Signal Processing Systems, Department of Electrical Engineering, Eindhoven University of Technology, Den Dolech 2, 5612 AZ Eindhoven, The Netherlands.
Resuscitation. 2013 Nov;84(11):1625-32. doi: 10.1016/j.resuscitation.2013.07.019. Epub 2013 Jul 30.
Reliable, non-invasive detection of return of spontaneous circulation (ROSC) with minimal interruptions to chest compressions would be valuable for high-quality cardiopulmonary resuscitation (CPR). We investigated the potential of photoplethysmography (PPG) to detect the presence of a spontaneous pulse during automated CPR in an animal study.
Twelve anesthetized pigs were instrumented to monitor circulatory and respiratory parameters. Here we present the simultaneously recorded PPG and arterial blood pressure (ABP) signals. Ventricular fibrillation was induced, followed by 20 min of automated CPR and subsequent defibrillation. After defibrillation, pediatric-guidelines-style life support was given in cycles of 2 min. PPG and ABP waveforms were recorded during all stages of the protocol. Raw PPG waveforms were acquired with a custom-built photoplethysmograph controlling a commercial reflectance pulse oximetry probe attached to the nose. ABP was measured in the aorta.
In nine animals ROSC was achieved. Throughout the protocol, PPG and ABP frequency content showed strong resemblance. We demonstrate that (1) the PPG waveform allows for the detection of a spontaneous pulse during ventilation pauses, and that (2) frequency analysis of the PPG waveform allows for the detection of a spontaneous pulse and the determination of the pulse rate, even during ongoing chest compressions, if the pulse and compression rates are sufficiently distinct.
These results demonstrate the potential of PPG as a non-invasive means to detect pulse presence or absence, as well as pulse rate during CPR.
可靠、无创地检测自主循环恢复（ROSC），同时尽量减少对胸外按压的干扰，这对高质量心肺复苏（CPR）非常重要。我们在一项动物研究中探讨了光电容积脉搏波（PPG）在自动 CPR 期间检测自主脉搏存在的潜力。
12 只麻醉猪被植入仪器以监测循环和呼吸参数。在此，我们展示了同时记录的 PPG 和动脉血压（ABP）信号。诱导心室颤动，随后进行 20 分钟的自动 CPR 和随后的除颤。除颤后，以儿科指南为指导进行 2 分钟为一个周期的生命支持。在协议的所有阶段都记录 PPG 和 ABP 波形。原始 PPG 波形是通过一个定制的光电容积脉搏波图采集的，该图控制一个连接在鼻子上的商业反射脉搏血氧仪探头。ABP 是在主动脉中测量的。
在 9 只动物中实现了 ROSC。在整个协议过程中，PPG 和 ABP 的频率内容表现出很强的相似性。我们证明了（1）PPG 波形允许在通气暂停期间检测到自主脉搏，以及（2）即使在持续进行的胸外按压期间，通过对 PPG 波形的频率分析也可以检测到自主脉搏并确定脉搏率，如果脉搏和按压频率足够不同的话。
这些结果表明 PPG 作为一种非侵入性手段来检测 CPR 期间脉搏的存在或缺失以及脉搏率的潜力。
