Treatment of hypotension in pigs with an inspiratory impedance threshold device: a feasibility study.

Objective: An inspiratory impedance threshold device was evaluated in spontaneously breathing animals with hypotension to determine whether it could help improve systemic arterial pressures when fluid replacement was not immediately available.

Design: Prospective, randomized.

Setting: Animal laboratory.

Feasibility and effects of transcutaneous phrenic nerve stimulation combined with an inspiratory impedance threshold in a pig model of hemorrhagic shock.

Objective: Intrathoracic pressure changes are of particular importance under hypovolemic conditions, especially when central venous blood pressure is critically low. Accordingly, the purpose of this study was to assess the feasibility of transcutaneous phrenic nerve stimulation, used in conjunction with an inspiratory impedance threshold, on hemodynamic variables during hemorrhagic shock.

Design: Prospective, randomized laboratory investigation using a porcine model for measurement of hemodynamic variables, left and right ventricular diameter, and transmitral, transpulmonary, and transaortic blood flow employing transesophageal echo-Doppler technique.

Evaluation of a prototypic inspiratory impedance threshold valve designed to enhance the efficiency of cardiopulmonary resuscitation.

Objective: Assess a prototype inspiratory impedance threshold valve (ITV) designed to enhance vital organ circulation during standard and active compression/decompression cardiopulmonary resuscitation (CPR).

Background: The ITV attaches to commonly used airway assist devices and decreases intrathoracic pressure during the decompression (chest recoil) phase of CPR by creating a vacuum within the thorax, which increases venous blood flow to the heart and thus increases coronary perfusion pressure and blood flow to the brain.

Methods: The evaluation included laboratory bench testing, according to American Society for Testing and Materials (ASTM) and International Standards Organization (ISO) guidelines, and performance testing with pigs in cardiac arrest.

Combination drug therapy with vasopressin, adrenaline (epinephrine) and nitroglycerin improves vital organ blood flow in a porcine model of ventricular fibrillation.

There is increasing evidence that the combination of epinephrine (adrenaline) with vasopressin may be superior to either epinephrine or vasopressin alone for treatment of cardiac arrest. However, the optimal combination, and dosage of cardiovascular drugs to minimize side effects, and to improve outcome has yet to be found. We therefore evaluated whether the combination of vasopressin plus epinephrine plus nitroglycerin (EVN), would improve vital organ blood flow during cardiopulmonary resuscitation (CPR) when compared with epinephrine (EPI) alone.