Transthoracic impedance variability to assess quality of chest compression in out-of-hospital cardiac arrest.

Autor: Magliocca A; Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy., Castagna V; Department of Anesthesia, Critical Care and Emergency, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy., Fornari C; Research Centre on Public Health, University of Milano-Bicocca, Monza, Italy., Zimei G; Department of Anesthesia, Critical Care and Emergency, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy., Merigo G; Department of Anesthesia, Critical Care and Emergency, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy., Penna A; Department of Anesthesia, Critical Care and Emergency, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy., Carlson J; Clinical Sciences, Helsingborg, Medical Faculty, Lund University, Helsingborg, Sweden., Fumagalli F; Department of Acute Brain and Cardiovascular Injury, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy., Stirparo G; Agenzia Regionale Emergenza Urgenza, Milan, Italy., Migliari M; Agenzia Regionale Emergenza Urgenza, Milan, Italy., Coppo A; Agenzia Regionale Emergenza Urgenza, Milan, Italy., Sechi GM; Agenzia Regionale Emergenza Urgenza, Milan, Italy., Grasselli G; Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.; Department of Anesthesia, Critical Care and Emergency, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy., Hardig BM; Clinical Sciences, Helsingborg, Medical Faculty, Lund University, Helsingborg, Sweden., Ristagno G; Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.; Department of Anesthesia, Critical Care and Emergency, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
Jazyk: angličtina
Zdroj: Acta anaesthesiologica Scandinavica [Acta Anaesthesiol Scand] 2024 Apr; Vol. 68 (4), pp. 556-566. Date of Electronic Publication: 2024 Jan 14.
DOI: 10.1111/aas.14374
Abstrakt: Background: Chest compression is a lifesaving intervention in out-of-hospital cardiac arrest (OHCA), but the optimal metrics to assess its quality have yet to be identified. The objective of this study was to investigate whether a new parameter, that is, the variability of the chest compression-generated transthoracic impedance (TTI), namely Imp CC , which measures the consistency of the chest compression maneuver, relates to resuscitation outcome.
Methods: This multicenter observational, retrospective study included OHCAs with shockable rhythm. Imp CC variability was evaluated with the power spectral density analysis of the TTI. Multivariate regression model was used to examine the impact of Imp CC variability on defibrillation success. Secondary outcome measures were return of spontaneous circulation and survival.
Results: Among 835 treated OHCAs, 680 met inclusion criteria and 565 matched long-term outcomes. Imp CC was significantly higher in patients with unsuccessful defibrillation compared to those with successful defibrillation (p = .0002). Lower Imp CC variability was associated with successful defibrillation with an odds ratio (OR) of 0.993 (95% confidence interval [95% CI], 0.989-0.998, p = .003), while the standard chest compression fraction (CCF) was not associated (OR 1.008 [95 % CI, 0.992-1.026, p = .33]). Neither Imp CC nor CCF was associated with long-term outcomes.
Conclusions: In this population, consistency of chest compression maneuver, measured by variability in TTI, was an independent predictor of defibrillation outcome. Imp CC may be a useful novel metrics for improving quality of care in OHCA.
(© 2024 Acta Anaesthesiologica Scandinavica Foundation.)
Databáze: MEDLINE
Externí odkaz: