is between the inner woven fabric portions 33, 43, 53 and the outer woven fabric portions 34, 44, 54. It is possible to fill the internal volume V of the bladder 31, 41, 51 with air.

In this example, each active portion 3, 4, 5 comprises a single fillable bladder 31, 41, 51, which has the advantage of simplifying the design of the compression garment 1. However, instead, each active portion 3, 4, 5 may comprise a plurality of fillable bladder. Each fillable bladder 31, 41, 51 of the compression garment 1 is intended to be filled with air, whereby in the regulatory configuration of active portions 3, 4, 5 on the patient's corresponding body site. , Inner woven fabric portions 33, 43, 53 apply positive pressure to the patient's corresponding body parts.

Each fillable bladder 31, 41, 51 of the compression garment 1 comprises a plurality of filling end pieces 36, 46, 56 distributed over the entire surface of the bladder to optimize its filling. As schematically shown in FIG. 5, the filling end pieces 36, 46, 56 of the active portions 3, 4, 5 are suitable for being connected to the air injection devices 63, 64, 65. Within the scope of the invention, different types of air injection devices can be used. In particular, each of the air injection devices 63, 64, 65 can be a portable pump built into clothing 1 or a compressed air delivery device in a hospital. Each fillable bladder 31, 41, 51 comprises at least one pressure gauge 60 for measuring the pressure as the bladder is filled with air. Preferably, with the bladder filling end pieces 36, 46, 56 and the corresponding air injection devices 63, 64, 65 to measure the filling pressure in different regions of each fillable bladder 31, 41, 51. A pressure gauge 60 is installed in each connecting pipe between them.

Abdomen A patients with abdominal active portion 3, and in order to effectively control the pressure applied to the lower leg L _1, L ₂ of the patient by the lower active part 4,5, the garment 1, each of the active portion 3, The interfacial pressure sensor 2 attached to the inner woven fabric portions 33, 43, 53 of 4 and 5 is provided. Each sensor 2 is intended to measure the pressure at the interface between the active portions 3, 4, 5 to which the sensor 2 is attached and the corresponding body part of the patient. Each sensor 2 may be sewn into a compartment provided within the corresponding inner woven fabric portions 33, 43, 53, for example, for sewing. Alternatively, each sensor 2 may be firmly secured to the corresponding inner woven fabric portions 33, 43, 53 by any other suitable means, especially by sewing or gluing.

In one exemplary embodiment, each interfacial pressure sensor 2 is an air pressure sensor as disclosed in WO 2009072011 (A1), which provides a predetermined amount of injected air corresponding to a known positive pressure. A flexible polymer cushion that can be received within the internal volume and can be a pneumatic sensor with a flexible polymer cushion that is hermetically connected to the measurement module 72 by a flexible tube (not shown). .. The measurement module 72 of each sensor 2 comprises, in particular, a pressure gauge and an air injection piston that communicate with each other and with the air pressure sensor 2. By using such a pneumatic sensor, it is possible to avoid the need for electronic components on the active parts 3, 4 and 5 of the compression garment 1, and the electronic device is inside the measurement module 72 outside the woven fabric portion. Is supplemented with. These pneumatic sensors also have the advantage of adapting to the relatively low interfacial pressure levels required for LBPP, especially in the range of 10-40 mmHg. Needless to say, the compression garment 1 may optionally be equipped with electronic interfacial pressure sensors, provided that the sensitivity of these electronic sensors meets the required interfacial pressure level.

For each of the active portions 3, 4, and 5, the number and arrangement of interfacial pressure sensors 2 are suitable to provide pressure measurements that represent the pressure effectively applied to the patient's body site. As a non-limiting example, in this embodiment, the abdominal active portion 3 of the compression garment 1 has three interfacial pressure sensors 2, i.e., an anterior central sensor intended to be positioned in front of the center of the patient's abdomen. 2 and two side sensors 2 intended to be positioned on both sides of the abdomen. Each lower active portion 4, 5 of the compression garment 1 has five interfacial pressure sensors 2, i.e., one posterior lower sensor 2 intended to be positioned behind the patient's calf, and on the inner surface of the calf. One medial lower sensor 2 intended to be positioned, one posterior upper sensor 2 intended to be positioned on the posterior surface of the patient's thigh, and positioned on the medial surface of the thigh. It comprises one medial upper sensor 2 intended to be such as, and one anterior medial superior sensor 2 intended to be positioned on the anterior medial surface of the thigh.

The compression garment 1 comprises the control unit 7 shown in FIG. 5, where the control unit 7 is where the compression session is performed on the surface of the woven portion of the compression garment 1 or using the garment 1. It can take the form of a housing that can be attached to furniture elements such as beds. In the case of the pneumatic interface pressure sensor 2, the measurement module 72 associated with each pneumatic interface pressure sensor of the compression garment 1 is advantageously incorporated in the housing of the control unit 7, and the control unit 7 has each pneumatic pressure. Further includes a receiving module 70 configured to receive the interfacial pressure measurement value from the interfacial pressure sensor measuring module 72. Therefore, the connection between each measurement module 72 and the reception module 70 may be a wired connection or a wireless connection. In the case of the electronic interfacial pressure sensor 2, each electronic interfacial pressure sensor is configured to directly transmit the interfacial pressure measurement value to the receiving module 70 of the control unit 7 by a wireless connection means in particular. Further, one or more filling pressure gauges 60 of each fillable bladder 31, 41, 51 are connected to the receiving module 70 of the control unit 7. Therefore, an automatic servo system can be realized between the filling pressure sensor 60 and the interfacial pressure sensor 2 of each of the active portions 3, 4, and 5.

As shown in FIG. 5, the receiving module 70 of the control unit 7 further comprises.
-A measurement representing the patient's blood pressure during a treatment session, especially continuously obtained using a tension gauge 67 with a cuff positioned on the patient's arm, especially systolic blood pressure (SBP). , A measure of the patient's blood pressure, including diastolic blood pressure (DBP), mean arterial pressure,
-Patients during a treatment session, particularly continuously obtained by the transcranial Doppler method using a device 68 with a probe positioned overhead of the patient, particularly a 2 MHz Doppler probe, associated with the computing unit. Intracerebral blood flow, in particular, systolic maximum blood flow velocity (PSV), end-diastolic blood flow velocity (EDV), resistance coefficient, and measurement value indicating intracerebral blood flow including the area under the curve. Is configured to receive.

The control unit 7 further includes a drive module 71, and the drive module 71 is
-The interfacial pressure measurement value received by the receiving module 70 for the active part, in order to maintain a predetermined interfacial pressure set value for each of the active parts 3, 4, 5
-To keep the patient's blood pressure below a predetermined threshold, especially to keep systolic blood pressure (SBP) strictly below 220 and diastolic blood pressure (DBP) strictly below 120. The measured value representing the patient's blood pressure received by the receiving module 70,
-To correlate changes in measurements that represent the patient's intracerebral blood flow with the pressure gradient applied to the patient's body area by compression clothing and / or to treat the measurement that represents the patient's intracerebral blood flow. For example, by associating an average 30% increase in intracerebral blood flow compared to the start of a treatment session with the possibility of generating an alert when the treatment goal is achieved, the functional results obtained by the physician. To determine whether to continue the session accordingly, drive one or more air infusion devices 63, 64, 65 depending on the measurements received by the receiving module 70 that represent the patient's intracerebral blood flow. It is configured as follows.

The control unit 7 automatically controls the interface pressure, and the bladder 31, 41 of each of the active portions 3, 4, and 5 corresponds to the interface pressure measurement value from the sensor 2 and the predetermined interface pressure set value for each active portion. , Performs servo control of air injection in 51. Therefore, it is possible to use the compression garment 1 to automatically apply a constant controlled pressure to each of the patient's body parts throughout the duration of the compression session without human intervention.

In particular, according to one example, in order to apply LBPP using the compression garment 1, a predetermined interface pressure setting value for the abdominal active portion 3 is 10 mmHg, and a predetermined interface for each of the lower active portions 4 and 5. The pressure set value is 20 mmHg, which favorably configures the garment 1 to maintain a predetermined interfacial pressure set value for each of the active portions 3, 4 and 5 for a duration of about 90 minutes. To.

More preferably, in order to form the shape of each body part of the patient and apply pressure to each part of the body as most effectively and uniformly as possible, the respective active parts 3, 4, 5 of the compression garment 1 are A coordinating means for adjusting the active parts 3, 4, 5 around the patient's corresponding body part is provided. In the examples shown in FIGS. 1-5, these control means are provided with a pair of gripping strips on each of the active portions 3, 4, 5 and the active portions are the corresponding body parts A, L _{1 of the patient.} , L ₂ can be closed with an adjustable configuration around it.

More specifically, in the illustrated example, each active portion 3, 4, 5 is an active portion on the side of the outer woven fabric portions 34, 44, 54 over its entire length in the axial direction in the tubular configuration. The first grip strips 37, 47, 57 with hooks located at the first longitudinal end and the second longitudinal end of the active portion on the side of the inner woven fabric portions 33, 43, 53. It comprises a second gripping strip 38, 48, 58 with a loop. The grip strips 37, 38, 47, 48, 57, 58 are around the patient's corresponding body parts A, L ₁ , L _{2 so that} the perimeters of the active parts 3, 4, and 5 are adapted over the entire length of the active part. To be able to adjust with.

Each of the two lower active part 4 and 5, on the opposite side of the abdomen active part 3, the length of the lower active part 4,5 is adapted to the length of the leg L _1, L ₂ of the patient, thus, possible It further comprises rollable portions 45, 55 intended to apply positive pressure to the lower extremities L ₁ , L _{2 in the most targeted manner possible.} As shown in FIGS. 1 and 5, each of the winding portions 45, 55 is formed by a plurality of segments S configured to be folded over each other. Preferably, when the segments S are folded over each other, the fillable bladder 41, 51 portions corresponding to the folded segments S cannot be filled with air.

As shown in FIG. 3, the lower active part 4 of the compression garment 1 which is intended to cover the right leg or the right leg L ₁ of the patient, the lower active part 4 around the right leg L ₁ of the patient It is provided with an inner cuff 40 that surrounds the patient's right thigh and can exert a tightening force on the right thigh when in place. The tightening cuff 40 is specifically provided with a gripping strip so that the cuff can be held in place around the patient's thigh and is inflatable intended to be filled with air at a standard pressure of approximately 50 mmHg. Can be a cuff. The tightening cuff 40 is intended to be able to assess a patient's mobilizable blood volume (or "venous bed") prior to performing a compression session (particularly LBPP) using compression clothing 1. ..

The procedure for assessing mobilizable blood volume is advantageously to apply a venous occlusion in the patient's right thigh using a tightening cuff 40 and the right lower extremity resulting from this occlusion and release of the occlusion. of a change in volume, in particular, by measuring the change in air pressure within the lower active part 4 forming a sleeve filled with air around the patient's right leg L _1, and measuring the air plethysmography Can include.

In the case of LBPP, an assessment of mobilizable blood volume prior to the LBPP differential pressure application session using compression garment 1 is important as this amount determines the effectiveness of LBPP treatment for the patient. There is a risk that the transfer of blood to the patient's upper body resulting from the application of LBPP will not be able to achieve effective revascularization of the brain, especially if the amount of blood that can be mobilized in the patient's lower body is low. In such cases, it is advantageous to "fill" the patient's venous network with liquid, especially saline, prior to applying LBPP using compression garment 1 to increase the amount of blood that can be mobilized. be. If the patient's mobilizable blood volume assessed as specified above is 0 or less than a predetermined value, infusion of 500 mL of saline into the patient's venous network is advantageous in compression clothing 1 It is believed that this can be done before the LBPP session using.

Preferably, as shown in FIG. 5, when worn on the patient, the compression garment 1 comprises a disposable protective cloth 8 between the patient's body and each of the active parts 3, 4, and 5. For example, the protective cloth 8, which is a microfiber woven cloth having a weight per unit area in the range of 40 to 170 g / m ² , functions as a “second skin” and comes into contact with the active parts 3, 4, and 5. Prevents irritation of the patient's skin due to. Advantageously, the protective cloth 8 is removably applied onto the inner woven portions 33, 43, 53 of the respective active portions 3, 4, 5 while potentially irritating the patient's skin. It is held in tension by any suitable means, eg, using a gripping strip, to prevent creases. The protective cloth also prevents the active parts 3, 4, and 5 from becoming dirty, whereby the compression garment 1 is for the subsequent session when the protective cloth 8 used during the session is removed. As long as it is replaced with a new protective cloth 8, it can be reused in different compression sessions without causing hygiene problems.

Using compression garment 1 as described above, an example of a method for compressing according to the "lower body positive pressure load method" (LBPP) principle abdomen A and leg L _1, L ₂ of a patient, comprises the following steps ..

First, the compression garment 1 is preferably in a non-inflated state of the compression garment, i.e., with each of the garment-fillable bladder 31, 41, 51 being unfilled or almost unfilled. , Attached to the patient.

For that purpose, the respective active portions 3, 4, 5 of the compression garment 1 are positioned in the unfolded configuration as shown in FIG. 3, and the protective cloth 8 is the respective active portions 3, 4, 5. It is applied on the inner woven fabric portions 33, 43, 53 of. Next, the abdominal active portion 3 of the compression garment 1 is attached at the position of the patient's abdomen A, and the two lower active portions 4 and 5 are attached at the positions of _one lower limb L 1 and L _{2 of the patient, respectively.} Each active portion 3, 4, 5 is then closed and moves from the deployed configuration to the tubular configuration around the patient's corresponding body part, gripping strips 37, 38, 47, 48, 57, 58. Is regulated around the patient's corresponding body part using.

For bedridden patients or patients suffering from quadriplegia, the design of the compression garment 1 allows the compression garment 1 to be worn on a supine patient. In such a case, the compression garment 1 is positioned on the bed with its respective active portions 3, 4 and 5 in a deployed configuration and with the protective cloth 8 attached, after which the patient is referred to the patient's abdomen A. was positioned in the position of abdomen active portion 3, in a state of being positioned at the position of the lower active part (4, 5) corresponding compression garments leg L _1, L ₂ of each patient, is on his back on the compression garment 1 To. Each active portion 3, 4, 5 is then closed by moving from its unfolded configuration to a tubular configuration around the corresponding body part of the lying patient and for adjustment of the compression garment. Grip strips 37, 38, 47, 48, 57, 58 provided at the front are used to adjust around the patient's corresponding body part.

Subsequently, a measurement of mobilizable blood volume may be performed on the patient wearing the compression garment 1. For this purpose, vein occlusion is applied using a fastening cuff 40 in the base of the right thigh of the patient, the volume change of the right leg L ₁ caused by the release of the occlusion and blockage is measured by plethysmography .. This may be, for example, air plethysmography to measure the variation in the air pressure in the lower active part 4 forming a sleeve which is filled with air around the patient's right leg L _1. Depending on the value of mobilizable blood volume thus assessed, to the patient's venous network to increase mobilizable blood volume in the case of a venous bed with reduced circulating blood volume and enhance the effectiveness of LBPP. Infusion of physiological saline can be performed.

Next, each of the bladder 31, 41, 51 of the compression garment 1 has a predetermined interface pressure set value of the active portion for each of the active portions 3, 4, and 5 by the interface pressure sensor 2 of each of the active portions. Fill using the air injection devices 63, 64, 65 connected to the filling end pieces 36, 46, 56 until substantially equal measurements are obtained. In particular, according to one advantageous example of the application of LBPP using compression garment 1, the predetermined interface pressure setting value for the abdominal active portion 3 is 10 mmHg, and the predetermined interface pressure for the lower active portions 4, 5 respectively. The set value is 20 mmHg. The control unit 7 of the compression garment 1 may be configured to automatically fill the garment bladder 31, 41, 51.

Then, for a determined duration, to maintain the interfacial pressure value measured by said sensor 2, equal to a predetermined interfacial pressure set value for each of the active portions 3, 4, 5 to which each sensor 2 is attached. , The duration determined by utilizing the control unit 7 of the compression garment 1 configured to selectively actuate the air injection devices 63, 64, 65 according to the interface pressure measurements from the sensor 2. During, for example, 90 minutes, the compression garment 1 automatically applies a constant and uniform pressure of 10 mmHg to the patient's abdomen A and 20 mmHg to each of the patient's lower limbs L1 and L2.

In the second embodiment shown in FIG. 6, elements similar to the elements of the first embodiment are designated by the same reference numerals. In the compression garment 1 of the second embodiment, the adjusting means of the active parts 3, 4, and 5 on the patient's body replaces the gripping strips 37, 38, 47, 48, 57, 58 with the tightening strap 37'. , 47 ′, 57 ′ and corresponding clips 38 ′, 48 ′, 58 ′, and are different from the compression garment 1 of the first embodiment in that they are formed by a plurality of closure systems. As shown in FIG. 6, a closure system using tightening straps 37', 47', 57'and clips 38', 48', 58' for each of the active portions 3, 4, 5' In a tubular configuration, it is axially distributed over the entire length of the active portion, whereby the active portion 3 around the _{patient's corresponding body parts A, L 1} , L _{2 in a conforming manner over the entire length of the active portion,} Allows adjustment of 4 and 5 circumferences.

In the third embodiment shown in FIGS. 7 and 8, elements similar to the elements of the first embodiment are designated by the same reference numerals. The compression garment 1 of the third embodiment is said that the adjusting means of the active parts 3, 4 and 5 on the patient's body is not limited to the gripping strips 37, 38, 47, 48, 57, 58 which are closed in the longitudinal direction. In that respect, it differs from the compression garment 1 of the first embodiment. In this third embodiment, the adjusting means further comprises sculptural seams 39, 49, 59 of the woven fabric of the respective active parts 3, 4, 5 respectively. The seams 39, 49, 59 of each of the active parts 3, 4, 5 are the corresponding body parts A, L ₁ , L of the patient while the fillable bladder 31, 41, 51 of the active part is filled with air. _It is configured to impart the shape of the active portions 3, 4, and 5 to be applied to 2. The seams 39, 49, 59 of the respective active parts 3, 4, 5 allow the active parts to more preferably form the shape of the corresponding body part of the patient. Further, as shown in FIG. 8, the compression garment 1 of the third embodiment surrounds the buttocks of the patient. The area covering the patient's buttocks is a fillable area that can be filled with air to the extent that it may also be useful to apply a constant controlled pressure to the patient's buttocks to drain blood from this area. Obtained, especially for fillable bladder. Alternatively, the area covering the patient's buttocks may not be fillable.

As shown in the previous example, the compression garment of the present invention equipped with an interfacial pressure sensor on the inner wall of each of the active parts can automatically apply uniform and constant pressure to the patient's abdomen and lower limbs. To. In particular, the compression garments of the present invention are well suited for compression according to the "Lower Body Positive Pressure Load Method" (LBPP) principle, which includes differential pressure applied to the patient's abdomen and lower limbs. Due to the airtightness and flexibility of the woven fabric that forms each of the active parts of the compression garment, each active part can serve as an air chamber while retaining the flexible structure, which means that Provides high wearing comfort and facilitates wearing to patients, including those who are bedridden or paralyzed. Further, by being able to provide the compression garments of the present invention of different sizes (eg S, M, L, XL) and the presence of regulatory means for adjusting the compression garments on each part of the body. It becomes possible to adapt the garment to the morphology of each patient, which contributes to the effectiveness of the garment for treatment by compression, especially according to the LBPP principle.

The invention is not limited to the examples described and illustrated. In particular, in the above example, each active portion 3, 4, 5 of the compression garment comprises a single fillable bladder 31, 41, 51. Alternatively, each active portion of the garment of the invention may comprise any number of fillable bladder. Therefore, preferably, each fillable bladder of each active portion comprises at least one interfacial pressure sensor. Moreover, the number and placement of interfacial pressure sensors on each active portion of the compression garment of the present invention may differ from those described in the previous examples. The interfacial pressure sensor used can be a different size, different type of interfacial pressure sensor adapted to fit the location, in particular a pneumatic sensor, an electronic sensor, or a combination of a pneumatic sensor and an electronic sensor. .. Finally, the compression garment of the present invention is described above for compression corresponding to the "lower body positive pressure loading method" (LBPP) principle. Alternatively, compression garments can be used for the automatic application of all kinds of pressure (eg, pressure that changes over time) to the patient's abdomen and / or lower limbs, and therefore automatic pressure. The application can be automatically controlled by the control unit of the compression garment.

The application of the "lower body positive pressure loading method" (LBPP) using the compression garment of the present invention includes, but is not limited to, the following treatments.
Improvement of cerebrovascular recruitment in different clinical situations 1-Acute phase of cerebral ischemia due to impaired cerebral perfusion-ischemic stroke-vascular spasm 2-to improve functional recovery, whatever the mechanism (s) Subacute phase of cerebral ischemia due to persistent cerebrovascular accident-ischemic stroke 3-chronic cerebral ischemia due to chronic cerebrovascular accident-vascular dementia 4-improvement of ocular vascular recruitment in different clinical situations-cervical Acute phase of arterial occlusion-anterior ischemic optic neuropathy (AION)
-Central retinal artery occlusion-Chronic disorder of choroidal perfusion-Aging-related macular degeneration (AMD)
5-LBPP to assist or increase the delivery of therapeutic agents for cerebrovascular accidents selected from the group comprising anticoagulants, fibrinolytics, free radical traps, NO donors in the hypoperfused body area. Use 6-LBPP to assist or increase the delivery of therapeutic agents for eye disorders selected from the group comprising antioxidants, anti-inflammatory agents, nutritional factors, apoptosis inhibitors and statins in the hypoperfused body area. Use of

Claims (20)

One abdominal active part (3) intended to surround the patient's abdomen (A) and two lower active parts intended to surround one of the patient's lower limbs (L ₁ , L ₂ ), respectively. A compression garment (1) for compressing the patient's body, comprising three active parts (3, 4, 5) of the parts (4, 5), of the active part (3, 4, 5). Each can be filled with fluid such that a uniform positive pressure is applied by the active portion to the entire corresponding body part of the patient between the abdomen (A) and the lower limbs (L ₁ , L _2). The compression garment (1) comprises at least one bladder (31, 41, 51).
-For each active part (3, 4, 5), the active part (3, 4, 5) is positioned between the active part (3, 4, 5) and the corresponding body part of the patient. At least one interface pressure sensor (2) configured to measure pressure at the interface between 4, 5) and the patient's corresponding body part.
-The receiving module (70) configured to receive the interfacial pressure measurement value from one or more interfacial pressure sensors (2) of each active part (3, 4, 5), and the above-mentioned for each active part. Based on the interfacial pressure measurement value received by the receiving module, the predetermined interfacial pressure value for the abdominal active portion (3) is strictly smaller than the predetermined interfacial pressure value for each of the lower active portions (4, 5). At least one injection device for injecting fluid into one or more fillable bladder (31, 41, 51) of said active part in order to maintain a predetermined interfacial pressure value for each active part. A control unit (7) comprising a drive module (71) configured to drive (63, 64, 65).
With compression clothing. The control unit (7) is
A first predetermined interface pressure value in the range of 10 to 20 mmHg with respect to the abdominal active portion (3), and
With respect to each of the two lower active portions (4, 5), a second predetermined interfacial pressure value in the range of 20 to 40 mmHg, and
The compression garment according to claim 1, which is configured to maintain. The control unit (7) receives a measured value representing the blood pressure of the patient, and keeps the blood pressure value (SBP, DBP) of the patient below a predetermined threshold value of the lower active portion (4, 5). The compression garment according to claim 1 or 2, wherein the infusion device (64, 65) for injecting fluid into one or more fillable bladder is configured to be controlled. .. The control unit (7) receives the measured value representing the intracerebral blood flow of the patient, which is obtained by the transcranial Doppler method, and changes the measured value representing the intracerebral blood flow in the compression clothing (1). The compression garment according to any one of the preceding claims, configured to correlate with a pressure gradient applied to the patient's body site (A, L ₁ , L _{2) by).} For each fillable bladder (31, 41, 51), the volume (V) for receiving the fluid is the fluid-impermeable flexible layer, especially having a substrate of woven fabric and / or plastic material. The compression garment according to any one of the preceding claims, as defined by (32-34, 42-44, 52-54). Each interfacial pressure sensor (2) precedes, firmly anchored to the wall (33, 43, 53) of the active portion (3, 4, 5) intended to be directed at the patient's body part. The compression garment according to any one of the claims. For each fillable bladder (31, 41, 51), at least one filling pressure sensor (60) for sensing the pressure as the bladder is filled with fluid, and said one or more filling pressure sensors. The compression according to any one of the preceding claims, comprising automatic servo control means between (60) and one or more interfacial pressure sensors (2) of each active unit (3, 4, 5). clothing. The compression garment according to any one of the preceding claims, wherein each interfacial pressure sensor (2) is a pneumatic sensor that is hermetically connected to the measurement module (72), in particular by a flexible tube. Each active part (3, 4, 5) is a regulatory means (37, 38, 39, 47, 48, 49, 57, 58, for regulating the active part around the corresponding body part of the patient. 59) The regulating means applies the active portion to the corresponding body part of the patient when filling the or each fillable bladder (31, 41, 51) of the active portion. The compression garment according to any one of the preceding claims, comprising the patterning element (39, 49, 59) of the active portion. Each active part (3, 4, 5) is a regulatory means (37, 38, 39, 47, 48, 49, 57, 58, for regulating the active part around the corresponding body part of the patient. 59) The regulating means comprises a closing element (37 (') of the active portion (3, 4, 5) that allows adjustment of the circumference of the active portion around the corresponding body part of the patient. ), 38 ('), 47 ('), 48 ('), 57 ('), 58 (')), according to any one of the preceding claims. At least one (4) of the lower active portion surrounds the patient's thigh and has a tightening force therein when the _{active portion (4) is in a predetermined position around the patient's lower limbs (L 1).} The compression garment according to any one of the preceding claims, comprising an inner tightening element (40) to which the garment can be added. A protective cloth (8) that can be replaced with each use of the compression garment and is a wall of one or each active portion (3, 4, 5) intended to face the body part side of the patient. 33, 43, 53. The compression garment according to any one of the preceding claims, comprising a protective cloth (8) removably secured to (33, 43, 53). A method for attaching the compression garment according to any one of the preferred claims to a patient, wherein the method is:
