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Pulse Oximetry: A Non-Invasive, Novel Marker for the Quality of Chest Compressions in Porcine Models of Cardiac Arrest.

Xu J, Li C, Zheng L, Han F, Li Y, Walline J, Fu Y, Yao D, Zhang X, Zhang H, Zhu H, Guo S, Wang Z, Yu X - PLoS ONE (2015)

Bottom Line: The FCPR was lower than the frequency of mechanical CPR at the 6th and the 9th minute of CPR.The frequency of POP closely matched the CPR heart rate.AUC and Amp of POP might be potential noninvasive quality monitoring markers for CPR.

View Article: PubMed Central - PubMed

Affiliation: Emergency Department, Peking Union Medical College Hospital, Chinese Academy of Medical sciences, Beijing, China.

ABSTRACT

Objective: Pulse oximetry, which noninvasively detects the blood flow of peripheral tissue, has achieved widespread clinical use. We have noticed that the better the quality of cardiopulmonary resuscitation (CPR), the better the appearance of pulse oximetry plethysmographic waveform (POP). We investigated whether the area under the curve (AUC) and/or the amplitude (Amp) of POP could be used to monitor the quality of CPR.

Design: Prospective, randomized controlled study.

Setting: Animal experimental center in Peking Union Medical Collage Hospital, Beijing, China.

Subjects: Healthy 3-month-old male domestic swine.

Interventions: 34 local pigs were enrolled in this study. After 4 minutes of untreated ventricular fibrillation, animals were randomly assigned into two resuscitation groups: a "low quality" group (with a compression depth of 3cm) and a "high quality" group (with a depth of 5cm). All treatments between the two groups were identical except for the depth of chest compressions. Hemodynamic parameters [coronary perfusion pressure (CPP), partial pressure of end-tidal carbon dioxide (PETCO2)] as well as AUC and Amp of POP were all collected and analyzed.

Measurements and findings: There were statistical differences between the "high quality" group and the "low quality" group in AUC, Amp, CPP and PETCO2 during CPR (P<0.05). AUC, Amp and CPP were positively correlated with PETCO2, respectively (P<0.01). There was no statistical difference between the heart rate calculated according to the POP (FCPR) and the frequency of mechanical CPR at the 3rd minute of CPR. The FCPR was lower than the frequency of mechanical CPR at the 6th and the 9th minute of CPR.

Conclusions: Both the AUC and Amp of POP correlated well with CPP and PETCO2 in animal models. The frequency of POP closely matched the CPR heart rate. AUC and Amp of POP might be potential noninvasive quality monitoring markers for CPR.

No MeSH data available.


Related in: MedlinePlus

The arterial waveform and POP during different stages of CPR A.The arterial waveform and POP during spontaneous circulation at baseline; B. Both the arterial waveform and POP disappeared during VF; C. The arterial waveform and POP during low quality resuscitation; D. The arterial waveform and POP during high quality resuscitation.
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pone.0139707.g002: The arterial waveform and POP during different stages of CPR A.The arterial waveform and POP during spontaneous circulation at baseline; B. Both the arterial waveform and POP disappeared during VF; C. The arterial waveform and POP during low quality resuscitation; D. The arterial waveform and POP during high quality resuscitation.

Mentions: When VF was induced, both the regular aortic blood pressure waveform and the POP disappeared, as shown in Fig 2. Correspondingly, the CPP, HR, AUC and Amp of POP all declined to zero suddenly. Similarly, PETCO2 also decreased to zero after 3 minutes of untreated VF.


Pulse Oximetry: A Non-Invasive, Novel Marker for the Quality of Chest Compressions in Porcine Models of Cardiac Arrest.

Xu J, Li C, Zheng L, Han F, Li Y, Walline J, Fu Y, Yao D, Zhang X, Zhang H, Zhu H, Guo S, Wang Z, Yu X - PLoS ONE (2015)

The arterial waveform and POP during different stages of CPR A.The arterial waveform and POP during spontaneous circulation at baseline; B. Both the arterial waveform and POP disappeared during VF; C. The arterial waveform and POP during low quality resuscitation; D. The arterial waveform and POP during high quality resuscitation.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4613139&req=5

pone.0139707.g002: The arterial waveform and POP during different stages of CPR A.The arterial waveform and POP during spontaneous circulation at baseline; B. Both the arterial waveform and POP disappeared during VF; C. The arterial waveform and POP during low quality resuscitation; D. The arterial waveform and POP during high quality resuscitation.
Mentions: When VF was induced, both the regular aortic blood pressure waveform and the POP disappeared, as shown in Fig 2. Correspondingly, the CPP, HR, AUC and Amp of POP all declined to zero suddenly. Similarly, PETCO2 also decreased to zero after 3 minutes of untreated VF.

Bottom Line: The FCPR was lower than the frequency of mechanical CPR at the 6th and the 9th minute of CPR.The frequency of POP closely matched the CPR heart rate.AUC and Amp of POP might be potential noninvasive quality monitoring markers for CPR.

View Article: PubMed Central - PubMed

Affiliation: Emergency Department, Peking Union Medical College Hospital, Chinese Academy of Medical sciences, Beijing, China.

ABSTRACT

Objective: Pulse oximetry, which noninvasively detects the blood flow of peripheral tissue, has achieved widespread clinical use. We have noticed that the better the quality of cardiopulmonary resuscitation (CPR), the better the appearance of pulse oximetry plethysmographic waveform (POP). We investigated whether the area under the curve (AUC) and/or the amplitude (Amp) of POP could be used to monitor the quality of CPR.

Design: Prospective, randomized controlled study.

Setting: Animal experimental center in Peking Union Medical Collage Hospital, Beijing, China.

Subjects: Healthy 3-month-old male domestic swine.

Interventions: 34 local pigs were enrolled in this study. After 4 minutes of untreated ventricular fibrillation, animals were randomly assigned into two resuscitation groups: a "low quality" group (with a compression depth of 3cm) and a "high quality" group (with a depth of 5cm). All treatments between the two groups were identical except for the depth of chest compressions. Hemodynamic parameters [coronary perfusion pressure (CPP), partial pressure of end-tidal carbon dioxide (PETCO2)] as well as AUC and Amp of POP were all collected and analyzed.

Measurements and findings: There were statistical differences between the "high quality" group and the "low quality" group in AUC, Amp, CPP and PETCO2 during CPR (P<0.05). AUC, Amp and CPP were positively correlated with PETCO2, respectively (P<0.01). There was no statistical difference between the heart rate calculated according to the POP (FCPR) and the frequency of mechanical CPR at the 3rd minute of CPR. The FCPR was lower than the frequency of mechanical CPR at the 6th and the 9th minute of CPR.

Conclusions: Both the AUC and Amp of POP correlated well with CPP and PETCO2 in animal models. The frequency of POP closely matched the CPR heart rate. AUC and Amp of POP might be potential noninvasive quality monitoring markers for CPR.

No MeSH data available.


Related in: MedlinePlus