Abstract
Objective
This study aimed to investigate the predictive value of pulse oximetry plethysmography
(POP) for the return of spontaneous circulation (ROSC) in cardiac arrest (CA) patients.
Methods
This was a multicenter, observational, prospective cohort study of patients hospitalized
with cardiac arrest at 14 teaching hospitals cross China from December 2013 through
November 2014. The study endpoint was ROSC, defined as the restoration of a palpable
pulse and an autonomous cardiac rhythm lasting for at least 20 minutes after the completion
or cessation of CPR.
Results
150 out-of-hospital cardiac arrest (OHCA) patients and 291 in-hospital cardiac arrest
(IHCA) patients were enrolled prospectively. ROSC was achieved in 20 (13.3%) and 64
(22.0%) patients in these cohorts, respectively. In patients with complete end-tidal
carbon dioxide (ETCO2) and POP data, patients with ROSC had significantly higher levels of POP area under
the curve (AUCp), wave amplitude (Amp) and ETCO2 level during CPR than those without ROSC (all p < 0.05). Pairwise comparison of receiver operating characteristic (ROC) curve analysis
indicated no significant difference was observed between ETCO2 and Amp (p = 0.204) or AUCp (p = 0.588) during the first two minutes of resuscitation.
Conclusion
POP may be a novel and effective method for predicting ROSC during resuscitation,
with a prognostic value similar to ETCO2 at early stage.
Keywords
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Article info
Publication history
Published online: October 05, 2021
Accepted:
September 27,
2021
Received in revised form:
September 26,
2021
Received:
February 28,
2021
Identification
Copyright
© 2021 Elsevier B.V. All rights reserved.
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- Pulse oximetry plethysmography: A new approach for physiology-directed CPR?ResuscitationVol. 169
- PreviewThe overarching aim of cardiopulmonary resuscitation (CPR) is to generate sufficient myocardial and cerebral blood flow to allow for survival with favorable neurologic outcome.1 The adequacy of myocardial and cerebral blood flow during CPR depends, in part, on force of chest compressions, rate of compressions, chest compression fraction, and allowing full chest recoil for sufficient venous return.2–6 Therefore, the core tenets of CPR are to push hard and push fast, minimize interruptions, and allow full chest recoil.
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