Abstract
BACKGROUND: Newer guidelines address the importance of effective chest compressions, citing evidence that this primary intervention is usually suboptimally performed during cardiopulmonary resuscitation. We therefore sought a readily available option for monitoring the effectiveness of chest compressions, specifically using the electrocardiogram. METHODS AND RESULTS: Ventricular fibrillation was induced by coronary artery occlusion and untreated for 5 mins. Male domestic pigs weighing 40 ± 2 kg were randomized to optimal or suboptimal chest compressions after onset of ventricular fibrillation. Optimal depth of mechanical compression in six animals was defined as a decrease of 25% in anterior posterior diameter of the chest during compression. Suboptimal compression, also in six animals, was defined as a decrease of 17.5% in anterior posterior diameter. For each group, the chest compressions were maintained at a rate of 100 per min. After 3 mins of chest compression, defibrillation was attempted with a 150-J biphasic shock.All animals had return of spontaneous circulation after optimal compressions. This contrasted with suboptimal compressions, after which none of the animals had return of spontaneous circulation. Amplitude spectrum area values, representing the electrocardiographic amplitude frequency spectral area computed from conventional precordial leads, like coronary perfusion pressure and end tidal Pco2, were predictive of outcomes. CONCLUSION: The effectiveness of chest compressions was reflected in the amplitude spectrum area values. Accordingly, the amplitude spectrum area predictor may be incorporated in current automated external defibrillators to monitor and prompt the effectiveness of chest compression during cardiopulmonary resuscitation.
| Original language | English |
|---|---|
| Pages (from-to) | 211-215 |
| Number of pages | 5 |
| Journal | Critical Care Medicine |
| Volume | 36 |
| Issue number | 1 |
| DOIs | |
| Publication status | Published - Jan 2008 |
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Keywords
- Amplitude spectrum area
- Cardiac arrest
- Cardiopulmonary resuscitation
- Chest compression
- Electrocardiogram waveforms
ASJC Scopus subject areas
- Critical Care and Intensive Care Medicine
Cite this
Electrocardiogram waveforms for monitoring effectiveness of chest compression during cardiopulmonary resuscitation. / Li, Yongqin; Ristagno, Giuseppe; Bisera, Joe; Tang, Wanchun; Deng, Qinkai; Weil, Max Harry.
In: Critical Care Medicine, Vol. 36, No. 1, 01.2008, p. 211-215.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Electrocardiogram waveforms for monitoring effectiveness of chest compression during cardiopulmonary resuscitation
AU - Li, Yongqin
AU - Ristagno, Giuseppe
AU - Bisera, Joe
AU - Tang, Wanchun
AU - Deng, Qinkai
AU - Weil, Max Harry
PY - 2008/1
Y1 - 2008/1
N2 - BACKGROUND: Newer guidelines address the importance of effective chest compressions, citing evidence that this primary intervention is usually suboptimally performed during cardiopulmonary resuscitation. We therefore sought a readily available option for monitoring the effectiveness of chest compressions, specifically using the electrocardiogram. METHODS AND RESULTS: Ventricular fibrillation was induced by coronary artery occlusion and untreated for 5 mins. Male domestic pigs weighing 40 ± 2 kg were randomized to optimal or suboptimal chest compressions after onset of ventricular fibrillation. Optimal depth of mechanical compression in six animals was defined as a decrease of 25% in anterior posterior diameter of the chest during compression. Suboptimal compression, also in six animals, was defined as a decrease of 17.5% in anterior posterior diameter. For each group, the chest compressions were maintained at a rate of 100 per min. After 3 mins of chest compression, defibrillation was attempted with a 150-J biphasic shock.All animals had return of spontaneous circulation after optimal compressions. This contrasted with suboptimal compressions, after which none of the animals had return of spontaneous circulation. Amplitude spectrum area values, representing the electrocardiographic amplitude frequency spectral area computed from conventional precordial leads, like coronary perfusion pressure and end tidal Pco2, were predictive of outcomes. CONCLUSION: The effectiveness of chest compressions was reflected in the amplitude spectrum area values. Accordingly, the amplitude spectrum area predictor may be incorporated in current automated external defibrillators to monitor and prompt the effectiveness of chest compression during cardiopulmonary resuscitation.
AB - BACKGROUND: Newer guidelines address the importance of effective chest compressions, citing evidence that this primary intervention is usually suboptimally performed during cardiopulmonary resuscitation. We therefore sought a readily available option for monitoring the effectiveness of chest compressions, specifically using the electrocardiogram. METHODS AND RESULTS: Ventricular fibrillation was induced by coronary artery occlusion and untreated for 5 mins. Male domestic pigs weighing 40 ± 2 kg were randomized to optimal or suboptimal chest compressions after onset of ventricular fibrillation. Optimal depth of mechanical compression in six animals was defined as a decrease of 25% in anterior posterior diameter of the chest during compression. Suboptimal compression, also in six animals, was defined as a decrease of 17.5% in anterior posterior diameter. For each group, the chest compressions were maintained at a rate of 100 per min. After 3 mins of chest compression, defibrillation was attempted with a 150-J biphasic shock.All animals had return of spontaneous circulation after optimal compressions. This contrasted with suboptimal compressions, after which none of the animals had return of spontaneous circulation. Amplitude spectrum area values, representing the electrocardiographic amplitude frequency spectral area computed from conventional precordial leads, like coronary perfusion pressure and end tidal Pco2, were predictive of outcomes. CONCLUSION: The effectiveness of chest compressions was reflected in the amplitude spectrum area values. Accordingly, the amplitude spectrum area predictor may be incorporated in current automated external defibrillators to monitor and prompt the effectiveness of chest compression during cardiopulmonary resuscitation.
KW - Amplitude spectrum area
KW - Cardiac arrest
KW - Cardiopulmonary resuscitation
KW - Chest compression
KW - Electrocardiogram waveforms
UR - http://www.scopus.com/inward/record.url?scp=37549012158&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=37549012158&partnerID=8YFLogxK
U2 - 10.1097/01.CCM.0000295594.93345.A2
DO - 10.1097/01.CCM.0000295594.93345.A2
M3 - Article
C2 - 18090357
AN - SCOPUS:37549012158
VL - 36
SP - 211
EP - 215
JO - Critical Care Medicine
JF - Critical Care Medicine
SN - 0090-3493
IS - 1
ER -