Jun Xu1, Chen Li2, Hanqi Tang1, Dingyu Tan3, Yangyang Fu1, Liang Zong1, Daoyuan Jing4, Banghan Ding5, Yu Cao6, Zhongqiu Lu7, Yingping Tian8, Yanfen Chai9, Yanli Meng10, Zhen Wang11, Ya-An Zheng12, Xiaodong Zhao13, Xinyan Zhang14, Lu Liang15, Zhongyi Zeng16, Yan Li1, Joseph H Walline17, Priscilla P Song17, Liangliang Zheng18, Feng Sun19, Shihuan Shao20, Ming Sun21, Mingwei Huang4, Ruifeng Zeng5, Shu Zhang6, Xiaoya Yang7, Dongqi Yao8, Muming Yu9, Hua Liao10, Yingxia Xiong11, Kang Zheng12, Yuhong Qin13, Yingbo An14, Yuxiang Liu15, Kun Chen4, Huadong Zhu1, Xuezhong Yu22, Bin Du23. 1. Department of Emergency Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China. 2. Department of Emergency Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China; Department of Emergency Medicine, Tianjin Medical University General Hospital, Tianjin 300052, China. 3. Department of Emergency Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China; Department of Emergency Medicine, Northern Jiangsu People's Hospital, Yangzhou 225001, China. 4. Department of Emergency Medicine, Jinhua Municipal Central Hospital, Jinhua 321000, China. 5. Department of Emergency Medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangdong Provincial Key Laboratory of Research on Emergency in TCM, Guangzhou 510120, China. 6. Department of Emergency Medicine, West China Hospital, Sichuan University, Chengdu 610041, China. 7. Department of Emergency Medicine, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China. 8. Department of Emergency Medicine, The Second Hospital of Hebei Medical University, Shijiazhuang 050000, China. 9. Department of Emergency Medicine, Tianjin Medical University General Hospital, Tianjin 300052, China. 10. Department of Emergency Medicine, HuaBei Petroleum General Hospital, Renqiu 062552, China. 11. Department of Emergency Medicine, Beijing Shijitan Hospital Capital Medical University, Beijing 100038, China. 12. Department of Emergency Medicine, Peking University Third Hospital, Beijing 100191, China. 13. Department of Emergency Medicine, First Affiliated Hospital of PLA Hospital, Beijing 100048, China. 14. Department of Emergency Medicine, Beijing Haidian Hospital, Beijing 100080, China. 15. Department of Emergency Medicine, Affiliated Hospital of Hebei University, Baoding 071000, China. 16. Department of Emergency Medicine, Shenzhen Traditional Chinese Medicine Hospital, Shenzhen 518033, China. 17. Centre for the Humanities and Medicine, The University of Hong Kong, Hong Kong Special Administrative Region. 18. Beijing Hospital, National Center of Gerontology, China, Beijing 100730, China. 19. Department of Emergency Medicine, Jiangsu Province Hospital, Yangzhou 210029, China. 20. Department of Emergency Medicine, Peking University People's Hospital, Beijing 100044, China; Department of Emergency Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China. 21. Department of Emergency Medicine, Affiliated Suqian Hospital of Xuzhou Medical University, Xuzhou 221004, China. 22. Department of Emergency Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China. Electronic address: yxzpumch@126.com. 23. Department of Medical Intensive Care, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China. Electronic address: dubin98@gmail.com.
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.
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.