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Pulse oximetry waveform: a non-invasive physiological predictor for the return of spontaneous circulation in cardiac arrest patients ---- A multicenter, prospective observational study
Resuscitation ( IF 6.5 ) Pub Date : 2021-10-06 , DOI: 10.1016/j.resuscitation.2021.09.032
Jun Xu 1 , Chen Li 2 , Hanqi Tang 1 , Dingyu Tan 3 , Yangyang Fu 1 , Liang Zong 1 , Daoyuan Jing 4 , Banghan Ding 5 , Yu Cao 6 , Zhongqiu Lu 7 , Yingping Tian 8 , Yanfen Chai 9 , Yanli Meng 10 , Zhen Wang 11 , Ya-An Zheng 12 , Xiaodong Zhao 13 , Xinyan Zhang 14 , Lu Liang 15 , Zhongyi Zeng 16 , Yan Li 1 , Joseph H Walline 17 , Priscilla P Song 17 , Liangliang Zheng 18 , Feng Sun 19 , Shihuan Shao 20 , Ming Sun 21 , Mingwei Huang 4 , Ruifeng Zeng 5 , Shu Zhang 6 , Xiaoya Yang 7 , Dongqi Yao 8 , Muming Yu 9 , Hua Liao 10 , Yingxia Xiong 11 , Kang Zheng 12 , Yuhong Qin 13 , Yingbo An 14 , Yuxiang Liu 15 , Kun Chen 4 , Huadong Zhu 1 , Xuezhong Yu 1 , Bin Du 22
Affiliation  

Objective

This study aimed to investigate the predictive value of pulse oximetry plethysmography (POP) for the return of spontaneous circulation (ROSC) in cardiac arrest (CA) patients.

Methods

This was a multicenter, observational, prospective cohort study of patients hospitalized with cardiac arrest at 14 teaching hospitals cross China from December 2013 through November 2014. The study endpoint was ROSC, defined as the restoration of a palpable pulse and an autonomous cardiac rhythm lasting for at least 20 minutes after the completion or cessation of CPR.

Results

150 out-of-hospital cardiac arrest (OHCA) patients and 291 in-hospital cardiac arrest (IHCA) patients were enrolled prospectively. ROSC was achieved in 20 (13.3%) and 64 (22.0%) patients in these cohorts, respectively. In patients with complete end-tidal carbon dioxide (ETCO2) and POP data, patients with ROSC had significantly higher levels of POP area under the curve (AUCp), wave amplitude (Amp) and ETCO2 level during CPR than those without ROSC (all p<0.05). Pairwise comparison of receiver operating characteristic (ROC) curve analysis indicated no significant difference was observed between ETCO2 and Amp (p=0.204) or AUCp (p=0.588) during the first two minutes of resuscitation.

Conclusion

POP may be a novel and effective method for predicting ROSC during resuscitation, with a prognostic value similar to ETCO2 at early stage.

更新日期:2021-10-06
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