| Use of an inspiratory impedance threshold device on a facemask and endotracheal tube to reduce intrathoracic pressures during the decompression phase of active compression-decompression cardiopulmonary resuscitation. | |
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MedLine Citation:
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PMID: 15891326 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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INTRODUCTION: Use of an inspiratory impedance threshold device (ITD) significantly increases coronary perfusion pressures and survival in patients ventilated with an endotracheal tube (ETT) during active compression-decompression cardiopulmonary resuscitation. We tested the hypothesis that the ITD could lower intratracheal pressures when attached to either a facemask or ETT. METHODS: An active and sham ITD were randomly applied first to a facemask and then to an ETT during active compression-decompression cardiopulmonary resuscitation in 13 out-of-hospital cardiac arrest patients in a randomized, double-blinded, prospective clinical trial. The compression-to-bag-valve ventilation ratio was 15:2. Airway pressures (surrogate for intrathoracic pressure) were measured with a pressure transducer. A sham and an active ITD were used for 1 min each in a randomized order, first on a facemask and then on an ETT. Statistical analyses were made using Friedman's and Wilcoxon's rank-sum tests. RESULTS: For the primary end point, mean +/- sd maximum negative intrathoracic pressures (mm Hg) during the decompression phase of cardiopulmonary resuscitation were -1.0 +/- 0.73 mm Hg with a sham vs. -4.6 +/- 3.7 mm Hg with an active ITD on the facemask (p = .003) and -1.3 +/- 1.3 mm Hg with a sham ITD vs. -7.3 +/- 4.5 mm Hg with an active ITD on an ETT (p = .0009). Decompression phase airway pressures with the facemask and ETT were not statistically different. CONCLUSIONS: Use of an active ITD attached to a facemask or an ETT resulted in a significantly lower negative intratracheal pressure during the decompression phase of active compression-decompression cardiopulmonary resuscitation when compared with controls. Airway pressures with an ITD on either a facemask or ETT were similar. The ITD-facemask combination was practical and enables rapid deployment of this life-saving technology. |
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Authors:
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Patrick Plaisance; Christian Soleil; Keith G Lurie; Eric Vicaut; Laurent Ducros; Didier Payen |
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Publication Detail:
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Type: Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Critical care medicine Volume: 33 ISSN: 0090-3493 ISO Abbreviation: Crit. Care Med. Publication Date: 2005 May |
Date Detail:
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Created Date: 2005-05-13 Completed Date: 2005-05-31 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0355501 Medline TA: Crit Care Med Country: United States |
Other Details:
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Languages: eng Pagination: 990-4 Citation Subset: AIM; IM |
Affiliation:
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Department of Anesthesiology and Critical Care, Lariboisière University Hospital, Paris, France. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Cardiography, Impedance Cardiopulmonary Resuscitation / instrumentation*, methods Emergency Medical Services Female Heart Arrest / therapy* Humans Intubation, Intratracheal Male Masks Middle Aged |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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