title: Electrocardiogram waveforms for monitoring effectiveness of chest compression during cardiopulmonary resuscitation.
abstract: BACKGROUND
  Newer guidelines address the importance of effective chest compressions, citing evidence that this primary intervention is usually suboptimally performed during cardiopulmonary resuscitation. We therefore sought a readily available option for monitoring the effectiveness of chest compressions, specifically using the electrocardiogram.
  
  
  RESULTS
  Ventricular fibrillation was induced by coronary artery occlusion and untreated for 5 mins. Male domestic pigs weighing 40 +/- 2 kg were randomized to optimal or suboptimal chest compressions after onset of ventricular fibrillation. Optimal depth of mechanical compression in six animals was defined as a decrease of 25% in anterior posterior diameter of the chest during compression. Suboptimal compression, also in six animals, was defined as a decrease of 17.5% in anterior posterior diameter. For each group, the chest compressions were maintained at a rate of 100 per min. After 3 mins of chest compression, defibrillation was attempted with a 150-J biphasic shock. All animals had return of spontaneous circulation after optimal compressions. This contrasted with suboptimal compressions, after which none of the animals had return of spontaneous circulation. Amplitude spectrum area values, representing the electrocardiographic amplitude frequency spectral area computed from conventional precordial leads, like coronary perfusion pressure and end tidal PCO2, were predictive of outcomes.
  
  
  CONCLUSIONS
  The effectiveness of chest compressions was reflected in the amplitude spectrum area values. Accordingly, the amplitude spectrum area predictor may be incorporated in current automated external defibrillators to monitor and prompt the effectiveness of chest compression during cardiopulmonary resuscitation.
authors: Weil Institute of Critical Care Medicine, Rancho Mirage, CA, USA.
authors: Yongqin
authors: Y
authors: Li
authors: Giuseppe
authors: G
authors: Ristagno
authors: Joe
authors: J
authors: Bisera
authors: Wanchun
authors: W
authors: Tang
authors: Qinkai
authors: Q
authors: Deng
authors: Max Harry
authors: MH
authors: Weil
mesh_terms: D000818:Animals; D004195:Disease Models, Animal; D004562:Electrocardiography / Q000379:methods*; D006323:Heart Arrest / Q000628:therapy*; D006336:Heart Massage / Q000295:instrumentation* / Q000379:methods; D008297:Male; D011897:Random Allocation; D034421:Sus scrofa; D016896:Treatment Outcome