| dc.description.abstract | Intermittent electrical stimulation of the common peroneal nerve by the Geko device TM has an effect
on haemodynamics. The Geko TM is a device, which prevents the formation of venous
thromboembolism (VTE). The Geko TM works to stimulate the foot and calf muscle pumps in the leg to
increase venous return. VTE carries a significant morbidity and mortality for patients, and so it is a
valid scientific question to ascertain whether the Geko TM can also have a beneficial secondary effect,
on the haemodynamics, which could be used clinically, to improve patient outcomes.
Increasing the venous return to the heart should theoretically increase cardiac output and possibly
arterial blood pressure. Firstly, we examined whether there could be any arterial blood pressure
increases caused by the Geko TM, which could then be used to stabilize the blood pressure changes that
occur after an anaesthetic induction. We did not find any significant change in blood pressure in 13
patients using a cross-over design pilot study.
Secondly, we examined the haemodynamic changes produced by the Geko TM in healthy volunteers
(n=21) using non-invasive cardiac output monitoring. We found that the cardiac output increased by
12% at the ten-minute stimulation period (p= 0.02), this effect ceased after the Geko TM was switched
off for ten minutes. We also found that this effect of increased cardiac output by the Geko TM was not
sustained if the device was left on for longer periods of up to 45 minutes, n=10.
Thirdly we sought to examine this finding of increased cardiac output using invasive cardiac
monitoring. Although we did find a slight increase in cardiac output, when using the Geko for a tenminute stimulation, (2.5%), p= 0.17, N-=5, the finding is not statistically significant.
In conclusion, this thesis points to some mild central haemodynamic changes from the Geko TM device
that needs more investigation. The haemodynamic changes are small and unlikely to be beneficial
clinically. This thesis also highlights the lack of knowledge, research and measuring equipment for the
venous circulatory system | en_US |
