Metrics of impulsiveness of manual chest compressions for out-of-hospital cardiopulmonary resuscitation
© 2024 The Author(s)..
Aim: Propose new metrics of impulsiveness of manual chest compressions (CCs) that account for shape and duration, separate the characteristics of the compressive part of the CC cycle from those of the recoil part, and are uncorrelated to CC depth and rate.
Methods: We conducted a retrospective analysis of adult out-of-hospital cardiac arrest monitor-defibrillator recordings having CPR data. Specifically, episodes of adult patients with ≥ 1000 compressions free of leaning were examined. CCs were obtained from the depth signal of the valid episodes, and we calculated the novel metrics: compression area index (CAI), recoil area index (RAI), compression impulsiveness index (CII) and recoil impulsiveness index (RII). Generalized linear mixed-effects models and Jonckheere-Terpstra trend analyses were employed to measure differences between populations and trends, and the absolute value of Pearson's correlation coefficient |r| was used to report dependence between variables. Statistics are reported as median and interquartile range.
Results: We analyzed 982,340 CCs corresponding to 453 episodes, for which we calculated their CAI, RAI and duty cycle (DC). We analyzed the metrics for various populations: age, sex, any ROSC achieved and disposition, and found that CAI was significantly different according to patient disposition and RAI relative to age and sex (p<0.05). None of the metrics was correlated strongly to depth or rate (|r| values of 0.22 or smaller), and all of them varied for CC series corresponding to the same rescuer over the course of resuscitation (ptrend<0.05). However, we observed that the metrics are not balanced, in that for any value of DC, CAI and RAI span almost their entire ranges.
Conclusion: The proposed metrics correctly and completely describe manual CC waveforms, improve upon the DC, since they depend on the signal waveform, and provide additional information to current indicators of quality CPR, depth and rate. Furthermore, they allow to differentiate the compressive and recoil parts of the CC cycle, reflecting influence of the rescuer (via CAI or CII) and of the biomechanics of the patient's chest (via RAI or RII). Thus, they have the potential to contribute to better understanding CPR dynamics and, eventually, to enhanced quality of CPR practice as additional indicators of proper manual CC technique.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2024 |
|---|---|
| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:10 |
|---|---|
| Enthalten in: |
Heliyon - 10(2024), 7 vom: 15. Apr., Seite e28739 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Urigüen, Jose Antonio [VerfasserIn] |
|---|
| Links: |
|---|
| Anmerkungen: |
Date Revised 25.04.2024 published: Electronic-eCollection Citation Status PubMed-not-MEDLINE |
|---|
| doi: |
10.1016/j.heliyon.2024.e28739 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM370909267 |
|---|
| LEADER | 01000caa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM370909267 | ||
| 003 | DE-627 | ||
| 005 | 20240425233844.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 240411s2024 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1016/j.heliyon.2024.e28739 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1386.xml |
| 035 | |a (DE-627)NLM370909267 | ||
| 035 | |a (NLM)38601572 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Urigüen, Jose Antonio |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Metrics of impulsiveness of manual chest compressions for out-of-hospital cardiopulmonary resuscitation |
| 264 | 1 | |c 2024 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Revised 25.04.2024 | ||
| 500 | |a published: Electronic-eCollection | ||
| 500 | |a Citation Status PubMed-not-MEDLINE | ||
| 520 | |a © 2024 The Author(s). | ||
| 520 | |a Aim: Propose new metrics of impulsiveness of manual chest compressions (CCs) that account for shape and duration, separate the characteristics of the compressive part of the CC cycle from those of the recoil part, and are uncorrelated to CC depth and rate | ||
| 520 | |a Methods: We conducted a retrospective analysis of adult out-of-hospital cardiac arrest monitor-defibrillator recordings having CPR data. Specifically, episodes of adult patients with ≥ 1000 compressions free of leaning were examined. CCs were obtained from the depth signal of the valid episodes, and we calculated the novel metrics: compression area index (CAI), recoil area index (RAI), compression impulsiveness index (CII) and recoil impulsiveness index (RII). Generalized linear mixed-effects models and Jonckheere-Terpstra trend analyses were employed to measure differences between populations and trends, and the absolute value of Pearson's correlation coefficient |r| was used to report dependence between variables. Statistics are reported as median and interquartile range | ||
| 520 | |a Results: We analyzed 982,340 CCs corresponding to 453 episodes, for which we calculated their CAI, RAI and duty cycle (DC). We analyzed the metrics for various populations: age, sex, any ROSC achieved and disposition, and found that CAI was significantly different according to patient disposition and RAI relative to age and sex (p<0.05). None of the metrics was correlated strongly to depth or rate (|r| values of 0.22 or smaller), and all of them varied for CC series corresponding to the same rescuer over the course of resuscitation (ptrend<0.05). However, we observed that the metrics are not balanced, in that for any value of DC, CAI and RAI span almost their entire ranges | ||
| 520 | |a Conclusion: The proposed metrics correctly and completely describe manual CC waveforms, improve upon the DC, since they depend on the signal waveform, and provide additional information to current indicators of quality CPR, depth and rate. Furthermore, they allow to differentiate the compressive and recoil parts of the CC cycle, reflecting influence of the rescuer (via CAI or CII) and of the biomechanics of the patient's chest (via RAI or RII). Thus, they have the potential to contribute to better understanding CPR dynamics and, eventually, to enhanced quality of CPR practice as additional indicators of proper manual CC technique | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Advanced life support (ALS) | |
| 650 | 4 | |a CPR quality | |
| 650 | 4 | |a Cardiopulmonary resuscitation (CPR) | |
| 650 | 4 | |a Chest compression depth | |
| 650 | 4 | |a Chest compression rate | |
| 650 | 4 | |a Duty cycle (DC) | |
| 650 | 4 | |a High-impulse chest compression (HI-CC) | |
| 650 | 4 | |a Metrics of impulsiveness | |
| 650 | 4 | |a Out-of-hospital cardiac arrest (OHCA) | |
| 700 | 1 | |a Ruiz de Gauna, Sofía |e verfasserin |4 aut | |
| 700 | 1 | |a Gutiérrez, Jose Julio |e verfasserin |4 aut | |
| 700 | 1 | |a Azcárate, Izaskun |e verfasserin |4 aut | |
| 700 | 1 | |a Leturiondo, Mikel |e verfasserin |4 aut | |
| 700 | 1 | |a Redondo, Koldo |e verfasserin |4 aut | |
| 700 | 1 | |a Russell, James Knox |e verfasserin |4 aut | |
| 700 | 1 | |a Daya, Mohamud Ramzan |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Heliyon |d 2015 |g 10(2024), 7 vom: 15. Apr., Seite e28739 |w (DE-627)NLM255913095 |x 2405-8440 |7 nnns |
| 773 | 1 | 8 | |g volume:10 |g year:2024 |g number:7 |g day:15 |g month:04 |g pages:e28739 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1016/j.heliyon.2024.e28739 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 10 |j 2024 |e 7 |b 15 |c 04 |h e28739 | ||