Pulse Oximetry: A Non-Invasive, Novel Marker for the Quality of Chest Compressions in Porcine Models of Cardiac Arrest.
OBJECTIVE
Pulse oximetry, which noninvasively detects the blood flow of peripheral tissue, has achieved widespread clinical use. We have noticed that the better the quality of cardiopulmonary resuscitation (CPR), the better the appearance of pulse oximetry plethysmographic waveform (POP). We investigated whether the area under the curve (AUC) and/or the amplitude (Amp) of POP could be used to monitor the quality of CPR.


METHODS
Prospective, randomized controlled study.


METHODS
Animal experimental center in Peking Union Medical Collage Hospital, Beijing, China.


METHODS
Healthy 3-month-old male domestic swine.


METHODS
34 local pigs were enrolled in this study. After 4 minutes of untreated ventricular fibrillation, animals were randomly assigned into two resuscitation groups: a "low quality" group (with a compression depth of 3cm) and a "high quality" group (with a depth of 5cm). All treatments between the two groups were identical except for the depth of chest compressions. Hemodynamic parameters [coronary perfusion pressure (CPP), partial pressure of end-tidal carbon dioxide (PETCO2)] as well as AUC and Amp of POP were all collected and analyzed.


RESULTS
There were statistical differences between the "high quality" group and the "low quality" group in AUC, Amp, CPP and PETCO2 during CPR (P<0.05). AUC, Amp and CPP were positively correlated with PETCO2, respectively (P<0.01). There was no statistical difference between the heart rate calculated according to the POP (FCPR) and the frequency of mechanical CPR at the 3rd minute of CPR. The FCPR was lower than the frequency of mechanical CPR at the 6th and the 9th minute of CPR.


CONCLUSIONS
Both the AUC and Amp of POP correlated well with CPP and PETCO2 in animal models. The frequency of POP closely matched the CPR heart rate. AUC and Amp of POP might be potential noninvasive quality monitoring markers for CPR.
Emergency Department, Peking Union Medical College Hospital, Chinese Academy of Medical sciences, Beijing, China.
Jun
J
Xu
Emergency Department, Tianjin Medical University General Hospital, Tianjin, China.
Chen
C
Li
Emergency Department, Beijing Hospital, Beijing, China.
Liangliang
L
Zheng
Institute of Life Monitoring, Mindray Corporation, Shenzhen, China.
Fei
F
Han
Emergency Department, Peking Union Medical College Hospital, Chinese Academy of Medical sciences, Beijing, China.
Yan
Y
Li
Division of Emergency Medicine, Department of Surgery, Saint Louis University Hospital, Saint Louis, Missouri, United States of America.
Joseph
J
Walline
Emergency Department, Peking Union Medical College Hospital, Chinese Academy of Medical sciences, Beijing, China.
Yangyang
Y
Fu
Emergency Department, Peking Union Medical College Hospital, Chinese Academy of Medical sciences, Beijing, China.
Dongqi
D
Yao
Institute of Life Monitoring, Mindray Corporation, Shenzhen, China.
Xiaocui
X
Zhang
Emergency Department, Peking Union Medical College Hospital, Chinese Academy of Medical sciences, Beijing, China.
Hui
H
Zhang
Emergency Department, Peking Union Medical College Hospital, Chinese Academy of Medical sciences, Beijing, China.
Huadong
H
Zhu
Emergency Department, Peking Union Medical College Hospital, Chinese Academy of Medical sciences, Beijing, China.
Shubin
S
Guo
Emergency Department, Beijing Tsinghua Chang Gung Hospital, Beijing, China.
Zhong
Z
Wang
Emergency Department, Peking Union Medical College Hospital, Chinese Academy of Medical sciences, Beijing, China.
Xuezhong
X
Yu
D000818:Animals; D016887:Cardiopulmonary Resuscitation / Q000379:methods*; D004195:Disease Models, Animal; D006323:Heart Arrest / Q000503:physiopathology / Q000628:therapy*; D008297:Male; D008991:Monitoring, Physiologic; D010092:Oximetry / Q000379:methods*; D011446:Prospective Studies; D013552:Swine; D014693:Ventricular Fibrillation / Q000503:physiopathology