Characterization of mechanical properties of adult chests during pre-hospital manual chest compressions through a simple viscoelastic model.

Autor: Ruiz de Gauna S; Group of Signal and Communications, University of the Basque Country, UPV/EHU, Bilbao School of Engineering, Plaza Torres Quevedo 1, 48013-Bilbao, Bizkaia, Spain. Electronic address: sofia.ruizdegauna@ehu.eus., Gutiérrez JJ; Group of Signal and Communications, University of the Basque Country, UPV/EHU, Bilbao School of Engineering, Plaza Torres Quevedo 1, 48013-Bilbao, Bizkaia, Spain., Sandoval CL; Unidades Tecnológicas de Santander, Av. Los Estudiantes 9-82, La Concordia, Bucaramanga, Santander, Colombia., Russell JK; Center for Policy and Research in Emergency Medicine (CPR-EM), Department of Emergency Medicine, Oregon Health & Science University, Portland, OR 97239, USA., Azcarate I; Group of Signal and Communications, University of the Basque Country, UPV/EHU, Bilbao School of Engineering, Plaza Torres Quevedo 1, 48013-Bilbao, Bizkaia, Spain; Department of Applied Mathematics, University of the Basque Country, UPV/EHU, Bilbao School of Engineering, 48013-Bilbao, Bizkaia, Spain., Urigüen JA; Group of Signal and Communications, University of the Basque Country, UPV/EHU, Bilbao School of Engineering, Plaza Torres Quevedo 1, 48013-Bilbao, Bizkaia, Spain; Department of Applied Mathematics, University of the Basque Country, UPV/EHU, Bilbao School of Engineering, 48013-Bilbao, Bizkaia, Spain., González-Otero DM; Bexen Cardio, Areitio Errepidea, 5, 48260-Ermua, Bizkaia, Spain., Daya MR; Center for Policy and Research in Emergency Medicine (CPR-EM), Department of Emergency Medicine, Oregon Health & Science University, Portland, OR 97239, USA.
Jazyk: angličtina
Zdroj: Computer methods and programs in biomedicine [Comput Methods Programs Biomed] 2023 Dec; Vol. 242, pp. 107847. Date of Electronic Publication: 2023 Oct 10.
DOI: 10.1016/j.cmpb.2023.107847
Abstrakt: Aim: The purpose of this study was to develop a simple viscoelastic model to characterize the mechanical properties of chests during manual chest compressions in pre-hospital cardiopulmonary resuscitation (CPR).
Methods: Force and acceleration signals were extracted from CPR monitors used during pre-hospital resuscitation attempts on adult patients. Individual chest compressions were identified and segmented from the chest displacement computed using the force and acceleration. Each compression-recoil cycle was characterized by its elastic coefficient k (a measure of stiffness) and its compression and recoil damping coefficients, d c and d r , respectively (measures of viscosity). We compared the estimated and the calculated chest displacement to assess the goodness of fit of the model. We characterized the chest of patients at the beginning of CPR in relation to sex and age, and their variation as CPR progressed.
Results: A total of 1,156,608 chest compressions from 615 patients were analysed. Mean (95% CI) coefficient of determination R 2 for the viscoelastic model was 97.9% (97.8-98.1). At the beginning of CPR, k was 104.9 N⋅cm -1 (102.0-107.8), d c was 2.868 N⋅s⋅cm -1 (2.751-2.984) and d r was 4.889 N⋅s⋅cm -1 (4.648-5.129). Damping during recoil was significantly higher than during compression. Stiffness was lower in women than in men. There were no differences in damping coefficients with sex but a higher d r with increasing age. All model coefficients decreased with compression count, with an overall decrease after 3,000 chest compressions of 34.6%, 48.8% and 37.2%, respectively.
Conclusion: The model accurately described adult chest mechanical properties during CPR, highlighting differences between compression and recoil, sex and age, and a progressive reduction in chest stiffness and viscosity along resuscitation. Our findings may merit further investigation into whether patient-tailored and time-sensitive chest compression technique may be appropriate.
Competing Interests: Declaration of Competing Interest Author Digna María González-Otero is employed by Bexen Cardio, a Spanish medical device manufacturer. Bexen Cardio had no role in study funding, or study design, data collection and analysis, decision to publish, or preparation of the manuscript. Authors Sofía Ruiz de Gauna, Jose Julio Gutiérrez, Camilo Leonardo Sandoval, James Knox Russell, Izaskun Azcarate, José Antonio Urigüen, and Mohamud Ramzan Daya declare no conflict of interest.
(Copyright © 2023 The Author(s). Published by Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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