Filtered electrocardiogram combined with end-tidal carbon dioxide for the identification of patients' cardiac arrest status during uninterrupted chest compressions in cardiopulmonary resuscitation.

OBJECTIVE

To explore the use of filtered Electrocardiogram combined with End-tidal carbon dioxide (fEEt) for the identification of cardiac arrest status without interruption of chest compressions in patients during cardiopulmonary resuscitation.

METHODS

This was a single-center prospective observational study involving 51 cardiac arrest patients at a tertiary hospital in China. The fEEt strategy was used to classify patients' cardiac arrest status during uninterrupted chest compressions, including return of spontaneous circulation (ROSC), shockable rhythm, pulseless electric activity (PEA) and asystole. Each episode was independently reported by a panel of emergency physicians. The traditional method was used to confirm the patients' status in real clinical situations, which served as the reference standard for the study. The primary outcome was the consistency and accuracy between the cardiac arrest status classified by the fEEt strategy and the traditional assessment.

RESULTS

A total of 51 cardiac arrest patients, with 575 segments were analyzed. Compared with the status assessed in reality, the fEEt strategy presented good consistency in predicting ROSC (Kappa = 0.695, p < 0.001) and shockable rhythm (Kappa = 0.704, p < 0.001), and moderate consistency in identifying PEA (Kappa = 0.535, p < 0.001) and asystole (Kappa = 0.574, p < 0.001). When the fEEt strategy was used to guide decisions regarding whether to stop chest compressions, considering that PEA and asystole indicate continuous compressions while ROSC and shockable rhythm were considered for cessation, the fEEt strategy also showed good consistency (Kappa = 0.656, p < 0.001) with traditional assessments.

CONCLUSION

Our findings suggest that the fEEt strategy might potentially help clinicians identify real time cardiac arrest status during ongoing chest compressions.