Communications Engineering Department, University of the Basque Country UPV/EHU, Alameda Urquijo S/N, 48013 Bilbao, Spain.
Communications Engineering Department, University of the Basque Country UPV/EHU, Alameda Urquijo S/N, 48013 Bilbao, Spain.
Resuscitation. 2015 Apr;89:25-30. doi: 10.1016/j.resuscitation.2014.11.022. Epub 2015 Jan 22.
Chest compression artefacts impede a reliable rhythm analysis during cardiopulmonary resuscitation (CPR). These artefacts are not present during ventilations in 30:2 CPR. The aim of this study is to prove that a fully automatic method for rhythm analysis during ventilation pauses in 30:2 CPR is reliable an accurate.
For this study 1414min of 30:2 CPR from 135 out-of-hospital cardiac arrest cases were analysed. The data contained 1942 pauses in compressions longer than 3.5s. An automatic pause detector identified the pauses using the transthoracic impedance, and a shock advice algorithm (SAA) diagnosed the rhythm during the detected pauses. The SAA analysed 3-s of the ECG during each pause for an accurate shock/no-shock decision.
The sensitivity and PPV of the pause detector were 93.5% and 97.3%, respectively. The sensitivity and specificity of the SAA in the detected pauses were 93.8% (90% low CI, 90.0%) and 95.9% (90% low CI, 94.7%), respectively. Using the method, shocks would have been advanced in 97% of occasions. For patients in nonshockable rhythms, rhythm reassessment pauses would be avoided in 95.2% (95% CI, 91.6-98.8) of occasions, thus increasing the overall chest compression fraction (CCF).
An automatic method could be used to safely analyse the rhythm during ventilation pauses. This would contribute to an early detection of refibrillation, and to increase CCF in patients with nonshockable rhythms.
心肺复苏（CPR）期间，胸外按压伪影会妨碍可靠的节律分析。在 30：2 心肺复苏中的通气期间，这些伪影不存在。本研究的目的是证明在 30：2 心肺复苏中的通气暂停期间使用全自动方法进行节律分析是可靠和准确的。
本研究分析了 135 例院外心脏骤停病例中 1414 分钟的 30：2 CPR。数据包含 1942 次超过 3.5 秒的压缩暂停。自动暂停检测器使用经胸阻抗识别暂停，并使用电击建议算法（SAA）在检测到的暂停期间诊断节律。SAA 在每次暂停期间分析 3 秒的 ECG，以做出准确的电击/非电击决策。
暂停检测器的灵敏度和阳性预测值分别为 93.5%和 97.3%。在检测到的暂停中，SAA 的灵敏度和特异性分别为 93.8%（90%置信区间的下限，90.0%）和 95.9%（90%置信区间的下限，94.7%）。使用该方法，电击将在 97%的情况下提前。对于非可电击节律的患者，节律重新评估暂停将在 95.2%（95%置信区间，91.6-98.8）的情况下避免，从而增加整体胸外按压分数（CCF）。
可以使用自动方法在通气暂停期间安全地分析节律。这将有助于早期发现再除颤，并增加非可电击节律患者的 CCF。
