Suppression of the cardiopulmonary resuscitation artefacts using the instantaneous chest compression rate extracted from the thoracic impedance
Suppression of the cardiopulmonary resuscitation artefacts using the instantaneous chest compression rate extracted from the thoracic impedance
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DOI：
10.1016/j.resuscitation.2011.11.029
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发表时间：
2012-06-01
期刊：
影响因子：
6.5
通讯作者：
Kramer-Johansen, J.
中科院分区：
文献类型：
--
作者：
Aramendi, E.;Ayala, U.;Kramer-Johansen, J.
目的：证明通过经胸阻抗(TTI)可以准确地估计瞬时胸腔按压率，并将该估计率用于抑制心肺复苏(CPR)伪影的方法。方法：分析372例院外心脏骤停记录，87例可电击和285例非电击，这些记录来自心肺复苏(CPR)伪影。每个记录包括从除颤垫获得的心电图和TTI，以及从胸骨CPR垫获得的压迫深度(CD)。比较TTI和CD估计的胸部按压比。然后，使用从TTI或CD信号估计的瞬时胸压比率来过滤CPR伪影。根据商业自动体外除颤器的休克建议算法的敏感性和特异性来评估过滤结果。结果：用TTI和CD估计的平均胸压比率之间的相关性为r=0.98(95%可信区间为0.97~0.98)。CD筛选后的敏感性为95.4%(88.4~98.6%)，特异性为87.0%(82.6~90.5%)。TTI筛选后的敏感性和特异性分别为95.4%(88.4~98.6%)和86.3%(81.8~89.9%)。过滤后的灵敏度和特异度与CD信号相似。我们的CPR抑制方法完全基于通过除颤器获得的信号，与基于CPR反馈设备获得的信号的方法一样准确。(C)2011爱思唯尔爱尔兰有限公司。保留所有权利。
Aim: To demonstrate that the instantaneous chest compression rate can be accurately estimated from the transthoracic impedance (TTI), and that this estimated rate can be used in a method to suppress cardiopulmonary resuscitation (CPR) artefacts.Methods: A database of 372 records, 87 shockable and 285 non-shockable, from out-of-hospital cardiac arrest episodes, corrupted by CPR artefacts, was analysed. Each record contained the ECG and TTI obtained from the defibrillation pads and the compression depth (CD) obtained from a sternal CPR pad. The chest compression rates estimated using TTI and CD were compared. The CPR artefacts were then filtered using the instantaneous chest compression rates estimated from the TTI or CD signals. The filtering results were assessed in terms of the sensitivity and specificity of the shock advice algorithm of a commercial automated external defibrillator.Results: The correlation between the mean chest compression rates estimated using TTI or CD was r = 0.98 (95% confidence interval, 0.97-0.98). The sensitivity and specificity after filtering using CD were 95.4% (88.4-98.6%) and 87.0% (82.6-90.5%), respectively. The sensitivity and specificity after filtering using TTI were 95.4% (88.4-98.6%) and 86.3% (81.8-89.9%), respectively.Conclusions: The instantaneous chest compression rate can be accurately estimated from TTI. The sensitivity and specificity after filtering are similar to those obtained using the CD signal. Our CPR suppression method based exclusively on signals acquired through the defibrillation pads is as accurate as methods based on signals obtained from CPR feedback devices. (C) 2011 Elsevier Ireland Ltd. All rights reserved.