Real-time feedback on chest compression efficacy by hands-free carotid Doppler in a porcine model
Aim: Current guidelines for cardiopulmonary resuscitation (CPR) recommend a one-size-fits-all approach in relation to the positioning of chest compressions. We recently developed RescueDoppler, a hands-free Doppler ultrasound device for continuous monitoring of carotid blood flow velocity during CPR...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2024-06-01
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| Series: | Resuscitation Plus |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666520424000341 |
| _version_ | 1797300295660732416 |
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| author | Bjørn Ove Faldaas Erik Waage Nielsen Benjamin Stage Storm Knut Tore Lappegård Bent Aksel Nilsen Gabriel Kiss Eirik Skogvoll Hans Torp Charlotte Björk Ingul |
| author_facet | Bjørn Ove Faldaas Erik Waage Nielsen Benjamin Stage Storm Knut Tore Lappegård Bent Aksel Nilsen Gabriel Kiss Eirik Skogvoll Hans Torp Charlotte Björk Ingul |
| author_sort | Bjørn Ove Faldaas |
| collection | DOAJ |
| description | Aim: Current guidelines for cardiopulmonary resuscitation (CPR) recommend a one-size-fits-all approach in relation to the positioning of chest compressions. We recently developed RescueDoppler, a hands-free Doppler ultrasound device for continuous monitoring of carotid blood flow velocity during CPR. The aim of the present study is to investigate whether RescueDoppler via real-time hemodynamic feedback, could identify both optimal and suboptimal compression positions. Methods: In this model of animal cardiac arrest, we induced ventricular fibrillation in five domestic pigs. Manual chest compressions were performed for ten seconds at three different positions on the sternum in random order and repeated six times. We analysed Time Average Velocity (TAV) with chest compression position as a fixed effect and animal, position, and sequential time within animals as random effects. Furthermore, we compared TAV to invasive blood pressure from the contralateral carotid artery. Results: We were able to detect changes in TAV when altering positions. The positions with the highest (range 19 to 48 cm/s) and lowest (6–25 cm/s) TAV were identified in all animals, with corresponding peak pressure 50–81 mmHg, and 46–64 mmHg, respectively. Blood flow velocity was, on average, highest at the middle position (TAV 33 cm/s), but with significant variability between animals (SD 2.8) and positions within the same animal (SD 9.3). Conclusion: RescueDoppler detected TAV changes during CPR with alternating chest compression positions, identifying the position yielding maximal TAV. Future clinical studies should investigate if RescueDoppler can be used as a real-time hemodynamical feedback device to guide compression position. |
| first_indexed | 2024-03-07T23:05:13Z |
| format | Article |
| id | doaj.art-80e5d8f0fe57462889ec3df9b15144de |
| institution | Directory Open Access Journal |
| issn | 2666-5204 |
| language | English |
| last_indexed | 2024-03-07T23:05:13Z |
| publishDate | 2024-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Resuscitation Plus |
| spelling | doaj.art-80e5d8f0fe57462889ec3df9b15144de2024-02-22T04:53:35ZengElsevierResuscitation Plus2666-52042024-06-0118100583Real-time feedback on chest compression efficacy by hands-free carotid Doppler in a porcine modelBjørn Ove Faldaas0Erik Waage Nielsen1Benjamin Stage Storm2Knut Tore Lappegård3Bent Aksel Nilsen4Gabriel Kiss5Eirik Skogvoll6Hans Torp7Charlotte Björk Ingul8Faculty of Nursing and Health Sciences, Nord University, Bodø, Norway; Department of Circulation and Medical Imaging, Norwegian University of Science and Technology (NTNU), Trondheim, NorwayFaculty of Nursing and Health Sciences, Nord University, Bodø, Norway; Department of Clinical Medicine, Faculty of Health Sciences, UiT the Arctic University of Norway, Tromsø, Norway; Department of Surgery, Nordland Hospital Trust, Bodø, Norway; Department of Pain Management and Research, Division of Emergencies and Critical Care, Oslo University Hospital, Oslo, NorwayFaculty of Nursing and Health Sciences, Nord University, Bodø, Norway; Department of Clinical Medicine, Faculty of Health Sciences, UiT the Arctic University of Norway, Tromsø, Norway; Department of Surgery, Nordland Hospital