Impedance-Based Ventilation Detection and Signal Quality Control During Out-of-Hospital Cardiopulmonary Resuscitation

Jaureguibeitia, Xabier; Aramendi, Elisabete; Wang, Henry E.; Idris, Ahamed H.

doi:10.1109/jbhi.2023.3253780

Cited by 4 publications

(3 citation statements)

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“…For group 1 and group 2, respectively, the median (Q1, Q3) number of pauses per minute was 1.3 (0.8, 1.8) versus 1.4 (0.9, 1.9 (nonsignificant [NS]), the median number of pauses over the time period assessed by the study was 12 (7,19) versus 12 (7, 17; NS), whereas the median number of ventilations was 2 (1, 5) versus 12 (6, 21; P<0.0001; Table 2). Furthermore, for group 1 versus group 2, respectively, the median duration of pauses was 5.8 s (5.0, 6.7) versus 5.8 s (5.1, 6.8; NS).…”

Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

“…A detectable bioimpedance ventilation waveform has a bioimpedance amplitude of ≥0.5 Ω, with a duration ≥1 s. Our ventilation detection method has a sensitivity of >90% and a positive predictive value of >90% compared with capnography. [18][19][20] Previous studies showed that >250 mL is a reasonable minimum tidal volume that can result in gas exchange. 21 The threshold of 250 mL approximates the minimum amount of tidal volume needed to overcome anatomical and physiological dead space and produce clinically meaningful gas exchange.…”

Section: Ventilation Waveform Analysismentioning

confidence: 99%

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Bag-Valve-Mask Ventilation and Survival From Out-of-Hospital Cardiac Arrest: A Multicenter Study

Idris,

Aramendi Ecenarro,

Leroux

et al. 2023

Circulation

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Background: Few studies have measured ventilation during early cardiopulmonary resuscitation (CPR) before advanced airway placement. Resuscitation guidelines recommend pauses after every 30 chest compressions to deliver ventilations. The effectiveness of bag-valve-mask ventilation delivered during the pause in chest compressions is unknown. We sought to determine: (1) the incidence of lung inflation with bag-valve-mask ventilation during 30:2 CPR; and (2) the association of ventilation with outcomes after out-of-hospital cardiac arrest. Methods: We studied patients with out-of-hospital cardiac arrest from 6 sites of the Resuscitation Outcomes Consortium CCC study (Trial of Continuous Compressions versus Standard CPR in Patients with Out-of-Hospital Cardiac Arrest). We analyzed patients assigned to the 30:2 CPR arm with ≥2 minutes of thoracic bioimpedance signal recorded with a cardiac defibrillator/monitor. Detectable ventilation waveforms were defined as having a bioimpedance amplitude ≥0.5 Ω (corresponding to ≥250 mL V T ) and a duration ≥1 s. We defined a chest compression pause as a 3- to 15-s break in chest compressions. We compared the incidence of ventilation and outcomes in 2 groups: patients with ventilation waveforms in <50% of pauses (group 1) versus those with waveforms in ≥50% of pauses (group 2). Results: Among 1976 patients, the mean age was 65 years; 66% were male. From the start of chest compressions until advanced airway placement, mean±SD duration of 30:2 CPR was 9.8±4.9 minutes. During this period, we identified 26861 pauses in chest compressions; 60% of patients had ventilation waveforms in <50% of pauses (group 1, n=1177), and 40% had waveforms in ≥50% of pauses (group 2, n=799). Group 1 had a median of 12 pauses and 2 ventilations per patient versus group 2, which had 12 pauses and 12 ventilations per patient. Group 2 had higher rates of prehospital return of spontaneous circulation (40.7% versus 25.2%; P <0.0001), survival to hospital discharge (13.5% versus 4.1%; P <0.0001), and survival with favorable neurological outcome (10.6% versus 2.4%; P <0.0001). These associations persisted after adjustment for confounders. Conclusions: In this study, lung inflation occurred infrequently with bag-valve-mask ventilation during 30:2 CPR. Lung inflation in ≥50% of pauses was associated with improved return of spontaneous circulation, survival, and survival with favorable neurological outcome.

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Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%