Intrathoracic Pressure Regulator for Blood Loss
Technical Report,01 Sep 2011,31 Oct 2013
CINCINNATI UNIV OH CINCINNATI United States
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Hemorrhagic shock is a leading cause of death in combat, yet potentially survivable with early intervention. This is especially true in patients with head injury. Resuscitative measures, e.g., fluid therapy, can be lifesaving however, delays in intravenous access and differential fluid responsiveness result in over- and under-resuscitation. Intrathoracic pressure regulation ITPR is an emerging technology used to treat hypovolemia and cardiac arrest. Preclinical trials demonstrate that ITPR increases venous return and thereby restores blood pressure and perfusion. We compared the effect of ITPR to placebo in restoring hemodynamics after hemorrhage under general anesthesia. A secondary aim was to determine if ITPR could reduce the fluid burden of hemorrhage. Based on group-to-group comparisons, ITPR had limited effect on improving mean arterial pressure and other hemodynamic responses. However, in some subjects, when ITPR is implemented, improvement in stroke volume, other indices of perfusion, and volume sparing occurs. While fluid resuscitation is the standard of care in hypovolemic hemorrhagic shock, delays in treatment can be potentially fatal.