The effect of using an impedance threshold device on hemodynamic parameters during cardiopulmonary resuscitation in dogs.

OBJECTIVE: To investigate the hemodynamic effects following the use of an impedance threshold device (ITD) in a canine model of cardiopulmonary arrest. DESIGN: Experimental, randomized crossover study. SETTING: Cardiovascular research laboratory at a university veterinary center. ANIMALS: Eight purpose bred beagle dogs. INTERVENTIONS: Dogs were anesthetized and instrumented for the measurement of right atrial pressure , systolic blood pressure, mean blood pressure, and diastolic arterial blood pressure, end-tidal CO(2) , and carotid blood flow (CBF). CBF was determined via ultrasonic flow probe placed around the carotid artery. Animals were taking part in an unassociated terminal study and following subsequent euthanasia with pentobarbital, standardized cardiopulmonary resuscitation (CPR) was performed with an impedance threshold device attached (ITD-CPR group) and without (S-CPR group). Order of treatment was randomized. MEASUREMENTS AND MAIN RESULTS: ITD group had increased CBF, coronary perfusion pressure, and a decrease in right atrial diastolic pressure. No differences in end-tidal CO(2) , diastolic arterial blood pressure, mean blood pressure, or systolic blood pressure were seen. Return of spontaneous circulation was not observed in any of the animals CONCLUSIONS: Use of the ITD resulted in favorable changes in hemodynamic parameters in dogs undergoing CPR. The ITD may be a useful adjunct during CPR in dogs and warrants clinical evaluation.