Impedance threshold device
| Impedance threshold device | |
|---|---|
| Specialty | Cardiology |
An inspiratory impedance threshold device is a valve used in
endotracheal tube, and may open at high or low pressures (called "cracking pressures")[citation needed
]
Overview
ITDs are still in the early phases of clinical use, but preliminary investigational studies have suggested a potential benefit in achieving
cardiopulmonary arrest in humans.[1]
More recently, the Resuscitation Outcomes Consortium (ROC) Prehospital Resuscitation Impedance Valve and Early Versus Delayed Analysis (PRIMED) study (n=8718) failed to demonstrate improved outcomes with the use of an impedance threshold device (ITD) as an adjunct to conventional CPR when compared with use of a sham device.
Quality of cardiopulmonary resuscitation (CPR) was a deciding factor, with ITD increasing survival when in combination with "acceptable" CPR quality, but decreasing survival when CPR quality was not "acceptable".[2] This negative high-quality study prompted a Class III: No Benefit recommendation regarding routine use of the ITD.[3]
ITD use may only be beneficial if the cardiac arrest is witnessed and the response time is rapid.[4]
References
- PMID 18434910.
- PMID 26073276.
- ^ "2015 Guidelines update". Part 6 Reommendations. American Heart Association. Retrieved 2019-01-02.
- PMID 25517475.
Further reading
- Seekins MB, Reiss AJ (June 2011). "Application of impedance threshold devices during cardiopulmonary cerebral resuscitation". Journal of Veterinary Emergency and Critical Care. 21 (3): 187–92. PMID 21631704.
- Pirracchio R, Payen D, Plaisance P (June 2007). "The impedance threshold valve for adult cardiopulmonary resuscitation: a review of the literature". Curr Opin Crit Care. 13 (3): 280–6. PMID 17468559.
External links
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