title: Use of impedance threshold device in conjunction with our novel adhesive glove device for ACD-CPR does not result in additional chest decompression.
abstract: 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.
  
  
  METHODS
  Controlled, randomized animal study.
  
  
  METHODS
  In this study, 18 piglets were anesthetized, ventilated, and continuously monitored. After 3min 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 2min at 100-120compressions/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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Anesthesiology, College of Veterinarian School, University of Florida, Gainesville, FL, United States.
authors.forename: Andre
authors.initials: A
authors.lastname: Shih
authors.forename: Sharda
authors.initials: S
authors.lastname: Udassi
authors.forename: Stacy L
authors.initials: SL
authors.lastname: Porvasnik
authors.forename: Melissa A
authors.initials: MA
authors.lastname: Lamb
authors.forename: Srinivasarao
authors.initials: S
authors.lastname: Badugu
authors.forename: Giridhar Kaliki
authors.initials: GK
authors.lastname: Venkata
authors.forename: Dalia
authors.initials: D
authors.lastname: Lopez-Colon
authors.forename: Ikram U
authors.initials: IU
authors.lastname: Haque
authors.forename: Arno L
authors.initials: AL
authors.lastname: Zaritsky
authors.forename: Jai P
authors.initials: JP
authors.lastname: Udassi
mesh_terms: D000269:Adhesives; D000818:Animals; D016887:Cardiopulmonary Resuscitation / Q000295:instrumentation* / Q000379:methods*; D003664:Decompression; D017097:Electric Impedance; D005260:Female; D005932:Gloves, Surgical; D006439:Hemodynamics; D008297:Male; D013552:Swine
chemical_list: D000269:Adhesives
keywords: Active compression–decompression; Cardiopulmonary resuscitation; Impedance threshold device; Pediatric cardiac arrest model