IMPACT OF MANUAL LYMPHATIC DRAINAGE ON HEMODYNAMIC PARAMETERS IN PATIENTS WITH HEART FAILURE AND LOWER LIMB EDEMA

Abstract

Manual lymphatic drainage (MLD),intermittent sequential pneumatic therapy(ISPT), multilayered bandages (MLB), andcompression garments are main techniques inconservative treatment of peripherallymphedema. Since 1990, it has been thoughtthat ISPT applied to both lower limbssimultaneously should not be used for patientswith heart failure because right atrial,pulmonary arterial, and pulmonary wedgepressures may increase to a critical point. In2005, these same results were observed inpatients with heart failure wearing MLB. Forthese reasons, MLB and ISPT have beencontraindicated during lymphedema treatmentin cardiac patients. The aim of this study wasto determine if we may continue the treatmentof lower limb lymphedema using MLD inpatients with heart failure. We evaluatedhemodynamic parameters using echographyduring MLD in patients with cardiac diseaseand obtained circumferential measurementsof the edematous limb before and after treatment.MLD treatment significantly decreasedthe limbs as expected. The heart rate alsodecreased following MLD in contrast with allother hemodynamic parameters which werenot affected by MLD. The findings suggestthat there is no contraindication to use MLDin patients with heart failure and lowerlimb edema.