Intrathoracic pressure regulation to treat intraoperative hypotension: A phase II pilot study

BACKGROUND: Intraoperative hypotension secondary to acute blood loss and fluid shifts increases morbidity and mortality. Intrathoracic pressure regulation (IPR) is a new therapy that enhances circulation by increasing venous return with a negative intrathoracic pressure created noninvasively, either actively (vacuum source or patient inspiration) or passively (chest recoil during cardiopulmonary resuscitation). OBJECTIVE: In this Phase II pilot study, we tested the hypothesis that active IPR therapy would improve the haemodynamic status of patients who developed clinically significant hypotension during abdominal surgery. DESIGN: A phase II, single cohort, interventional pilot study. SETTING: University of Minnesota Fairview Hospital. PATIENTS: Twenty-two patients [American Society of Anesthesiologists (ASA) physical status I to III] were enrolled prospectively of whom 15 experienced intraoperative hypotension. INTERVENTION: If intraoperative hypotension occurred more than 10 min after induction, the IPR device was applied immediately for a minimum of 10 min. MAIN OUTCOME MEASURE: The hypotensive SBP immediately before the start of IPR treatment was compared with the SBP obtained at the end of IPR therapy. The paired Student's t-test was used to determine statistical significance (P 
Source: European Journal of Anaesthesiology - Category: Anesthesiology Tags: Monitoring Source Type: research