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Detection of a spontaneous pulse in photoplethysmograms during automated cardiopulmonary resuscitation in a porcine model.

Abstract：

INTRODUCTION: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. METHODS: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. RESULTS: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. CONCLUSIONS: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.

journal_name

Resuscitation

journal_title

Resuscitation

authors

Wijshoff RW,van der Sar T,Peeters WH,Bezemer R,Aelen P,Paulussen IW,Ordelman SC,Venema A,van Berkom PF,Aarts RM,Woerlee PH,Scheffer GJ,Noordergraaf GJ

doi

10.1016/j.resuscitation.2013.07.019

subject

Has Abstract

pub_date

2013-11-01 00:00:00

pages

1625-32

issue

11

eissn

0300-9572

issn

1873-1570

pii

S0300-9572(13)00388-2

journal_volume

84

pub_type

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