Circulation assessment by automated external defibrillators during cardiopulmonary resuscitation.
Resuscitation
; 128: 158-163, 2018 07.
Article
em En
| MEDLINE
| ID: mdl-29733921
ABSTRACT
AIM:
To design and evaluate a simple algorithm able to discriminate pulsatile rhythms from pulseless electrical activity during automated external defibrillator (AED) analysis intervals, using the ECG and the transthoracic impedance (TI) acquired from defibrillation pads.METHODS:
ECG and TI signals from out-of-hospital AED recordings were retrospectively analysed. Experts annotated the cardiac rhythm during AED analysis intervals and at the end of each episode. We developed an algorithm to classify 3-s segments of non-shockable and non-asystole rhythms as either pulsatile rhythm or pulseless electrical activity. The algorithm consisted on a decision tree based on two features the mean power of the TI segment and the mean cross-power between ECG and TI segments.RESULTS:
From the 302 annotated episodes, 167 contained segments eligible for the study. The circulation detector algorithm presented a sensitivity (ability of detecting pulsatile rhythms) of 98.3% (95% CI 95.1-100) and a specificity (ability to detect pulseless electrical activity) of 98.4% (95% CI 97.1-99.8) in the validation subset. Absence of pulsatile rhythm was confirmed during the first AED analysis interval in 98.9% of the episodes, and presence of a pulse was confirmed in the first 3â¯s of all intervals with annotated return of spontaneous circulation.CONCLUSION:
Accurate automated detection of circulation based on TI and ECG is possible during AED analysis intervals. This functionality could potentially contribute to enhance patient's care by laypersons using AEDs.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Fluxo Pulsátil
/
Cardiografia de Impedância
/
Desfibriladores
/
Eletrocardiografia
/
Parada Cardíaca Extra-Hospitalar
Tipo de estudo:
Observational_studies
/
Prognostic_studies
Limite:
Female
/
Humans
/
Male
Idioma:
En
Ano de publicação:
2018
Tipo de documento:
Article