Chest compression rate feedback based on transthoracic impedance

Digna M. González-Otero, Sofía Ruiz de Gauna, Jesus Ruiz, Mohamud Ramzan Daya, Lars Wik, James K. Russell, Jo Kramer-Johansen, Trygve Eftestøl, Erik Alonso, Unai Ayala

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Background: Quality of cardiopulmonary resuscitation (CPR) is an important determinant of survival from cardiac arrest. The use of feedback devices is encouraged by current resuscitation guidelines as it helps rescuers to improve quality of CPR performance. Aim: To determine the feasibility of a generic algorithm for feedback related to chest compression (CC) rate using the transthoracic impedance (TTI) signal recorded through the defibrillation pads. Methods: We analysed 180 episodes collected equally from three different emergency services, each one using a unique defibrillator model. The new algorithm computed the CC-rate every 2. s by analysing the TTI signal in the frequency domain. The obtained CC-rate values were compared with the gold standard, computed using the compression force or the ECG and TTI signals when the force was not recorded. The accuracy of the CC-rate, the proportion of alarms of inadequate CC-rate, chest compression fraction (CCF) and the mean CC-rate per episode were calculated. Results: Intervals with CCs were detected with a mean sensitivity and a mean positive predictive value per episode of 96.3% and 97.0%, respectively. Estimated CC-rate had an error below 10% in 95.8% of the time. Mean percentage of accurate alarms per episode was 98.2%. No statistical differences were found between the gold standard and the estimated values for any of the computed metrics. Conclusion: We developed an accurate algorithm to calculate and provide feedback on CC-rate using the TTI signal. This could be integrated into automated external defibrillators and help improve the quality of CPR in basic-life-support settings.

Original languageEnglish (US)
Pages (from-to)82-88
Number of pages7
JournalResuscitation
Volume93
DOIs
StatePublished - Aug 1 2015

Fingerprint

Impedance Cardiography
Thorax
Cardiopulmonary Resuscitation
Defibrillators
Heart Arrest
Resuscitation
Electrocardiography
Emergencies
Guidelines

Keywords

  • Automated external defibrillator
  • Basic life support
  • Chest compression
  • CPR quality
  • Transthoracic impedance

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Emergency
  • Emergency Medicine

Cite this

González-Otero, D. M., Ruiz de Gauna, S., Ruiz, J., Daya, M. R., Wik, L., Russell, J. K., ... Ayala, U. (2015). Chest compression rate feedback based on transthoracic impedance. Resuscitation, 93, 82-88. https://doi.org/10.1016/j.resuscitation.2015.05.027

Chest compression rate feedback based on transthoracic impedance. / González-Otero, Digna M.; Ruiz de Gauna, Sofía; Ruiz, Jesus; Daya, Mohamud Ramzan; Wik, Lars; Russell, James K.; Kramer-Johansen, Jo; Eftestøl, Trygve; Alonso, Erik; Ayala, Unai.

In: Resuscitation, Vol. 93, 01.08.2015, p. 82-88.

Research output: Contribution to journalArticle

González-Otero, DM, Ruiz de Gauna, S, Ruiz, J, Daya, MR, Wik, L, Russell, JK, Kramer-Johansen, J, Eftestøl, T, Alonso, E & Ayala, U 2015, 'Chest compression rate feedback based on transthoracic impedance', Resuscitation, vol. 93, pp. 82-88. https://doi.org/10.1016/j.resuscitation.2015.05.027
González-Otero DM, Ruiz de Gauna S, Ruiz J, Daya MR, Wik L, Russell JK et al. Chest compression rate feedback based on transthoracic impedance. Resuscitation. 2015 Aug 1;93:82-88. https://doi.org/10.1016/j.resuscitation.2015.05.027
González-Otero, Digna M. ; Ruiz de Gauna, Sofía ; Ruiz, Jesus ; Daya, Mohamud Ramzan ; Wik, Lars ; Russell, James K. ; Kramer-Johansen, Jo ; Eftestøl, Trygve ; Alonso, Erik ; Ayala, Unai. / Chest compression rate feedback based on transthoracic impedance. In: Resuscitation. 2015 ; Vol. 93. pp. 82-88.
@article{93109f0228834c0b89b73e8d42817c1d,
title = "Chest compression rate feedback based on transthoracic impedance",
abstract = "Background: Quality of cardiopulmonary resuscitation (CPR) is an important determinant of survival from cardiac arrest. The use of feedback devices is encouraged by current resuscitation guidelines as it helps rescuers to improve quality of CPR performance. Aim: To determine the feasibility of a generic algorithm for feedback related to chest compression (CC) rate using the transthoracic impedance (TTI) signal recorded through the defibrillation pads. Methods: We analysed 180 episodes collected equally from three different emergency services, each one using a unique defibrillator model. The new algorithm computed the CC-rate every 2. s by analysing the TTI signal in the frequency domain. The obtained CC-rate values were compared with the gold standard, computed using the compression force or the ECG and TTI signals when the force was not recorded. The accuracy of the CC-rate, the proportion of alarms of inadequate CC-rate, chest compression fraction (CCF) and the mean CC-rate per episode were calculated. Results: Intervals with CCs were detected with a mean sensitivity and a mean positive predictive value per episode of 96.3{\%} and 97.0{\%}, respectively. Estimated CC-rate had an error below 10{\%} in 95.8{\%} of the time. Mean percentage of accurate alarms per episode was 98.2{\%}. No statistical differences were found between the gold standard and the estimated values for any of the computed metrics. Conclusion: We developed an accurate algorithm to calculate and provide feedback on CC-rate using the TTI signal. This could be integrated into automated external defibrillators and help improve the quality of CPR in basic-life-support settings.",
keywords = "Automated external defibrillator, Basic life support, Chest compression, CPR quality, Transthoracic impedance",
author = "Gonz{\'a}lez-Otero, {Digna M.} and {Ruiz de Gauna}, Sof{\'i}a and Jesus Ruiz and Daya, {Mohamud Ramzan} and Lars Wik and Russell, {James K.} and Jo Kramer-Johansen and Trygve Eftest{\o}l and Erik Alonso and Unai Ayala",
year = "2015",
month = "8",
day = "1",
doi = "10.1016/j.resuscitation.2015.05.027",
language = "English (US)",
volume = "93",
pages = "82--88",
journal = "Resuscitation",
issn = "0300-9572",
publisher = "Elsevier Ireland Ltd",

