Use of an Impedance Threshold Device in Spontaneously Breathing Patients with Hypotension Secondary to Trauma: An Observational Cohort Feasibility Study

Abstract

BACKGROUND: An impedance threshold device (ITD) intended for use in the spontaneously breathing patient has been shown to raise blood pressure in hypotensive patients. This device has not been evaluated in patients with hypotension secondary to trauma. This study focused on changes in key vital signs when the ITD was added to the paramedic treatment protocol for hypotensive patients with prehospital traumatic injury. METHODS: A 6-month prospective nonrandomized observational cohort study was conducted of 200 spontaneously breathing symptomatic adult patients with prehospital hypotension due to multiple causes; the patients of primary interest experienced a traumatic injury. Upon determination of hypotension (systolic blood pressure of approximately e90mmHg), standard therapy was initiated by application of the mask-style ITD. Vital signs were documented every 2 minutes to 5 minutes after intervention. A change in mean arterial pressure (MAP) with ITD use was the primary study endpoint. RESULTS: Of the 200 hypotensive subjects treated, 29 (3 were excluded because of incomplete data sets and 3 patients treated with the ITD were excluded because their blood pressure did not meet inclusion criterion) were hypotensive secondary to trauma.

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Document Details

Document Type
Technical Report
Publication Date
Sep 09, 2014
Accession Number
ADA620246

Entities

People

  • Craig Manifold
  • David Wampler
  • Jacob Larrumbide
  • Michael Hernandez
  • Shannon Weeks
  • Victor A Convertino

Organizations

  • United States Army Institute of Surgical Research

Tags

DTIC Thesaurus Topics

  • Blood
  • Cardiovascular Diseases
  • Cardiovascular Physiological Phenomena
  • Cardiovascular System
  • Casualties
  • Feasibility Studies
  • Health Services
  • Hemorrhagic Shock
  • Hypotension
  • Impedance
  • Medical Personnel
  • Paramedics
  • Respiration
  • Therapy
  • United States
  • Vascular Diseases
  • Vital Signs

Fields of Study

  • Medicine

Readers

  • Auditory Neuroscience/Auditory Physiology.
  • Systems Analysis and Design
  • Trauma or Military Medicine