Background: Devices that measure ventilation in the pre-hospital setting are deficient especially during early cardiopulmonary resuscitation (CPR) before placement of an advanced airway. Consequently, evidence is limited regarding the role of ventilation during early CPR and its effect on outcomes.
Objective: To develop software that automatically identifies ventilation waveforms recorded by defibrillators based on changes in transthoracic impedance during standard CPR.
Methods: This was an observational, retrospective analysis of non-traumatic pre-hospital cardiac arrest patients who received 30:2 CPR by emergency medical service rescuers. Data was collected from 550 cases recorded by the bioimpedance channel of defibrillators. Two expert clinicians independently assessed all episodes from the time of initial CPR until placement of an advanced airway, defined acceptable ventilation waveforms, and annotated the pauses between compressions with ventilation waveforms. We then developed software that incorporated the expert criteria and automatically annotated pauses with acceptable ventilations.
Results: A total of 7396 pauses were analyzed, mean(SD) duration of 30:2 CPR was 13 (8) min, with 13 (10) pauses/patient, and mean pause duration of 6 (3) s. Reviewer 1 and reviewer 2 identified 2375 and 2249 pauses with any acceptable ventilation, respectively, with an inter-rater reliability of 0.94. The novel software program reproduced expert annotation with excellent agreement (>0.8) and high accuracy, both sensitivity and specificity above 90%, compared to two reviewers. The software presented a substantial agreement with the reviewers (κ > 0.73) for ventilation counts in the pauses.
Conclusion: We developed a novel and reliable strategy that enables investigation of ventilation quality during standard CPR using thoracic bioimpedance. This strategy would allow a timely and reliable automatic annotation of large scale resuscitation datasets.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.resuscitation.2018.08.016 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Optimizing Mechanical Ventilation: A Clinical and Practical Bedside Method for the Identification and Management of Patient-Ventilator Asynchronies in Critical Care.
J Clin Med
January 2025
Department of Critical Care Medicine, Hospital de São Francisco Xavier, Unidade Local de Saúde Lisboa Ocidental (ULSLO), Estrada Forte do Alto Duque, 1449-005 Lisbon, Portugal.
The prompt identification and correction of patient-ventilator asynchronies (PVA) remain a cornerstone for ensuring the quality of respiratory failure treatment and the prevention of further injury to critically ill patients. These disruptions, whether due to over- or under-assistance, have a profound clinical impact not only on the respiratory mechanics and the mortality associated with mechanical ventilation but also on the patient's cardiac output and hemodynamic profile. Strong evidence has demonstrated that these frequently occurring and often underdiagnosed events have significant prognostic value for mechanical ventilation outcomes and are strongly associated with prolonged ICU stays and hospital mortality.
View Article and Find Full Text PDFA rare phenomenon involving ventricular separation: a case report.
BMC Cardiovasc Disord
December 2024
Department of Electrocardiology, The Third Affiliated Hospital of Wenzhou Medical University, No.108 WansongRoad, Wenzhou, 325200, People's Republic of China.
Background: Ventricular separation is a multipart, extensive disease of the heart that hinders the electrical conduction of the cardiac system ventricular muscle, causing a bidirectional conduction block. The occurrence of ventricular separation suggests that the myocardium is in a state of severe ischemia, and the prognosis is generally poor. Herein, we present arescue case in which the extremely rare phenomenon of ventricular separation developed and was documented in realtime.
View Article and Find Full Text PDFManaging Intracranial Pressure Crisis.
Curr Neurol Neurosci Rep
December 2024
Division of Critical Care, Department of Medicine, Siriraj Hospital, Mahidol University, 2 Wanglang Road, Bangkok, 10700, Thailand.
Article Synopsis
- The review aims to establish a detailed management protocol for treating intracranial pressure (ICP) crises based on the latest research findings.
- It highlights crucial elements of critical care for ICP management, including ventilation, fluid therapy, and ICP monitoring, which can significantly influence patient outcomes.
- The article suggests that ongoing research is needed to create effective intervention protocols for both invasive and noninvasive neuromonitoring techniques in ICP cases.
A Technique for Monitoring Mechanically Ventilated Patient Lung Conditions.
Diagnostics (Basel)
November 2024
Faculty of Engineering, North-West University, Potchefstroom 2531, South Africa.
Background: Mechanical ventilation is a critical but resource-intensive treatment. Automated tools are common in screening diagnostics, whereas real-time, continuous trend analysis in mechanical ventilation remains rare. Current techniques for monitoring lung conditions are often invasive, lack accuracy, and fail to isolate respiratory resistance-making them impractical for continuous monitoring and diagnosis.
View Article and Find Full Text PDFFocus on POCUS: Identification of Early Successful Intubation by Point-of-Care Ultrasound Versus End-Tidal Carbon Dioxide: A Prospective Comparative Study.
Turk J Anaesthesiol Reanim
December 2024
Sri Ramachandra Institute of Higher Education and Research, Department of Anaesthesiology and Pain Medicine, Chennai, Tamilnadu, India.
Objective: Successful endotracheal intubation is a key step in advanced airway management. The gold standard confirmation for successful endotracheal intubation is end-tidal carbon dioxide (etCO) monitoring, although recent studies suggest that ultrasound can also be used. In this study, we explored the time-sensitive early recognition of successful endotracheal intubation by comparing ultrasound and etCO monitoring.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!