}

TY - JOUR

T1 - Chest compression rate feedback based on transthoracic impedance

AU - González-Otero, Digna M.

AU - Ruiz de Gauna, Sofía

AU - Ruiz, Jesus

AU - Daya, Mohamud Ramzan

AU - Wik, Lars

AU - Russell, James K.

AU - Kramer-Johansen, Jo

AU - Eftestøl, Trygve

AU - Alonso, Erik

AU - Ayala, Unai

PY - 2015/8/1

Y1 - 2015/8/1

N2 - Background: Quality of cardiopulmonary resuscitation (CPR) is an important determinant of survival from cardiac arrest. The use of feedback devices is encouraged by current resuscitation guidelines as it helps rescuers to improve quality of CPR performance. Aim: To determine the feasibility of a generic algorithm for feedback related to chest compression (CC) rate using the transthoracic impedance (TTI) signal recorded through the defibrillation pads. Methods: We analysed 180 episodes collected equally from three different emergency services, each one using a unique defibrillator model. The new algorithm computed the CC-rate every 2. s by analysing the TTI signal in the frequency domain. The obtained CC-rate values were compared with the gold standard, computed using the compression force or the ECG and TTI signals when the force was not recorded. The accuracy of the CC-rate, the proportion of alarms of inadequate CC-rate, chest compression fraction (CCF) and the mean CC-rate per episode were calculated. Results: Intervals with CCs were detected with a mean sensitivity and a mean positive predictive value per episode of 96.3% and 97.0%, respectively. Estimated CC-rate had an error below 10% in 95.8% of the time. Mean percentage of accurate alarms per episode was 98.2%. No statistical differences were found between the gold standard and the estimated values for any of the computed metrics. Conclusion: We developed an accurate algorithm to calculate and provide feedback on CC-rate using the TTI signal. This could be integrated into automated external defibrillators and help improve the quality of CPR in basic-life-support settings.

AB - Background: Quality of cardiopulmonary resuscitation (CPR) is an important determinant of survival from cardiac arrest. The use of feedback devices is encouraged by current resuscitation guidelines as it helps rescuers to improve quality of CPR performance. Aim: To determine the feasibility of a generic algorithm for feedback related to chest compression (CC) rate using the transthoracic impedance (TTI) signal recorded through the defibrillation pads. Methods: We analysed 180 episodes collected equally from three different emergency services, each one using a unique defibrillator model. The new algorithm computed the CC-rate every 2. s by analysing the TTI signal in the frequency domain. The obtained CC-rate values were compared with the gold standard, computed using the compression force or the ECG and TTI signals when the force was not recorded. The accuracy of the CC-rate, the proportion of alarms of inadequate CC-rate, chest compression fraction (CCF) and the mean CC-rate per episode were calculated. Results: Intervals with CCs were detected with a mean sensitivity and a mean positive predictive value per episode of 96.3% and 97.0%, respectively. Estimated CC-rate had an error below 10% in 95.8% of the time. Mean percentage of accurate alarms per episode was 98.2%. No statistical differences were found between the gold standard and the estimated values for any of the computed metrics. Conclusion: We developed an accurate algorithm to calculate and provide feedback on CC-rate using the TTI signal. This could be integrated into automated external defibrillators and help improve the quality of CPR in basic-life-support settings.

KW - Automated external defibrillator

KW - Basic life support

KW - Chest compression

KW - CPR quality

KW - Transthoracic impedance

UR - http://www.scopus.com/inward/record.url?scp=84937392803&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84937392803&partnerID=8YFLogxK

U2 - 10.1016/j.resuscitation.2015.05.027

DO - 10.1016/j.resuscitation.2015.05.027

M3 - Article

C2 - 26051811

AN - SCOPUS:84937392803

VL - 93

SP - 82

EP - 88

JO - Resuscitation

JF - Resuscitation

SN - 0300-9572

ER -