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 the vacuum in the chest to help 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 Affects Circulation

The human body continually regulates the circulation of blood whenever we breathe. When we inhale, a negative pressure (or 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. This process is called negative intrathoracic pressure. Then, when we exhale, we experience positive intrathoracic pressure. 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 utilizes this inverse relationship to improve circulation in patients who require better perfusion to the brain and vital organs. When IPR is used to treat states of low blood flow, it helps to improve perfusion to vital organs, which can help to improve outcomes.3

IPR Therapy and Resuscitation In Practice

IPR therapy can be used to treat hypotension due to hemorrhage, shock, dehydration or sepsis. It is done by attaching an impedance threshold device (ITD), such as the ResQGARD® ITD, to a facemask and placing it on the patient to breathe through normally. ResQGARD has been shown to increase blood pressure by up to 30%, which could help prevent death by hemorrhage.

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 25-40% 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.

For more information on IPR therapy, watch our video below:

1https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3152622/
2Moreno AH, et al. Am J Physiol. 1967;213(2):455-465.
3Studies available upon request. The generally cleared indication for use of the ResQPOD® ITD 10 available for sale in the United States (U.S.) 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.

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