Use of the impedance threshold device improves survival rate and neurological outcome in a swine model of asphyxial cardiac arrest

valve and 14 (93.3%) animals treated with the active valve (p .005, odds ratio: 21.0, 95% confidence interval: 2.16‐204.6). Neuron-specific enolase and S-100 levels increased in the ensuing 4 hrs post resuscitation in both groups, but they were significantly elevated in animals treated with the sham valve (p < .01). At 48 hrs, neurologic alertness score was significantly better in animals treated with the active valve (79.1 18.7 vs. 50 10, p < .05) and was strongly negatively correlated with 1- and 4-hr postresuscitation neuron-specific enolase (r .86, p < .001 and r .87, p < .001, respectively) and S-100 (r .77, p < .001 and r 0.8, p .001) values. Conclusions: In this model of asphyxial cardiac arrest, intermittent airway occlusion with the impedance threshold device during the decompression phase of active compression-decompression cardiopulmonary resuscitation significantly improved hemodynamic parameters, 24- and 48-hr survival, and neurologic outcome evaluated both with clinical and biochemical parameters (neuron-specific enolase, S-100). (Crit Care Med 2012; 40: 000‐000)