Detection of a spontaneous pulse in photoplethysmograms during automated cardiopulmonary resuscitation in a porcine model

R.W.C.G.R. Wijshoff, T. Sar, van der, W.H. Peeters, R. Bezemer, P. Aelen, I.W.F. Paulussen, S.C.M.A. Ordelman, A. Venema, P.F.J. Berkom, van, R.M. Aarts, P.H. Woerlee, G.J. Scheffer, G.J. Noordergraaf

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Abstract

Introduction Reliable, non-invasive detection of return of spontaneous circulation (ROSC) with minimal interruptions to chest compressions would be valuable for high-quality cardiopulmonary resuscitation (CPR). We investigated the potential of photoplethysmography (PPG) to detect the presence of a spontaneous pulse during automated CPR in an animal study. Methods Twelve anesthetized pigs were instrumented to monitor circulatory and respiratory parameters. Here we present the simultaneously recorded PPG and arterial blood pressure (ABP) signals. Ventricular fibrillation was induced, followed by 20 min of automated CPR and subsequent defibrillation. After defibrillation, pediatric-guidelines-style life support was given in cycles of 2 min. PPG and ABP waveforms were recorded during all stages of the protocol. Raw PPG waveforms were acquired with a custom-built photoplethysmograph controlling a commercial reflectance pulse oximetry probe attached to the nose. ABP was measured in the aorta. Results In nine animals ROSC was achieved. Throughout the protocol, PPG and ABP frequency content showed strong resemblance. We demonstrate that (1) the PPG waveform allows for the detection of a spontaneous pulse during ventilation pauses, and that (2) frequency analysis of the PPG waveform allows for the detection of a spontaneous pulse and the determination of the pulse rate, even during ongoing chest compressions, if the pulse and compression rates are sufficiently distinct. Conclusions These results demonstrate the potential of PPG as a non-invasive means to detect pulse presence or absence, as well as pulse rate during CPR.
Original languageEnglish
Pages (from-to)1625-1632
JournalResuscitation
Volume84
Issue number11
DOIs
Publication statusPublished - Nov 2013

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Photoplethysmography
Cardiopulmonary Resuscitation
Pulse
Swine
Arterial Pressure
Thorax
Heart Rate
Oximetry
Ventricular Fibrillation
Nose
Ventilation
Aorta
Life Style
Guidelines
Pediatrics

Cite this

Wijshoff, R. W. C. G. R., Sar, van der, T., Peeters, W. H., Bezemer, R., Aelen, P., Paulussen, I. W. F., ... Noordergraaf, G. J. (2013). Detection of a spontaneous pulse in photoplethysmograms during automated cardiopulmonary resuscitation in a porcine model. Resuscitation, 84(11), 1625-1632. https://doi.org/10.1016/j.resuscitation.2013.07.019
Wijshoff, R.W.C.G.R. ; Sar, van der, T. ; Peeters, W.H. ; Bezemer, R. ; Aelen, P. ; Paulussen, I.W.F. ; Ordelman, S.C.M.A. ; Venema, A. ; Berkom, van, P.F.J. ; Aarts, R.M. ; Woerlee, P.H. ; Scheffer, G.J. ; Noordergraaf, G.J. / Detection of a spontaneous pulse in photoplethysmograms during automated cardiopulmonary resuscitation in a porcine model. In: Resuscitation. 2013 ; Vol. 84, No. 11. pp. 1625-1632.
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abstract = "Introduction Reliable, non-invasive detection of return of spontaneous circulation (ROSC) with minimal interruptions to chest compressions would be valuable for high-quality cardiopulmonary resuscitation (CPR). We investigated the potential of photoplethysmography (PPG) to detect the presence of a spontaneous pulse during automated CPR in an animal study. Methods Twelve anesthetized pigs were instrumented to monitor circulatory and respiratory parameters. Here we present the simultaneously recorded PPG and arterial blood pressure (ABP) signals. Ventricular fibrillation was induced, followed by 20 min of automated CPR and subsequent defibrillation. After defibrillation, pediatric-guidelines-style life support was given in cycles of 2 min. PPG and ABP waveforms were recorded during all stages of the protocol. Raw PPG waveforms were acquired with a custom-built photoplethysmograph controlling a commercial reflectance pulse oximetry probe attached to the nose. ABP was measured in the aorta. Results In nine animals ROSC was achieved. Throughout the protocol, PPG and ABP frequency content showed strong resemblance. We demonstrate that (1) the PPG waveform allows for the detection of a spontaneous pulse during ventilation pauses, and that (2) frequency analysis of the PPG waveform allows for the detection of a spontaneous pulse and the determination of the pulse rate, even during ongoing chest compressions, if the pulse and compression rates are sufficiently distinct. Conclusions These results demonstrate the potential of PPG as a non-invasive means to detect pulse presence or absence, as well as pulse rate during CPR.",
author = "R.W.C.G.R. Wijshoff and {Sar, van der}, T. and W.H. Peeters and R. Bezemer and P. Aelen and I.W.F. Paulussen and S.C.M.A. Ordelman and A. Venema and {Berkom, van}, P.F.J. and R.M. Aarts and P.H. Woerlee and G.J. Scheffer and G.J. Noordergraaf",
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Wijshoff, RWCGR, Sar, van der, T, Peeters, WH, Bezemer, R, Aelen, P, Paulussen, IWF, Ordelman, SCMA, Venema, A, Berkom, van, PFJ, Aarts, RM, Woerlee, PH, Scheffer, GJ & Noordergraaf, GJ 2013, 'Detection of a spontaneous pulse in photoplethysmograms during automated cardiopulmonary resuscitation in a porcine model', Resuscitation, vol. 84, no. 11, pp. 1625-1632. https://doi.org/10.1016/j.resuscitation.2013.07.019

