A hands-free carotid Doppler can identify spontaneous circulation without interrupting cardiopulmonary resuscitation: an animal study

Abstract Background Identifying spontaneous circulation during cardiopulmonary resuscitation (CPR) is challenging. Current methods, which involve intermittent and time-consuming pulse checks, necessitate pauses in chest compressions. This issue is problematic in both in-hospital cardiac arrest and o...

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Main Authors: Bjørn Ove Faldaas, Benjamin Stage Storm, Knut Tore Lappegård, Ole-Jakob How, Bent Aksel Nilsen, Gabriel Kiss, Eirik Skogvoll, Erik Waage Nielsen, Hans Torp, Charlotte Björk Ingul
Format: Article
Language:English
Published: SpringerOpen 2024-12-01
Series:Intensive Care Medicine Experimental
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Online Access:https://doi.org/10.1186/s40635-024-00704-w
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author Bjørn Ove Faldaas
Benjamin Stage Storm
Knut Tore Lappegård
Ole-Jakob How
Bent Aksel Nilsen
Gabriel Kiss
Eirik Skogvoll
Erik Waage Nielsen
Hans Torp
Charlotte Björk Ingul
author_facet Bjørn Ove Faldaas
Benjamin Stage Storm
Knut Tore Lappegård
Ole-Jakob How
Bent Aksel Nilsen
Gabriel Kiss
Eirik Skogvoll
Erik Waage Nielsen
Hans Torp
Charlotte Björk Ingul
author_sort Bjørn Ove Faldaas
collection DOAJ
description Abstract Background Identifying spontaneous circulation during cardiopulmonary resuscitation (CPR) is challenging. Current methods, which involve intermittent and time-consuming pulse checks, necessitate pauses in chest compressions. This issue is problematic in both in-hospital cardiac arrest and out-of-hospital cardiac arrest situations, where resources for identifying circulation during CPR may be limited. The fraction of chest compression plays a pivotal role in improving survival rates. To address this challenge, we evaluated a newly developed hands-free, continuous carotid Doppler system (RescueDoppler), designed to identify spontaneous circulation during chest compressions. In our study, we utilized a porcine model of cardiac arrest to investigate sequences of ventricular fibrillation, followed by defibrillation, and monitoring for the return of spontaneous circulation during chest compressions with the carotid Doppler system. We explored both manual compressions at 100 and 50 compressions per minute and mechanical compressions. To estimate the detection rate (i.e., sensitivity), we employed a logistic mixed model with animal identity as random effect. Results Offline analysis of Doppler color M-mode and spectral display successfully identified spontaneous circulation during chest compressions in all compression models. Spontaneous circulation was detected in 51 of 59 sequences, yielding an expected sensitivity of 98% with a 95% confidence interval of 59% to 99%. Conclusion The RescueDoppler, a continuous hands-free carotid Doppler system, demonstrates an expected sensitivity of 98% for identifying spontaneous circulation during both manual and mechanical chest compressions. Clinical studies are needed to further validate these findings.
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spelling doaj-art-0399eeaa3f4148b69ddd361d2a42d6c72024-12-29T12:07:59ZengSpringerOpenIntensive Care Medicine Experimental2197-425X2024-12-0112111310.1186/s40635-024-00704-wA hands-free carotid Doppler can identify spontaneous circulation without interrupting cardiopulmonary resuscitation: an animal studyBjørn Ove Faldaas0Benjamin Stage Storm1Knut Tore Lappegård2Ole-Jakob How3Bent Aksel Nilsen4Gabriel Kiss5Eirik Skogvoll6Erik Waage Nielsen7Hans Torp8Charlotte Björk Ingul9Faculty of Nursing and Health Sciences, Nord UniversityFaculty of Nursing and Health Sciences, Nord UniversityDepartment of Clinical Medicine, Faculty of Health Sciences, UiT the Arctic University of NorwayFaculty of Biosciences and Aquaculture, Nord UniversityFaculty of Nursing and Health Sciences, Nord UniversityDepartment of Computer Science (IDI), Faculty of Information Technology and Electrical Engineering, Norwegian University of Science and Technology (NTNU)Department of Circulation and Medical Imaging, Norwegian University of Science and Technology (NTNU)Faculty of Nursing and Health Sciences, Nord UniversityDepartment of Circulation and Medical Imaging, Norwegian University of Science and Technology (NTNU)Faculty of Nursing and Health Sciences, Nord UniversityAbstract Background Identifying spontaneous circulation during cardiopulmonary resuscitation (CPR) is challenging. Current methods, which involve intermittent and time-consuming pulse checks, necessitate pauses in chest compressions. This issue is problematic in both in-hospital cardiac arrest and out-of-hospital cardiac arrest situations, where resources for identifying circulation during CPR may be limited. The fraction of chest compression plays a pivotal role in improving survival rates. To address this challenge, we evaluated a newly developed hands-free, continuous carotid Doppler system (RescueDoppler), designed to identify spontaneous circulation during chest compressions. In our study, we utilized a porcine model of cardiac arrest to investigate sequences of ventricular fibrillation, followed by defibrillation, and monitoring for the return of spontaneous circulation during chest compressions with the carotid Doppler system. We explored both manual compressions at 100 and 50 compressions per minute and mechanical compressions. To estimate the detection rate (i.e., sensitivity), we employed a logistic mixed model with animal identity as random effect. Results Offline analysis of Doppler color M-mode and spectral display successfully identified spontaneous circulation during chest compressions in all compression models. Spontaneous circulation was detected in 51 of 59 sequences, yielding an expected sensitivity of 98% with a 95% confidence interval of 59% to 99%. Conclusion The RescueDoppler, a continuous hands-free carotid Doppler system, demonstrates an expected sensitivity of 98% for identifying spontaneous circulation during both manual and mechanical chest compressions. Clinical studies are needed to further validate these findings.https://doi.org/10.1186/s40635-024-00704-wCardiac arrestChest compressionCardiopulmonary resuscitationFeedback deviceReturn of spontaneous circulationCardiac arrest monitor
spellingShingle Bjørn Ove Faldaas
Benjamin Stage Storm
Knut Tore Lappegård
Ole-Jakob How
Bent Aksel Nilsen
Gabriel Kiss
Eirik Skogvoll
Erik Waage Nielsen
Hans Torp
Charlotte Björk Ingul
A hands-free carotid Doppler can identify spontaneous circulation without interrupting cardiopulmonary resuscitation: an animal study
Intensive Care Medicine Experimental
Cardiac arrest
Chest compression
Cardiopulmonary resuscitation
Feedback device
Return of spontaneous circulation
Cardiac arrest monitor
title A hands-free carotid Doppler can identify spontaneous circulation without interrupting cardiopulmonary resuscitation: an animal study
title_full A hands-free carotid Doppler can identify spontaneous circulation without interrupting cardiopulmonary resuscitation: an animal study
title_fullStr A hands-free carotid Doppler can identify spontaneous circulation without interrupting cardiopulmonary resuscitation: an animal study
title_full_unstemmed A hands-free carotid Doppler can identify spontaneous circulation without interrupting cardiopulmonary resuscitation: an animal study
title_short A hands-free carotid Doppler can identify spontaneous circulation without interrupting cardiopulmonary resuscitation: an animal study
title_sort hands free carotid doppler can identify spontaneous circulation without interrupting cardiopulmonary resuscitation an animal study
topic Cardiac arrest
Chest compression
Cardiopulmonary resuscitation
Feedback device
Return of spontaneous circulation
Cardiac arrest monitor
url https://doi.org/10.1186/s40635-024-00704-w
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