-A step in which each active portion (3, 4, 5) of the compression garment in the unfolded configuration is _{positioned facing the patient's corresponding body part (A, L 1} , L _2).
-A step in which each active part (3, 4, 5) of the compression garment in the unfolded configuration is moved to a regulated configuration that is regulated around the _{patient's corresponding body part (A, L 1} , L _2). When,
-For each active part (3, 4, 5), until a measured value substantially equal to a predetermined interface pressure value for the active part is obtained from each interface pressure sensor (2) of the active part. , And the step of filling each fillable bladder (31, 41, 51) of the compression garment with fluid.
How to prepare. One abdominal active part (3) intended to surround the patient's abdomen (A) and two lower active parts intended to surround one of the _{patient's lower limbs (L 1} , L _{2), respectively.} A first predetermined application to the patient's abdomen (A) for a predetermined duration using a compression garment (1) comprising the three active parts (3, 4, 5) of (4, 5). A method for compressing a patient's body according to a predetermined protocol, comprising a pressure value of the patient and a second predetermined pressure value applied to each of the patient's lower limbs (L ₁ , L _2). Each of (3, 4, 5) is at least one bladder (31, 3, which can be filled with fluid so that uniform positive pressure is applied by the active part to the entire corresponding body part of the patient in the abdomen and lower limbs. 41, 51), wherein the compression garment (1) is positioned with respect to each active portion (3, 4, 5) between the active portion and the corresponding body part of the patient. The method comprises at least one interface pressure sensor (2) configured to measure the pressure at the interface between the active portion and the corresponding body part of the patient.
-A step in which each active portion (3, 4, 5) of the compression garment in the unfolded configuration is _{positioned facing the patient's corresponding body part (A, L 1} , L _2).
-A step in which each active part (3, 4, 5) of the compression garment in the unfolded configuration is moved to a regulated configuration that is regulated around the _{patient's corresponding body part (A, L 1} , L _2). When,
-For each active part (3, 4, 5), from each interface pressure sensor (2) of the active part to a predetermined pressure value applied to the body part of the patient corresponding to the active part. A step of filling each fillable bladder (31, 41, 51) of the compression garment with fluid until substantially equal measurements are obtained.
-For each active part (3, 4, 5) for a predetermined duration, the interfacial pressure measurement received for each active part is one or more fillable bladder of said active part (3, 4, 5). Used as a reference for driving at least one injection device (63, 64, 65) for injecting fluid into 31, 41, 51), thereby corresponding to the active portion of the patient's body. A step of maintaining the measured value from each interface pressure sensor (2) of the active part, which is substantially equal to a predetermined pressure value applied to the site.
Methods for squeezing, including. The method for compression according to claim 14, wherein the fluid infusion device (63, 64, 65) is automatically controlled using the control unit (7). The predetermined protocol is LBPP treatment and
-The first predetermined pressure value applied to the patient's abdomen (A) is in the range of 10-20 mmHg, preferably about 10 mmHg.
-The second predetermined pressure value applied to each of the patient's lower limbs (L ₁ , L ₂ ) is in the range of 20-40 mmHg, preferably about 20 mmHg.
-The first predetermined pressure value for the abdominal active part is strictly smaller than the second predetermined pressure value for each lower active part.
-The predetermined duration is about 90 minutes,
The method for compression according to claim 14 or claim 15. Prior to the step of filling each fillable bladder (31, 41, 51) of the compression garment with fluid to apply the predetermined pressure value to the patient's body part, on one of the patient's lower limbs. 14-16, comprising the steps of measuring mobilizable blood volume, comprising applying a venous occlusion and measuring the volume change of the lower extremity due to the occlusion and release of the occlusion by plethysmography. The method for compression as described in any one paragraph. The venous occlusion is applied to the patient's lower limbs by one medial tightening element (40) of the lower active portion (4, 5) of the compression garment (1), wherein the medial tightening element (40) is the lower active portion. Claims that, when the portions (4, 5) are _{in place around the patient's corresponding lower limbs (L 1} , L ₂ ), the patient's thigh can be surrounded and a tightening force applied therein. Item 17. The method for compression according to item 17. The measurement of the volume change of the lower limbs due to the obstruction of the lower limbs (L ₁ , L ₂ ) and the release of the obstruction of the compression garment (1) forming an air-filled sleeve around the lower limbs of the patient. The method for compression according to any one of claims 17 or 18, which is performed by air plethysmography by measuring the change in air pressure in the lower active portion (4, 5). If the measured mobilizable blood volume is less than a predetermined threshold, the compression garment (1) may apply the predetermined pressure value to the patient's body site (A, L ₁ , L ₂ ). The method for compression according to any one of claims 17 to 19, wherein the infusion of saline into the patient's venous network is performed.

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