Detection of a spontaneous pulse in photoplethysmograms during automated cardiopulmonary resuscitation in a porcine model. / Wijshoff, R.W.C.G.R.; Sar, van der, T.; Peeters, W.H.; Bezemer, R.; Aelen, P.; Paulussen, I.W.F.; Ordelman, S.C.M.A.; Venema, A.; Berkom, van, P.F.J.; Aarts, R.M.; Woerlee, P.H.; Scheffer, G.J.; Noordergraaf, G.J.

In: Resuscitation, Vol. 84, No. 11, 11.2013, p. 1625-1632.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Detection of a spontaneous pulse in photoplethysmograms during automated cardiopulmonary resuscitation in a porcine model

AU - Wijshoff, R.W.C.G.R.

AU - Sar, van der, T.

AU - Peeters, W.H.

AU - Bezemer, R.

AU - Aelen, P.

AU - Paulussen, I.W.F.

AU - Ordelman, S.C.M.A.

AU - Venema, A.

AU - Berkom, van, P.F.J.

AU - Aarts, R.M.

AU - Woerlee, P.H.

AU - Scheffer, G.J.

AU - Noordergraaf, G.J.

PY - 2013/11

Y1 - 2013/11

N2 - Introduction Reliable, non-invasive detection of return of spontaneous circulation (ROSC) with minimal interruptions to chest compressions would be valuable for high-quality cardiopulmonary resuscitation (CPR). We investigated the potential of photoplethysmography (PPG) to detect the presence of a spontaneous pulse during automated CPR in an animal study. Methods Twelve anesthetized pigs were instrumented to monitor circulatory and respiratory parameters. Here we present the simultaneously recorded PPG and arterial blood pressure (ABP) signals. Ventricular fibrillation was induced, followed by 20 min of automated CPR and subsequent defibrillation. After defibrillation, pediatric-guidelines-style life support was given in cycles of 2 min. PPG and ABP waveforms were recorded during all stages of the protocol. Raw PPG waveforms were acquired with a custom-built photoplethysmograph controlling a commercial reflectance pulse oximetry probe attached to the nose. ABP was measured in the aorta. Results In nine animals ROSC was achieved. Throughout the protocol, PPG and ABP frequency content showed strong resemblance. We demonstrate that (1) the PPG waveform allows for the detection of a spontaneous pulse during ventilation pauses, and that (2) frequency analysis of the PPG waveform allows for the detection of a spontaneous pulse and the determination of the pulse rate, even during ongoing chest compressions, if the pulse and compression rates are sufficiently distinct. Conclusions These results demonstrate the potential of PPG as a non-invasive means to detect pulse presence or absence, as well as pulse rate during CPR.

AB - Introduction Reliable, non-invasive detection of return of spontaneous circulation (ROSC) with minimal interruptions to chest compressions would be valuable for high-quality cardiopulmonary resuscitation (CPR). We investigated the potential of photoplethysmography (PPG) to detect the presence of a spontaneous pulse during automated CPR in an animal study. Methods Twelve anesthetized pigs were instrumented to monitor circulatory and respiratory parameters. Here we present the simultaneously recorded PPG and arterial blood pressure (ABP) signals. Ventricular fibrillation was induced, followed by 20 min of automated CPR and subsequent defibrillation. After defibrillation, pediatric-guidelines-style life support was given in cycles of 2 min. PPG and ABP waveforms were recorded during all stages of the protocol. Raw PPG waveforms were acquired with a custom-built photoplethysmograph controlling a commercial reflectance pulse oximetry probe attached to the nose. ABP was measured in the aorta. Results In nine animals ROSC was achieved. Throughout the protocol, PPG and ABP frequency content showed strong resemblance. We demonstrate that (1) the PPG waveform allows for the detection of a spontaneous pulse during ventilation pauses, and that (2) frequency analysis of the PPG waveform allows for the detection of a spontaneous pulse and the determination of the pulse rate, even during ongoing chest compressions, if the pulse and compression rates are sufficiently distinct. Conclusions These results demonstrate the potential of PPG as a non-invasive means to detect pulse presence or absence, as well as pulse rate during CPR.

U2 - 10.1016/j.resuscitation.2013.07.019

DO - 10.1016/j.resuscitation.2013.07.019

M3 - Article

C2 - 23907100

VL - 84

SP - 1625

EP - 1632

JO - Resuscitation

JF - Resuscitation

SN - 0300-9572

IS - 11

ER -