Intrathoracic Pressure Regulation (IPR) Therapy
When patients experience shock or, in extreme cases, cardiac arrest, they require enhanced blood flow to provide sufficient perfusion to vital organs. One way to improve outcomes in states of low blood flow is to enhance negative pressure in the chest by using intrathoracic pressure regulation (IPR) therapy. This treatment enhances negative pressure (or a vacuum) in the chest to draw more blood into the heart to improve pre-load, lower intracranial pressure, and increase cardiac output.1
How Positive and Negative Intrathoracic Pressure Affect Circulation
The human body continually regulates the circulation of blood whenever we breathe. When we inhale, a vacuum is created in the chest. This vacuum pulls air into the lungs, pulls blood into the heart, slightly lowers pressure in the brain, and increases blood flow to the brain and vital organs. Then, when we exhale, positive pressure in the chest forces air out of the lungs, diminishes blood return to the heart, and slightly raises pressure in the brain.2 IPR therapy uses this natural physiologic relationship to improve perfusion to the brain and vital organs by enhancing negative pressure in the chest.
IPR Therapy and Resuscitation in Practice
IPR therapy can be used to treat hypotension due to hemorrhage, shock, dehydration, or sepsis. Rescuers attach an impedance threshold device (ITD), such as the ResQGARD® ITD, to a facemask and place it on the patient, allowing them to breathe normally. ResQGARD has been shown to increase blood pressure by up to 30%, which could help prevent death by hemorrhage.3
In addition, IPR therapy can be used to improve blood flow during cardiac arrest. When an individual experiences sudden cardiac arrest outside the hospital, they typically receive CPR from bystanders or EMS rescuers. Even though high-quality CPR has been shown to increase survival, it only provides about 25% to 40% of normal blood flow to the heart and brain. Using the ResQPOD® ITD in conjunction with high-quality CPR has been shown to improve blood flow to the heart, brain, and other vital organs while improving survival by up to 25%.4
For more information on IPR therapy, watch our video below:
1 Metzger A, Matsuura T, McKnite S, et al. Intrathoracic pressure regulation improves 24-hour survival in a pediatric porcine model of hemorrhagic shock. Pediatr Res. 2011; 70:3:267–271.
2 Moreno AH, et al. Am J Physiol. 1967;213:2:455–465.
3 Convertino VA, Parquette BA, Wampler DA, et al. Use of intrathoracic pressure regulation therapy in breathing patients for the treatment of hypotension secondary to trauma. Scand J Trauma Resusc Emerg Med. 2017;25:105. Doi:10.1186/s13049-017-0450-5
4 Studies available upon request. The generally cleared indication for use of the ResQPOD ITD 10 available for sale in the United States is for a temporary increase in blood circulation during emergency care, hospital, clinic, and home use. The studies referenced here are not intended to imply specific outcomes-based claims not cleared by the U.S. FDA.
