BACKGROUND: An impedance threshold device (ITD) has been designed to enhance circulation during CPR by creating a negative intrathoracic pressure during the relaxation phase of chest compression. HYPOTHESIS: We sought to determine the effects of the ITD on coronary perfusion pressure (CPP), return of spontaneous circulation (ROSC), and short-term survival (20 minutes after ROSC). We hypothesized that the ITD would improve all 3 variables when compared to standard CPR. METHODS: Using a case-control design nested within a randomized primary study, we compared CPR with the ITD (ITD-CPR) to standard CPR without the device (S-CPR). We systematically assigned 36 domestic swine, weighing 23-29 kg, (18 per group) to resuscitation with either ITD-CPR or S-CPR after 8 minutes of untreated ventricular fibrillation (VF). At minute 8, mechanical chest compression and ventilation began, and drugs (0.1 mg/kg epinephrine, 40U vasopressin, 1.0 mg propranolol, 1 mEq/kg sodium bicarbonate) were given. The first rescue shock (150J biphasic) was delivered at minute 11 of VF. We recorded CPP, ROSC (systolic pressure > 80 mmHg sustained for 60 s continuously), and survival. Data were analyzed with Fisher's exact test and generalized estimating equations (GEE), with alpha = 0.05. RESULTS: We analyzed 3,150 compressions. CPP for the ITD-CPR group (28.1 mmHg [95% CI 27-29.3 mmHg]), did not differ from the S-CPR group (32.3 mmHg [95% CI 31.2-33.4 mmHg]). ROSC occurred in 6/18 (33%) animals in the ITD-CPR, and 14/18 (78%) in the S-CPR group (p = 0.02). Survival occurred in 3/18 (17%) ITD-CPR and 13/18 (72%) S-CPR group (p = 0.003). CONCLUSIONS: ITD-CPR did not improve CPP compared to S-CPR. ROSC and survival were significantly lower with ITD-CPR.
BACKGROUND: An impedance threshold device (ITD) has been designed to enhance circulation during CPR by creating a negative intrathoracic pressure during the relaxation phase of chest compression. HYPOTHESIS: We sought to determine the effects of the ITD on coronary perfusion pressure (CPP), return of spontaneous circulation (ROSC), and short-term survival (20 minutes after ROSC). We hypothesized that the ITD would improve all 3 variables when compared to standard CPR. METHODS: Using a case-control design nested within a randomized primary study, we compared CPR with the ITD (ITD-CPR) to standard CPR without the device (S-CPR). We systematically assigned 36 domestic swine, weighing 23-29 kg, (18 per group) to resuscitation with either ITD-CPR or S-CPR after 8 minutes of untreated ventricular fibrillation (VF). At minute 8, mechanical chest compression and ventilation began, and drugs (0.1 mg/kg epinephrine, 40U vasopressin, 1.0 mg propranolol, 1 mEq/kg sodium bicarbonate) were given. The first rescue shock (150J biphasic) was delivered at minute 11 of VF. We recorded CPP, ROSC (systolic pressure > 80 mmHg sustained for 60 s continuously), and survival. Data were analyzed with Fisher's exact test and generalized estimating equations (GEE), with alpha = 0.05. RESULTS: We analyzed 3,150 compressions. CPP for the ITD-CPR group (28.1 mmHg [95% CI 27-29.3 mmHg]), did not differ from the S-CPR group (32.3 mmHg [95% CI 31.2-33.4 mmHg]). ROSC occurred in 6/18 (33%) animals in the ITD-CPR, and 14/18 (78%) in the S-CPR group (p = 0.02). Survival occurred in 3/18 (17%) ITD-CPR and 13/18 (72%) S-CPR group (p = 0.003). CONCLUSIONS:ITD-CPR did not improve CPP compared to S-CPR. ROSC and survival were significantly lower with ITD-CPR.
Authors: Tom P Aufderheide; Graham Nichol; Thomas D Rea; Siobhan P Brown; Brian G Leroux; Paul E Pepe; Peter J Kudenchuk; Jim Christenson; Mohamud R Daya; Paul Dorian; Clifton W Callaway; Ahamed H Idris; Douglas Andrusiek; Shannon W Stephens; David Hostler; Daniel P Davis; James V Dunford; Ronald G Pirrallo; Ian G Stiell; Catherine M Clement; Alan Craig; Lois Van Ottingham; Terri A Schmidt; Henry E Wang; Myron L Weisfeldt; Joseph P Ornato; George Sopko Journal: N Engl J Med Date: 2011-09-01 Impact factor: 91.245
Authors: Jon C Rittenberger; Brian Suffoletto; David Salcido; Eric Logue; James J Menegazzi Journal: Resuscitation Date: 2008-07-11 Impact factor: 5.262
Authors: Benedict Kjaergaard; Hans O Holdgaard; Sigridur O Magnusdottir; Søren Lundbye-Christensen; Erika F Christensen Journal: J Transl Med Date: 2020-02-14 Impact factor: 5.531