Document Detail


Capnography and chest-wall impedance algorithms for ventilation detection during cardiopulmonary resuscitation.
MedLine Citation:
PMID:  20036047     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Hyperventilation is both common and detrimental during cardiopulmonary resuscitation (CPR). Chest-wall impedance algorithms have been developed to detect ventilations during CPR. However, impedance signals are challenged by noise artifact from multiple sources, including chest compressions. Capnography has been proposed as an alternate method to measure ventilations. We sought to assess and compare the adequacy of these two approaches.
METHODS: Continuous chest-wall impedance and capnography were recorded during consecutive in-hospital cardiac arrests. Algorithms utilizing each of these data sources were compared to a manually determined "gold standard" reference ventilation rate. In addition, a combination algorithm, which utilized the highest of the impedance or capnography values in any given minute, was similarly evaluated.
RESULTS: Data were collected from 37 cardiac arrests, yielding 438min of data with continuous chest compressions and concurrent recording of impedance and capnography. The manually calculated mean ventilation rate was 13.3+/-4.3/min. In comparison, the defibrillator's impedance-based algorithm yielded an average rate of 11.3+/-4.4/min (p=0.0001) while the capnography rate was 11.7+/-3.7/min (p=0.0009). There was no significant difference in sensitivity and positive predictive value between the two methods. The combination algorithm rate was 12.4+/-3.5/min (p=0.02), which yielded the highest fraction of minutes with respiratory rates within 2/min of the reference. The impedance signal was uninterpretable 19.5% of the time, compared with 9.7% for capnography. However, the signals were only simultaneously non-interpretable 0.8% of the time.
CONCLUSIONS: Both the impedance and capnography-based algorithms underestimated the ventilation rate. Reliable ventilation rate determination may require a novel combination of multiple algorithms during resuscitation.
Authors:
Dana P Edelson; Joar Eilevstjønn; Elizabeth K Weidman; Elizabeth Retzer; Terry L Vanden Hoek; Benjamin S Abella
Related Documents :
16215137 - The validity of bioelectrical impedance models in clinical populations.
19522677 - Operational equivalence of bioimpedance indices and perometry for the assessment of uni...
17722227 - Nanoparticles-a thoracic toxicology perspective.
1629097 - Physical models of the smaller pulmonary airways.
12047667 - Comparison between medical students' experience, confidence and competence.
20795897 - A critical review of the biological mechanisms underlying the in vivo and in vitro toxi...
Publication Detail:
Type:  Comparative Study; Evaluation Studies; Journal Article; Research Support, N.I.H., Extramural     Date:  2009-12-29
Journal Detail:
Title:  Resuscitation     Volume:  81     ISSN:  1873-1570     ISO Abbreviation:  Resuscitation     Publication Date:  2010 Mar 
Date Detail:
Created Date:  2010-02-17     Completed Date:  2010-05-04     Revised Date:  2011-09-26    
Medline Journal Info:
Nlm Unique ID:  0332173     Medline TA:  Resuscitation     Country:  Ireland    
Other Details:
Languages:  eng     Pagination:  317-22     Citation Subset:  IM    
Copyright Information:
Copyright 2009 Elsevier Ireland Ltd. All rights reserved.
Affiliation:
Section of Hospital Medicine, University of Chicago, Chicago, USA; Emergency Resuscitation Center, University of Chicago, Chicago, IL 60637, USA. dperes@medicine.bsd.uchicago.edu
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Algorithms*
Capnography*
Cardiography, Impedance*
Cardiopulmonary Resuscitation*
Female
Heart Arrest / physiopathology*,  therapy*
Heart Massage
Humans
Hyperventilation / diagnosis,  prevention & control
Inpatients*
Male
Middle Aged
Predictive Value of Tests
Prospective Studies
Respiration*
Respiratory Rate
Sensitivity and Specificity
Young Adult
Grant Support
ID/Acronym/Agency:
1K23HL097157-01/HL/NHLBI NIH HHS; 5K23HL083082-04/HL/NHLBI NIH HHS; K23 HL083082-04/HL/NHLBI NIH HHS; K23 HL097157-01/HL/NHLBI NIH HHS; L30 HL086229-01/HL/NHLBI NIH HHS
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Dominique-Jean Larrey: The effects of therapeutic hypothermia and the first ambulance.
Next Document:  Evaluation of transobturator tapes (E-TOT) study: randomised prospective single-blinded study compar...