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Harnessing Cardiopulmonary Interactions to Improve Circulation and Outcomes After Cardiac Arrest and Other States of Low Blood Pressure

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Handbook of Cardiac Anatomy, Physiology, and Devices

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Abstract

Novel noninvasive technologies that harness the inherent physiological interactions between the heart, lungs, and brain have recently been shown to improve circulation and outcomes after cardiac arrest and other states of low blood pressure including hypovolemic shock. The impedance threshold devices (ResQPOD® and ResQGard®) and the intrathoracic pressure regulator (CirQlator™) are three new devices that create a negative intrathoracic pressure. The decrease in intrathoracic pressure creates a vacuum within the thorax relative to the rest of the body thereby enhancing venous blood return to the heart, increasing cardiac output and systemic arterial blood pressure, lowering right atrial and pulmonary artery pressures, lowering intracranial pressure, and increasing cerebral perfusion pressure. The animal and clinical data supporting the use of technologies that harness the intrathoraic pump are reviewed in this chapter.

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Notes

  1. 1.

    Conflict of Interest: Keith Lurie is the founder and Chief Medical Officer of Advanced Circulatory Systems, the company that manufactures the impedance threshold device. He is also a Professor of Emergency Medicine at the University of Minnesota (lurie002@umn.edu). Anja Metzger is employed by Advanced Circulatory Systems and is the Vice President of Research and Development.

Abbreviations

ACD:

active compression decompression

AHA:

American Heart Association

CePP:

cerebral perfusion pressure

CPP:

coronary perfusion pressure

CPR:

cardiopulmonary resuscitation

EMS:

emergency medical services

ICP:

intracranial pressure

ITD:

impedance threshold device

ITPR:

intrathoracic pressure regulator

MAP:

mean arterial pressure

PEA:

pulseless electrical activity

VF:

ventricular fibrillation

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Author information

Authors and Affiliations

  1. Department of Emergency Medicine, University of Minnesota, 13683 47th St. N, 55455, Minneapolis, MN, USA

    Anja Metzger

  2. Department of Emergency Medicine, University of Minnesota, HCMC, 701 Park Ave. S., 55415, Minneapolis, MN, USA

    Keith Lurie

Authors
  1. Anja Metzger
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  2. Keith Lurie
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Corresponding author

Correspondence to Anja Metzger .

Editor information

Editors and Affiliations

  1. Dept. Surgery, University of Minnesota, Delaware St. SE., 420, Minneapolis, 55455, U.S.A.

    Paul A. Iaizzo

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Metzger, A., Lurie, K. (2009). Harnessing Cardiopulmonary Interactions to Improve Circulation and Outcomes After Cardiac Arrest and Other States of Low Blood Pressure. In: Iaizzo, P. (eds) Handbook of Cardiac Anatomy, Physiology, and Devices. Humana Press. https://doi.org/10.1007/978-1-60327-372-5_35

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  • DOI: https://doi.org/10.1007/978-1-60327-372-5_35

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