• Constance Jenkins, Katrina Brinkley, Heidi Alford, Kevin Costello, Nanette Korkow, Don Johnson, and Lawrence V Fulton.
• US Army Graduate Program in Anesthesia Nursing, Fort Sam Houston, TX 78234.
• Mil Med. 2015 Sep 1; 180 (9): 1011-6.

BackgroundVentilation 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 ResultsThis 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).ConclusionsOur data suggest that there is no difference in drug kinetics or clinical outcomes in terms of survivability with or without the ResQPOD.Reprint & Copyright © 2015 Association of Military Surgeons of the U.S.

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