scholarly journals Study on the Improvement of Electrical Facility System of Automated External Defibrillators by Real-Time Measurement of Thoracic Impedance

2020 ◽  
Vol 10 (9) ◽  
pp. 3323
Author(s):  
Tae-Jin Ha ◽  
Hong-Gyu Park ◽  
Su-Kang Park ◽  
Sang-Geon Park
Keyword(s):  
Cardiac Arrest ◽  
Real Time ◽  
Electric Shock ◽  
Artificial Respiration ◽  
Cardiac Arrest Patient ◽  
Impedance Change ◽  
Thoracic Impedance ◽  
Peak Current ◽  
Shock Energy ◽  
Facility System

Sudden Cardiac Arrest (SCA) is a serious emergency disease that has increased steadily every year. To this end, an Automated External Defibrillator (AED) is placed in a public place so that even non-professional medical personnel can respond to SCA. However, the thoracic impedance of patients changes due to CardioPulmonary Resuscitation (CPR) and artificial respiration during first aid treatment. In addition, changes in chest statues due to gender, age, and accidents cause changes in thoracic impedance in real time. The change in thoracic impedance caused by this has a negative effect on the intended electrical energy of the automatic heart shocker to the emergency patient. To prove this, we divided it into adult and pediatric modes and experimented with the energy error of the AED according to the same impedance change. When the first peak current was up to 56.4 (A) and at least 8.4 (A) in the adult mode, the first peak current was up to 32.2 (A) and at least 4.8 (A), respectively, when the impedance changed, the error of the current figure occurred. In this paper, the inverse relationship between thoracic impedance and electric shock energy according to the state of the cardiac arrest patient is demonstrated through the results of the experiment, and the need for an electric facility system that can revise for changes in thoracic impedance of the cardiac arrest patient by reflecting them on electric shock energy in real time is presented.

Critical Care of the Post–Cardiac Arrest Patient

2018 ◽  
Vol 36 (3) ◽  
pp. 419-428 ◽  
Author(s):  
Amy C. Walker ◽  
Nicholas J. Johnson
Keyword(s):  
Cardiac Arrest ◽  
Critical Care ◽  
Cardiac Arrest Patient

Abstract 264: Automatic Detection of Ventilations Using the Thoracic Impedance Signal During Lucas Chest Compressions

Circulation ◽  
2019 ◽  
Vol 140 (Suppl_2) ◽  
Author(s):  
Xabier Jaureguibeitia ◽  
Unai Irusta ◽  
Elisabete Aramendi ◽  
Pamela Owens ◽  
Henry E Wang ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Minute Ventilation ◽  
Lung Ventilation ◽  
Detection Algorithm ◽  
Ventilation Rate ◽  
Thoracic Impedance ◽  
Chest Compressions ◽  
Signal Processing Algorithm ◽  
Ventilation Rates ◽  
Mechanical Cpr

Introduction: Resuscitation from out-of-cardiac arrest (OHCA) requires control of both chest compressions and lung ventilation. There are few effective methods for detecting ventilations during cardiopulmonary resuscitation. Thoracic impedance (TI) is sensitive to changes in lung air volumes and may allow detection of ventilations but has not been tested with concurrent mechanical chest compressions. Hypothesis: It is possible to automatically detect and characterize ventilations from TI changes during mechanical chest compressions. Methods: A cohort of 420 OHCA cases (27 survivors to hospital discharge) were enrolled in the Dallas-Fort Worth Center for Resuscitation Research cardiac arrest registry. These patients were treated with the LUCAS-2 CPR device and had concurrent TI and capnogram recordings from MRx (Philips, Andover, MA) monitor-defibrillators. We developed a signal processing algorithm to suppress chest compression artifacts from the TI signal, allowing identification of ventilations. We used the capnogram as gold standard for delivered ventilations. We determined the accuracy of the algorithm for detecting capnogram-indicated ventilations, calculating sensitivity, the proportion of true ventilations detected in the TI, and positive predictive value (PPV), the proportion of true ventilations within the detections. We calculated per minute ventilation rate and mean TI amplitude, as surrogate for tidal volume. Statistical differences between survivors and non-survivors were assessed using the Mann-Whitney test. Results: We studied 4331 minutes of TI during CPR. There were a median of 10 (IQR 6-14) ventilations per min and 52 (30-81) ventilations per patient. Sensitivity of TI was 95.9% (95% CI, 74.5-100), and PPV was 95.8% (95% CI, 80.0-100). The median ventilation rates for survivors and non-survivors were 7.75 (5.37-9.91) min -1 and 5.64 (4.46-7.15) min -1 (p<10 -3 ), and the median TI amplitudes were 1.33 (1.03-1.75) Ω and 1.14 (0.77-1.66) Ω (p=0.095). Conclusions: An accurate automatic TI ventilation detection algorithm was demonstrated during mechanical CPR. The relation between ventilation rate during mechanical CPR and survival was significant, but it was not for impedance amplitude.

scholarly journals Rescue-Thrombolysis in Cardiac Arrest: The ‘Provider’ of Last Resort

2020 ◽  
Vol 19 (2) ◽  
pp. 319-321
Author(s):  
Lim Khai Yen ◽  
Shahira Ismail ◽  
Shukri Saad ◽  
Mohd Hashairi Fauzi ◽  
Nik Hisamuddin Nik Ab Rahman
Keyword(s):  
Adverse Effect ◽  
Cardiac Arrest ◽  
Risk Factor ◽  
Heart Disease ◽  
Case Report ◽  
Thrombolytic Therapy ◽  
Cause Of Death ◽  
Medical Science ◽  
Cardiac Arrest Patient ◽  
Major Risk Factor

Cardiac arrest is the leading cause of death globally, and heart disease is known to be a major risk factor for cardiac arrest. In practice, an arrest is presumed to be of cardiac origin unless it is known or likely due to non-cardiac causes. The prognosis of the patient following cardiac arrest is generally poor. Although thrombolytic therapy is well known to be the treatment for myocardial thrombosis, it is not routinely recommended in cardiac arrest due to its potential bleeding adverse effect. We described a case report of successful thrombolytic therapy in cardiac arrest patient Bangladesh Journal of Medical Science Vol.19(2) 2020 p.319-321

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