| Capnography and chest-wall impedance algorithms for ventilation detection during cardiopulmonary resuscitation. | |
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MedLine Citation:
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PMID: 20036047 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Dana P Edelson; Joar Eilevstjønn; Elizabeth K Weidman; Elizabeth Retzer; Terry L Vanden Hoek; Benjamin S Abella |
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Publication Detail:
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Type: Comparative Study; Evaluation Studies; Journal Article; Research Support, N.I.H., Extramural Date: 2009-12-29 |
Journal Detail:
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Title: Resuscitation Volume: 81 ISSN: 1873-1570 ISO Abbreviation: Resuscitation Publication Date: 2010 Mar |
Date Detail:
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Created Date: 2010-02-17 Completed Date: 2010-05-04 Revised Date: 2011-09-26 |
Medline Journal Info:
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Nlm Unique ID: 0332173 Medline TA: Resuscitation Country: Ireland |
Other Details:
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Languages: eng Pagination: 317-22 Citation Subset: IM |
Copyright Information:
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Copyright 2009 Elsevier Ireland Ltd. All rights reserved. |
Affiliation:
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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:
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| MeSH Terms | |
Descriptor/Qualifier:
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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:
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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 | |
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