Effects of the ResQPOD on Kinetics, Hemodynamics of Vasopressin, and Survivability in a Porcine Cardiac Arrest Model.

Abstract

BACKGROUND: Ventilation through an impedance threshold device (ITD) purportedly improves hemodynamics and survivability and is given a Class IIb recommendation by the American Heart Association/American College of Cardiology for adult cardiac arrest. No studies have investigated the effects of an ITD with vasopressin. METHODS AND RESULTS: This study compared return of spontaneous circulation (ROSC), time to ROSC, hemodynamics, and pharmacokinetics with and without the use of a ResQPOD ITD. Swine were randomized to three groups: cardiopulmonary resuscitation and defibrillation alone, vasopressin with ResQPOD, and vasopressin without ResQPOD. Survival differences between the cardiopulmonary resuscitation and defibrillation group versus with and without ResQPOD groups were found (p = 0.001, FET; p = 0.021, FET, respectively) but no differences between with and without ResQPOD groups (p = 0.462). A test of Cmax between the IV and IV/ResQPOD group provided limited evidence that the IV/ResQPOD group attained higher Cmax than then IV only group (U = 11.00, p = 0.097). Median Tmax and ROSC were not statistically different between the groups (U = 11.00, p = 0.314). CONCLUSIONS: Our data suggest that there is no difference in drug kinetics or clinical outcomes in terms of survivability with or without the ResQPOD.