Inspiratory impedance threshold valve during CPR

Langhelle, Audun; Strømme, Tævje A.; Sunde, Kjetil; Wik, Lars; Nicolaysen, Gunnar; Steen, Petter Andreas

doi:10.1016/s0300-9572(01)00442-7

Cited by 56 publications

(36 citation statements)

References 24 publications

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“…In an adult porcine hemorrhagic shock model without fluid resuscitation, augmenting negative intrathoracic pressure with the ITD improved hemodynamic parameters and survival (14). It has also been found to increase cardiac and cerebral blood flow during resuscitation in cardiac arrest (18,19). The device increases cardiac preload during cardiopulmonary resuscitation by increasing negative intrathoracic pressure during the chest wall recoil phase of cardiopulmonary resuscitation.…”

mentioning

confidence: 99%

Spontaneous breathing through an inspiratory impedance threshold device augments cardiac index and stroke volume index in a pediatric porcine model of hemorrhagic hypovolemia

Marino

Yannopoulos

Sigurðsson

et al. 2004

Critical Care Medicine

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ITD-assisted breathing significantly augmented systolic blood pressure, cardiac index, and stroke volume index in this pediatric porcine model of hemorrhagic hypovolemia. These effects appear related to increased left ventricular preload and not by increased systemic vascular resistance or heart rate. These beneficial effects of ITD-assisted breathing are not changed by the addition of positive end-expiratory pressures of 3 cm H2O.

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mentioning

confidence: 99%

Spontaneous breathing through an inspiratory impedance threshold device augments cardiac index and stroke volume index in a pediatric porcine model of hemorrhagic hypovolemia

Marino

Yannopoulos

Sigurðsson

et al. 2004

Critical Care Medicine

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show abstract

“…Langhelle et al (33) independently confirmed that use of the ITD improved blood flow to the heart with both standard and ACD CPR when compared with standard CPR. The beneficial effects of the combination of ACD CPR plus the ITD can also be seen on cerebral metabolism.…”

Section: Vital Organ Blood Flow In Animalsmentioning

confidence: 94%

“…Concurrently with studies with ACD CPR, investigations were undertaken to evaluate the ITD during standard CPR in animals (3,21,22,33) and, more recently, in humans (7-9). Results from initial studies using a 4-min period of cardiac arrest without CPR demonstrated that the use of the ITD increased myocardial perfusion by 50% when compared with standard CPR alone (p Ͻ .05) (3).…”

Section: Vital Organ Blood Flow In Animalsmentioning

confidence: 99%

Vital organ blood flow with the impedance threshold device

Aufderheide

Lurie

2006

Critical Care Medicine

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“…(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19) Compared with standard CPR, improved hemodymanics with use of the ITD is dependent on the quality of CPR provided (20)(21)(22)(23)(24)(25)(26) and the degree of chest wall recoil. (27,28) This concept has been evaluated in animals (6,7,(9)(10)(11)1416,18) as well as in human patients with prolonged cardiac arrest undergoing standard manual CPR. (29)(30)(31) The first controlled animal study of the ITD with standard CPR used a four-minute period of cardiac arrest followed by standard CPR with an automated compression device.…”

Section: Background and Significancementioning

confidence: 99%

Resuscitation Outcomes Consortium (ROC) PRIMED cardiac arrest trial methods

Aufderheide¹,

Kudenchuk

Hedges

et al. 2008

Resuscitation

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Aim-The primary aim of this study is to compare survival to hospital discharge with a modified Rankin score (MRS) ≤3 between standard cardiopulmonary resuscitation (CPR) plus an active impedance threshold device (ITD) versus standard CPR plus a sham ITD in patients with out-ofhospital cardiac arrest. Secondary aims are to compare functional status and depression at discharge and at 3 and 6 months post discharge in survivors.Design: Prospective, double-blind, randomized, controlled, clinical trial. Population:Patients with non-traumatic out-of-hospital cardiac arrest treated by emergency medical services (EMS) providers. Setting: EMS systems participating in the Resuscitation Outcomes Consortium.Sample Size: Based on a one-sided significance level of 0.025, power = 0.90, a survival with MRS ≤ 3 to discharge rate of 5.33% with standard CPR and sham ITD, and two interim analyses, a maximum of 14,742 evaluable patients are needed to detect a 6.69% survival with MRS ≤ 3 to discharge with standard CPR and active ITD (1.36% absolute survival difference).Conclusion-If the ITD demonstrates the hypothesized improvement in survival, it is estimated that2,700 deaths from cardiac arrest per year would be averted in North America alone.

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Inspiratory impedance threshold valve during CPR

Cited by 56 publications

References 24 publications

Spontaneous breathing through an inspiratory impedance threshold device augments cardiac index and stroke volume index in a pediatric porcine model of hemorrhagic hypovolemia

Spontaneous breathing through an inspiratory impedance threshold device augments cardiac index and stroke volume index in a pediatric porcine model of hemorrhagic hypovolemia

Vital organ blood flow with the impedance threshold device

Resuscitation Outcomes Consortium (ROC) PRIMED cardiac arrest trial methods

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