• Resuscitation · Dec 2021

    Multicenter Study Observational Study

    Pulse oximetry waveform: a non-invasive physiological predictor for the return of spontaneous circulation in cardiac arrest patients ---- A multicenter, prospective observational study.

    • Jun Xu, Chen Li, Hanqi Tang, Dingyu Tan, Yangyang Fu, Liang Zong, Daoyuan Jing, Banghan Ding, Yu Cao, Zhongqiu Lu, Yingping Tian, Yanfen Chai, Yanli Meng, Zhen Wang, Ya-An Zheng, Xiaodong Zhao, Xinyan Zhang, Lu Liang, Zhongyi Zeng, Yan Li, Joseph H Walline, Priscilla P Song, Liangliang Zheng, Feng Sun, Shihuan Shao, Ming Sun, Mingwei Huang, Ruifeng Zeng, Shu Zhang, Xiaoya Yang, Dongqi Yao, Muming Yu, Hua Liao, Yingxia Xiong, Kang Zheng, Yuhong Qin, Yingbo An, Yuxiang Liu, Kun Chen, Huadong Zhu, Xuezhong Yu, and Bin Du.
    • Department of Emergency Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China.
    • Resuscitation. 2021 Dec 1; 169: 189-197.

    ObjectiveThis study aimed to investigate the predictive value of pulse oximetry plethysmography (POP) for the return of spontaneous circulation (ROSC) in cardiac arrest (CA) patients.MethodsThis 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.Results150 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.ConclusionPOP may be a novel and effective method for predicting ROSC during resuscitation, with a prognostic value similar to ETCO2 at early stage.Copyright © 2021 Elsevier B.V. All rights reserved.

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