Reliability and accuracy of the thoracic impedance signal for measuring cardiopulmonary resuscitation quality metrics

Alonso, Erik; Ruiz, J.; Aramendi, Elisabete; González-Otero, Digna M.; Gauna, Sofía Ruiz de; Ayala, Unai; Russell, James K.; Daya, Mohamud

doi:10.1016/j.resuscitation.2014.11.027

Cited by 42 publications

(29 citation statements)

References 36 publications

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“…Alonso et al used 61 episodes from the TVF&R database and reported a mean Se of 97.2% and a PPV value of 97.7% with the 31 episodes of the test set. After adjusting the feedback intervals to 1.5 s, Alonso et al 15 reported less than 6% of feedback intervals with an error above 10%. Both detection systems present the limitation of having been optimized and tested on OHCA episodes from the same database.…”

Section: Performance Of the Methodsmentioning

confidence: 99%

“…The SISTER and TVF&R databases included a force signal that was acquired using an auxiliary chest pad containing an accelerometer and a pressure sensor. 20,15 We extracted the episodes that had the required signals correctly recorded and with at least 1000 CCs: 156/364 in Sister, 136/623 in TVF&R and 267/370 in Oslo EMS. We randomly selected 60 episodes per database for annotation and review, a sample expected to be sufficient to make clinically relevant distinctions based on our prior experience.…”

Section: Data Collectionmentioning

confidence: 99%

“…We randomly selected 60 episodes per database for annotation and review, a sample expected to be sufficient to make clinically relevant distinctions based on our prior experience. 14,15 CC instants were annotated in the 180 episodes used in the study. For the Sister and TVF&R episodes we applied an automatic peak detector on the force signal with a fixed threshold of 2 kg.…”

Section: Data Collectionmentioning

confidence: 99%

“…13 Recently, automatic detectors of individual CCs in the TTI signal have been developed. 14,15 Each TTI fluctuation was automatically classified as CC or not, depending on its amplitude and duration. The ability of the algorithm to provide feedback on CC-rate was http determined.…”

Section: Introductionmentioning

confidence: 99%

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Chest compression rate feedback based on transthoracic impedance

et al. 2015

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Section: Performance Of the Methodsmentioning

confidence: 99%

Section: Data Collectionmentioning

confidence: 99%

Section: Data Collectionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Chest compression rate feedback based on transthoracic impedance

et al. 2015

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“…• Circulation component: the impedance shows a small fluctuation (<100 mΩ ) with each effective heartbeat [26,28,29].…”

Section: Thoracic Impedance For Ventilation Monitoringmentioning

confidence: 99%

Noninvasive Monitoring of Manual Ventilation during Out-of- Hospital Cardiopulmonary Resuscitation

Elola¹,

Alonso²,

Aramendi³

et al. 2019

Noninvasive Ventilation in Medicine - Recent Updates

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Cardiopulmonary resuscitation (CPR) consisting of chest compressions and assisted ventilation is crucial to treat out-of-hospital cardiac arrest (OHCA). It is well reported that quality of manual ventilations, in terms of rate and volume, is suboptimal, with a high incidence of hyperventilation, which is linked to poor outcomes. The lack of a noninvasive technology to monitor ventilations during out-of-hospital CPR precludes feedback on ventilations to the rescuer, and it handicaps the evaluation of the effect of ventilations on the outcome of the patient. This chapter addresses the possibilities and challenges of monitoring the quality of manual ventilations in current defibrillators. Methods are proposed to monitor ventilations based on the thoracic impedance and the capnogram. These methods can be integrated in defibrillators used in both basic and advanced life support. The algorithms are described, and the accuracy of the methods to monitor the ventilation rate and the quality metrics of the ventilations is reported using real OHCA episodes. The accuracy and limitations of the methods as well as the implications of integrating them in the treatment of patients in cardiac arrest are discussed.

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A review of ventilation in adult out‐of‐hospital cardiac arrest

et al. 2020

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Out‐of‐hospital cardiac arrest continues to be a devastating condition despite advances in resuscitation care. Ensuring effective gas exchange must be weighed against the negative impact hyperventilation can have on cardiac physiology and survival. The goals of this narrative review are to evaluate the available evidence regarding the role of ventilation in out‐of‐hospital cardiac arrest resuscitation and to provide recommendations for future directions. Ensuring successful airway patency is fundamental for effective ventilation. The airway management approach should be based on professional skill level and the situation faced by rescuers. Evidence has explored the influence of different ventilation rates, tidal volumes, and strategies during out‐of‐hospital cardiac arrest; however, other modifiable factors affecting out‐of‐hospital cardiac arrest ventilation have limited supporting data. Researchers have begun to explore the impact of ventilation in adult out‐of‐hospital cardiac arrest outcomes, further stressing its importance in cardiac arrest resuscitation management. Capnography and thoracic impedance signals are used to measure ventilation rate, although these strategies have limitations. Existing technology fails to reliably measure real‐time clinical ventilation data, thereby limiting the ability to investigate optimal ventilation management. An essential step in advancing cardiac arrest care will be to develop techniques to accurately and reliably measure ventilation parameters. These devices should allow for immediate feedback for out‐of‐hospital practitioners, in a similar way to chest compression feedback. Once developed, new strategies can be established to guide out‐of‐hospital personnel on optimal ventilation practices.

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Reliability and accuracy of the thoracic impedance signal for measuring cardiopulmonary resuscitation quality metrics

Cited by 42 publications

References 36 publications

Chest compression rate feedback based on transthoracic impedance

Chest compression rate feedback based on transthoracic impedance

Noninvasive Monitoring of Manual Ventilation during Out-of- Hospital Cardiopulmonary Resuscitation

A review of ventilation in adult out‐of‐hospital cardiac arrest

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