Ruiz de Gauna Sofia, Ruiz Jesus, Irusta Unai, Aramendi Elisabete, Eftestøl Trygve, Kramer-Johansen Jo
Department of Electronics and Telecommunications, University of the Basque Country, Alameda de Urquijo s/n, 48013-Bilbao, Spain.
Resuscitation. 2008 Feb;76(2):271-8. doi: 10.1016/j.resuscitation.2007.08.002. Epub 2007 Sep 17.
To show the possibility of using cardiopulmonary resuscitation (CPR) artefact suppression methods that do not need additional reference signals to model CPR artefacts.
A CPR suppression method based on a Kalman filter was designed. The artefact was modelled using the fundamental frequency of the compressions, estimated from the spectral analysis of the ECG. Artificial mixtures of human shockable rhythms and CPR artefacts were used to design the algorithm that was then tested on samples obtained from real out-of-hospital cardiac arrest episodes.
The shock/no-shock decision of an automated external defibrillator (AED) was evaluated before and after CPR suppression for 131 shockable and 347 non-shockable samples. The sensitivity improved from 56% (95% CI, 47-64%) to 90% (95% CI, 84-94%). However, the specificity decreased from 91% (95% CI, 87-93%) to 80% (95% CI, 76-84%).
CPR artefacts can be suppressed using methods based on the analysis of the ECG alone. The hardware of current AEDs does not need to be replaced, although better artefact suppression methods exist for modified AEDs with additional reference channels.
展示使用无需额外参考信号来模拟心肺复苏(CPR)伪迹的心肺复苏伪迹抑制方法的可能性。
设计了一种基于卡尔曼滤波器的心肺复苏抑制方法。利用从心电图频谱分析估计的按压基频对伪迹进行建模。使用人工混合的可电击心律和心肺复苏伪迹来设计算法,然后在从实际院外心脏骤停事件中获取的样本上进行测试。
对131个可电击样本和347个不可电击样本在心肺复苏抑制前后评估了自动体外除颤器(AED)的电击/非电击决策。敏感性从56%(95%CI,47 - 64%)提高到90%(95%CI,84 - 94%)。然而,特异性从91%(95%CI,87 - 93%)降至80%(95%CI,76 - 84%)。
仅基于心电图分析的方法可抑制心肺复苏伪迹。尽管具有额外参考通道的改良AED存在更好的伪迹抑制方法,但当前AED的硬件无需更换。