dc.contributor.author | Gutiérrez Ruiz, José Julio | |
dc.contributor.author | Leturiondo Sota, Mikel | |
dc.contributor.author | Ruiz de Gauna Gutiérrez, Sofía | |
dc.contributor.author | Ruiz Ojeda, Jesús María | |
dc.contributor.author | Azcarate Blanco, Izaskun | |
dc.contributor.author | González Otero, Digna María | |
dc.contributor.author | Urtusagasti, Juan Francisco | |
dc.contributor.author | Russell, James Knox | |
dc.contributor.author | Daya, Mohamud Ramzan | |
dc.date.accessioned | 2021-06-18T08:00:48Z | |
dc.date.available | 2021-06-18T08:00:48Z | |
dc.date.issued | 2021-05-18 | |
dc.identifier.citation | Plos One 16(5) : (2021) // Article ID e0251511 | es_ES |
dc.identifier.issn | 1932-6203 | |
dc.identifier.uri | http://hdl.handle.net/10810/51928 | |
dc.description.abstract | Background
Measurement of end-tidal CO2 (ETCO2) can help to monitor circulation during cardiopulmonary resuscitation (CPR). However, early detection of restoration of spontaneous circulation
(ROSC) during CPR using waveform capnography remains a challenge. The aim of the
study was to investigate if the assessment of ETCO2 variation during chest compression
pauses could allow for ROSC detection. We hypothesized that a decay in ETCO2 during a
compression pause indicates no ROSC while a constant or increasing ETCO2 indicates
ROSC.
Methods
We conducted a retrospective analysis of adult out-of-hospital cardiac arrest (OHCA) episodes treated by the advanced life support (ALS). Continuous chest compressions and ventilations were provided manually. Segments of capnography signal during pauses in chest
compressions were selected, including at least three ventilations and with durations less
than 20 s. Segments were classified as ROSC or non-ROSC according to case chart annotation and examination of the ECG and transthoracic impedance signals. The percentage
variation of ETCO2 between consecutive ventilations was computed and its average value,
ΔETavg, was used as a single feature to discriminate between ROSC and non-ROSC
segments.
Results
A total of 384 segments (130 ROSC, 254 non-ROSC) from 205 OHCA patients (30.7%
female, median age 66) were analyzed. Median (IQR) duration was 16.3 (12.9,18.1) s.
ΔETavg was 0.0 (-0.7, 0.9)% for ROSC segments and -11.0 (-14.1, -8.0)% for non-ROSC segments (p < 0.0001). Best performance for ROSC detection yielded a sensitivity of 95.4%
(95% CI: 90.1%, 98.1%) and a specificity of 94.9% (91.4%, 97.1%) for all ventilations in the
segment. For the first 2 ventilations, duration was 7.7 (6.0, 10.2) s, and sensitivity and specificity were 90.0% (83.5%, 94.2%) and 89.4 (84.9%, 92.6%), respectively. Our method
allowed for ROSC detection during the first compression pause in 95.4% of the patients.
Conclusion
Average percent variation of ETCO2 during pauses in chest compressions allowed for
ROSC discrimination. This metric could help confirm ROSC during compression pauses in
ALS settings | es_ES |
dc.description.sponsorship | Authors JJG, JMR, IA, and SRG received
research support from the Basque Government
through the grant IT1087-16 (for research groups),
and author ML through the predoctoral grant PRE2019-2-0251. https://www.euskadi.eus Authors
JJG, JMR, ML, and SRG received research support
from the Spanish Ministry of Science, Innovation and Universities through the grant RTI2018-
094396-B-I00 and author DMGO from the program
Torres Quevedo PTQ-16-08201 | es_ES |
dc.language.iso | eng | es_ES |
dc.publisher | Public Library Of Science | es_ES |
dc.relation | info:eu-repo/grantAgreement/MICINN/RTI2018- 094396-B-I00 | es_ES |
dc.rights | info:eu-repo/semantics/openAccess | es_ES |
dc.rights.uri | http://creativecommons.org/licenses/by/3.0/es/ | * |
dc.subject | cardiopulmonary resuscitation | es_ES |
dc.subject | waveform capnography | es_ES |
dc.subject | chest compression pauses | es_ES |
dc.title | Assessment of the Evolution of End-Tidal Carbon Dioxide within Chest Compression Pauses to Detect Restoration of Spontaneous Circulation | es_ES |
dc.type | info:eu-repo/semantics/article | es_ES |
dc.rights.holder | This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY 4.0) | es_ES |
dc.rights.holder | Atribución 3.0 España | * |
dc.relation.publisherversion | https://www-proquest-com.ehu.idm.oclc.org/docview/2528873155/abstract/893D8D92E0944083PQ/1?accountid=17248 | es_ES |
dc.identifier.doi | 10.1371/journal.pone.0251511 | |
dc.departamentoes | Ingeniería de comunicaciones | es_ES |
dc.departamentoes | Matemática aplicada | es_ES |
dc.departamentoeu | Komunikazioen ingeniaritza | es_ES |
dc.departamentoeu | Matematika aplikatua | es_ES |