Use of impedance threshold device in conjunction with our novel adhesive glove device for ACD-CPR does not result in additional chest decompression

Autor: Sharda Udassi, Stacy Porvasnik, Giridhar Kaliki Venkata, Jai P. Udassi, Srinivasarao Badugu, Melissa A. Lamb, Arno Zaritsky, Dalia Lopez-Colon, Andre Shih, Ikram U. Haque
Rok vydání: 2013
Předmět:
Zdroj: Resuscitation. 84:1433-1438
ISSN: 0300-9572
DOI: 10.1016/j.resuscitation.2013.05.019
Popis: Objective To evaluate the hemodynamic effects of using an adhesive glove device (AGD) to perform active compression–decompression CPR (AGD-CPR) in conjunction with an impedance threshold device (ITD) in a pediatric cardiac arrest model. Design Controlled, randomized animal study. Methods In this study, 18 piglets were anesthetized, ventilated, and continuously monitored. After 3 min of untreated ventricular fibrillation, animals were randomized (6/group) to receive either standard CPR (S-CPR), active compression–decompression CPR via adhesive glove device (AGD-CPR) or AGD-CPR along with an ITD (AGD-CPR + ITD) for 2 min at 100–120 compressions/min. AGD is delivered using a fingerless leather glove with a Velcro patch on the palmer aspect and the counter Velcro patch adhered to the pig's chest. Data (mean ± SD) were analyzed using one-way ANOVA with pair wise multiple comparisons to assess differences between groups. p -Value ≤ 0.05 was considered significant. Results Both AGD-CPR and AGD-CPR + ITD groups produced lower intrathoracic pressure (IttP, mmHg) during decompression phase (−13.4 ± 6.7, p = 0.01 and −11.9 ± 6.5, p = 0.01, respectively) in comparison to S-CPR (−0.3 ± 4.2). Carotid blood flow (CBF, % of baseline mL/min) was higher in AGD-CPR and AGD-CPR + ITD (respectively 64.3 ± 47.3%, p = 0.03 and 67.5 ± 33.1%, p = 0.04) as compared with S-CPR (29.1 ± 12.5%). Coronary perfusion pressure (CPP, mmHg) was higher in AGD-CPR and AGD-CPR + ITD (respectively 19.7 ± 4.6, p = 0.04 and 25.6 ± 12.1, p = 0.02) when compared to S-CPR (9.6 ± 9.1). There was no statistically significant difference between AGD-CPR and AGD-CPR + ITD groups with reference to intra-thoracic pressure, carotid blood flow and coronary perfusion pressure. Conclusion Active compression decompression delivered by this simple and inexpensive adhesive glove device resulted in improved cerebral blood flow and coronary perfusion pressure. There was no statistically significant added effect of ITD use along with AGD-CPR on the decompression of the chest.
Databáze: OpenAIRE
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