Jason Coult1, Heemun Kwok2, Lawrence Sherman3, Jennifer Blackwood4, Peter J Kudenchuk5, Thomas D Rea6. 1. Department of Bioengineering, University of Washington, Seattle, WA, USA; Center for Progress in Resuscitation, University of Washington, Seattle, WA, USA. Electronic address: jasonc4@uw.edu. 2. Center for Progress in Resuscitation, University of Washington, Seattle, WA, USA; Department of Medicine, University of Washington School of Medicine, Seattle, WA, USA. Electronic address: heemun@uw.edu. 3. Department of Bioengineering, University of Washington, Seattle, WA, USA; Center for Progress in Resuscitation, University of Washington, Seattle, WA, USA; Department of Medicine, University of Washington School of Medicine, Seattle, WA, USA. Electronic address: shermld7@uw.edu. 4. Center for Progress in Resuscitation, University of Washington, Seattle, WA, USA; King County Emergency Medical Services, Seattle King County Department of Public Health, Seattle, WA, USA. Electronic address: jennifer.blackwood@kingcounty.gov. 5. Center for Progress in Resuscitation, University of Washington, Seattle, WA, USA; Department of Medicine, University of Washington School of Medicine, Seattle, WA, USA; King County Emergency Medical Services, Seattle King County Department of Public Health, Seattle, WA, USA. Electronic address: kudenchu@uw.edu. 6. Center for Progress in Resuscitation, University of Washington, Seattle, WA, USA; Department of Medicine, University of Washington School of Medicine, Seattle, WA, USA; King County Emergency Medical Services, Seattle King County Department of Public Health, Seattle, WA, USA. Electronic address: rea123@uw.edu.
Abstract
AIM: Amplitude Spectrum Area (AMSA) and Median Slope (MS) are ventricular fibrillation (VF) waveform measures that predict defibrillation shock success. Cardiopulmonary resuscitation (CPR) obscures electrocardiograms and must be paused for analysis. Studies suggest waveform measures better predict subsequent shock success when combined with prior shock success. We determined whether this relationship applies during CPR. METHODS: AMSA and MS were calculated from 5-second pre-shock segments with and without CPR, and compared to logistic models combining each measure with prior return of organized rhythm (ROR). RESULTS: VF segments from 692 patients were analyzed during CPR before 1372 shocks and without CPR before 1283 shocks. Combining waveform measures with prior ROR increased areas under receiver operating characteristic curves for AMSA/MS with CPR (0.66/0.68 to 0.73/0.74, p<0.001) and without CPR (0.71/0.72 to 0.76/0.76, p<0.001). CONCLUSIONS: Prior ROR improves prediction of shock success during CPR, and may enable waveform measure calculation without chest compression pauses.
AIM: Amplitude Spectrum Area (AMSA) and Median Slope (MS) are ventricular fibrillation (VF) waveform measures that predict defibrillation shock success. Cardiopulmonary resuscitation (CPR) obscures electrocardiograms and must be paused for analysis. Studies suggest waveform measures better predict subsequent shock success when combined with prior shock success. We determined whether this relationship applies during CPR. METHODS: AMSA and MS were calculated from 5-second pre-shock segments with and without CPR, and compared to logistic models combining each measure with prior return of organized rhythm (ROR). RESULTS:VF segments from 692 patients were analyzed during CPR before 1372 shocks and without CPR before 1283 shocks. Combining waveform measures with prior ROR increased areas under receiver operating characteristic curves for AMSA/MS with CPR (0.66/0.68 to 0.73/0.74, p<0.001) and without CPR (0.71/0.72 to 0.76/0.76, p<0.001). CONCLUSIONS: Prior ROR improves prediction of shock success during CPR, and may enable waveform measure calculation without chest compression pauses.
Authors: Mark S Link; Lauren C Berkow; Peter J Kudenchuk; Henry R Halperin; Erik P Hess; Vivek K Moitra; Robert W Neumar; Brian J O'Neil; James H Paxton; Scott M Silvers; Roger D White; Demetris Yannopoulos; Michael W Donnino Journal: Circulation Date: 2015-11-03 Impact factor: 29.690
Authors: Peter Schoene; Jason Coult; Lauren Murphy; Carol Fahrenbruch; Jennifer Blackwood; Peter Kudenchuk; Lawrence Sherman; Thomas Rea Journal: Heart Rhythm Date: 2013-10-28 Impact factor: 6.343
Authors: Jason Coult; Lawrence Sherman; Heemun Kwok; Jennifer Blackwood; Peter J Kudenchuk; Thomas D Rea Journal: Resuscitation Date: 2016-10-01 Impact factor: 5.262
Authors: Sheldon Cheskes; Robert H Schmicker; Jim Christenson; David D Salcido; Tom Rea; Judy Powell; Dana P Edelson; Rebecca Sell; Susanne May; James J Menegazzi; Lois Van Ottingham; Michele Olsufka; Sarah Pennington; Jacob Simonini; Robert A Berg; Ian Stiell; Ahamed Idris; Blair Bigham; Laurie Morrison Journal: Circulation Date: 2011-06-20 Impact factor: 29.690
Authors: Andreas Neurauter; Trygve Eftestøl; Jo Kramer-Johansen; Benjamin S Abella; Kjetil Sunde; Volker Wenzel; Karl H Lindner; Joar Eilevstjønn; Helge Myklebust; Petter A Steen; Hans-Ulrich Strohmenger Journal: Resuscitation Date: 2007-02-06 Impact factor: 5.262
Authors: Jason Coult; Jennifer Blackwood; Lawrence Sherman; Thomas D Rea; Peter J Kudenchuk; Heemun Kwok Journal: Circ Arrhythm Electrophysiol Date: 2019-01
Authors: Jason Coult; Jennifer Blackwood; Thomas D Rea; Peter J Kudenchuk; Heemun Kwok Journal: IEEE J Biomed Health Inform Date: 2019-05-24 Impact factor: 5.772
Authors: Jasmeet Soar; Bernd W Böttiger; Pierre Carli; Keith Couper; Charles D Deakin; Therese Djärv; Carsten Lott; Theresa Olasveengen; Peter Paal; Tommaso Pellis; Gavin D Perkins; Claudio Sandroni; Jerry P Nolan Journal: Notf Rett Med Date: 2021-06-08 Impact factor: 0.826
Authors: Jasmeet Soar; Katherine M Berg; Lars W Andersen; Bernd W Böttiger; Sofia Cacciola; Clifton W Callaway; Keith Couper; Tobias Cronberg; Sonia D'Arrigo; Charles D Deakin; Michael W Donnino; Ian R Drennan; Asger Granfeldt; Cornelia W E Hoedemaekers; Mathias J Holmberg; Cindy H Hsu; Marlijn Kamps; Szymon Musiol; Kevin J Nation; Robert W Neumar; Tonia Nicholson; Brian J O'Neil; Quentin Otto; Edison Ferreira de Paiva; Michael J A Parr; Joshua C Reynolds; Claudio Sandroni; Barnaby R Scholefield; Markus B Skrifvars; Tzong-Luen Wang; Wolfgang A Wetsch; Joyce Yeung; Peter T Morley; Laurie J Morrison; Michelle Welsford; Mary Fran Hazinski; Jerry P Nolan Journal: Resuscitation Date: 2020-10-21 Impact factor: 5.262
Authors: Jos Thannhauser; Joris Nas; Priya Vart; Joep L R M Smeets; Menko-Jan de Boer; Niels van Royen; Judith L Bonnes; Marc A Brouwer Journal: Resusc Plus Date: 2021-04-02