Trust, Bodø, NorwayDepartment of Clinical Medicine, Faculty of Health Sciences, UiT the Arctic University of Norway, Tromsø, Norway; Department of Medicine, Nordland Hospital Trust, Bodø, NorwayFaculty of Nursing and Health Sciences, Nord University, Bodø, Norway; Department of Surgery, Nordland Hospital Trust, Bodø, NorwayDepartment of Computer Science (IDI), Faculty of Information Technology and Electrical Engineering, Norwegian University of Science and Technology (NTNU), Trondheim, NorwayDepartment of Circulation and Medical Imaging, Norwegian University of Science and Technology (NTNU), Trondheim, Norway; Clinic of Anesthesia and Intensive Care Medicine, St Olav University Hospital, Trondheim, NorwayDepartment of Circulation and Medical Imaging, Norwegian University of Science and Technology (NTNU), Trondheim, NorwayFaculty of Nursing and Health Sciences, Nord University, Bodø, Norway; Department of Circulation and Medical Imaging, Norwegian University of Science and Technology (NTNU), Trondheim, Norway; Corresponding author.Aim: Current guidelines for cardiopulmonary resuscitation (CPR) recommend a one-size-fits-all approach in relation to the positioning of chest compressions. We recently developed RescueDoppler, a hands-free Doppler ultrasound device for continuous monitoring of carotid blood flow velocity during CPR. The aim of the present study is to investigate whether RescueDoppler via real-time hemodynamic feedback, could identify both optimal and suboptimal compression positions. Methods: In this model of animal cardiac arrest, we induced ventricular fibrillation in five domestic pigs. Manual chest compressions were performed for ten seconds at three different positions on the sternum in random order and repeated six times. We analysed Time Average Velocity (TAV) with chest compression position as a fixed effect and animal, position, and sequential time within animals as random effects. Furthermore, we compared TAV to invasive blood pressure from the contralateral carotid artery. Results: We were able to detect changes in TAV when altering positions. The positions with the highest (range 19 to 48 cm/s) and lowest (6–25 cm/s) TAV were identified in all animals, with corresponding peak pressure 50–81 mmHg, and 46–64 mmHg, respectively. Blood flow velocity was, on average, highest at the middle position (TAV 33 cm/s), but with significant variability between animals (SD 2.8) and positions within the same animal (SD 9.3). Conclusion: RescueDoppler detected TAV changes during CPR with alternating chest compression positions, identifying the position yielding maximal TAV. Future clinical studies should investigate if RescueDoppler can be used as a real-time hemodynamical feedback device to guide compression position.http://www.sciencedirect.com/science/article/pii/S2666520424000341Cardiopulmonary resuscitation (CPR)Manual chest compressionsDoppler ultrasoundCarotid arteryReal-time feedbackPhysiologic monitoring |
| spellingShingle | Bjørn Ove Faldaas Erik Waage Nielsen Benjamin Stage Storm Knut Tore Lappegård Bent Aksel Nilsen Gabriel Kiss Eirik Skogvoll Hans Torp Charlotte Björk Ingul Real-time feedback on chest compression efficacy by hands-free carotid Doppler in a porcine model Resuscitation Plus Cardiopulmonary resuscitation (CPR) Manual chest compressions Doppler ultrasound Carotid artery Real-time feedback Physiologic monitoring |
| title | Real-time feedback on chest compression efficacy by hands-free carotid Doppler in a porcine model |
| title_full | Real-time feedback on chest compression efficacy by hands-free carotid Doppler in a porcine model |
| title_fullStr | Real-time feedback on chest compression efficacy by hands-free carotid Doppler in a porcine model |
| title_full_unstemmed | Real-time feedback on chest compression efficacy by hands-free carotid Doppler in a porcine model |
| title_short | Real-time feedback on chest compression efficacy by hands-free carotid Doppler in a porcine model |
| title_sort | real time feedback on chest compression efficacy by hands free carotid doppler in a porcine model |
| topic | Cardiopulmonary resuscitation (CPR) Manual chest compressions Doppler ultrasound Carotid artery Real-time feedback Physiologic monitoring |
| url | http://www.sciencedirect.com/science/article/pii/S2666520424000341 |
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