“Advanced life support therapy and on out-of-hospital cardiac arrest patients: Applying signal processing and pattern recognition methods”

Authors: Trygve Eftestøl, Martin Risdal, Joar Eilevstjønn and Petter A. Steen,
Affiliation: University of Stavanger, Laerdal Medical and Ullevål University Hospital
Reference: 2005, Vol 26, No 4, pp. 221-235.

Keywords: Cardiac arrest, ventricular fibrillation, cardiopulmonary resuscitation, ECG analysis, decision support, defibrillation, CPR artefact removal

Abstract: In the US alone, several hundred thousands die of sudden cardiac arrests each year. Basic life support defined as chest compressions and ventilations and early defibrillation are the only factors proven to increase the survival of patients with out-of-hospital cardiac arrest, and are key elements in the chain of survival defined by the American Heart Association. The current cardiopulmonary resuscitation guidelines treat all patients the same, but studies show need for more individualiza- tion of treatment. This review will focus on ideas on how to strengthen the weak parts of the chain of survival including the ability to measure the effects of therapy, improve time efficiency, and optimize the sequence and quality of the various components of cardiopulmonary resuscitation.

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References:
[1] AASE, S.O., EFTESTØL, T. HUSØY, J. H. (2000). CPR artifact removal from human ECG using optimal multichannel filtering, IEEE Trans BME, 48, pp. 1440-1449 doi:10.1109/10.880095
[2] ACHLEITNER, U., WENZEL, V. STROHMENGER, H. U. (2000). The effects of repeated doses of epinephrine on ventricular fibrillation in a porcine model of prolonged cardiopulmonary resuscitation, Anesth AnaIg, 90, pp. 1067-1075 doi:10.1097/00000539-200005000-00012
[3] AMANN, A., RHEINBERGER, K. ACHLEITNER, U. (2001). Algorithms to analyze ventricular fibrillation signals, Current Opinion in Critical Care, 7, pp. 152-156 doi:10.1097/00075198-200106000-00003
[4] COBB, L. A., FAHRENBRUCH, C. E. WALSH, T.R. (1999). Influence of cardiopulmonary resuscitation prior to defibrillation in patients with out-of-hospital ventricular fibrillation, JAMA, 28.13, pp. 1181-1188 doi:10.1001/jama.281.13.1182
[5] CUMMINS, R.O., EISENBERG, M. S., HALLSTROM, A. P., HEARNE, T. R., GRAVES, J. R. LITWIN, P. E. (1985). What is a ´save´?, American Heart Journal, 110, pp. 1133-1138 doi:10.1016/0002-8703(85)90002-X
[6] DUDA, R.O., HART, P. E. STORK, D. G. (2001). Pattern classification: Second edition, John Wiley and Sons, New York.NY.
[7] EFTESTØL, T., EILEVSTJØNN, J. STEEN, P. A. (2003). Advanced life support therapy on out-of-hospital cardiac arrest patients: an engineering perspective, Expert Rev. Cardiovasc. Ther., .2, pp. 89-99.
[8] EFTESTØL, T., LOSERT, H, KRAMER-JOHANSEN, J., WIK, L., STERZ, F. STEEN, P. A. (2005). Independent evaluation of a defibrillation outcome predictor for out-of-hospital cardiac arrest patients, Resuscitation, In press doi:10.1016/j.resuscitation.2005.05.006
[9] EFTESTØL, T., SUNDE, K. AASE, S.O. (2001). ´Probability of successful defibrillation´ as a monitor during CPR in out-of-hospital cardiac arrested patients, Resuscitation, 48, pp. 245-254 doi:10.1016/S0300-9572(00)00266-5
[10] EFTESTØL, T., SUNDE, K. AASE, S.O. (2000). Predicting outcome of defibrillation by spectral characterization and nonparametric classification of ventricular fibrillation in patients with out-of-hospital cardiac arrest, Circulation, 102, pp. 1523-1529.
[11] EFTESTØL, T., SUNDE, K. STEEN, P. A. (2002). The effects of interrupting precordial compressions on the calculated probability of defibrillation success during out-of-hospital cardiac arrest, Circulation, 105, pp. 2270-2273 doi:10.1161/01.CIR.0000016362.42586.FE
[12] EFTESTØL, T., Wix, L., SUNDE, K. STEEN, P. A. (2004). Effects of cardiopulmonary resuscitation on predictors of ventricular fibrillation defibrillation success during out-of-hospital cardiac arrest, Circulation, 110, 10-15 doi:10.1161/01.CIR.0000133323.15565.75
[13] EILEVSTJØNN, J., EFTESTØL, T., AASE, S.O., MYKLEBUST, H., HUSØY, J. H. H. STEEN, P. A. (2004). Feasability of shock advice analysis during CPR through removal of CPR artefacts from human ECG, Resuscitation, 2, pp. 131-141 doi:10.1016/j.resuscitation.2003.12.019
[14] EILEVSTJØNN, J., KRAMER-JOHANSEN, J., EFTESTØL, T., STAVLAND, M., MYKLEBUST, H. STEEN, P. A. (2005). Reducing no flow times during automated external defibrillation, Resuscitation In press doi:10.1016/j.resuscitation.2005.04.009
[15] EISENBERG, M. S., HORWOOD, B. T. CUMMINS, R.O. (1990). Cardiac arrest and resuscitation: A tale of 29 cities, Ann Emerg Med, 19, pp. 179-186 doi:10.1016/S0196-0644(05)81805-0
[16] FONG, A. C. M., Hui, S. C. JIIA, G. (2002). Data mining for decision support IT Pro March/April, pp. 9-17.
[17] GLINER, B. E. WHITE, R. D. (1999). Electrocardiographic evaluation of defibrillation shocks delivered to out-of-hospital sudden cardiac arrest patients, Resuscitation, 41, pp. 133-144 doi:10.1016/S0300-9572(99)00040-4
[18] Circulation (2000). Guidelines for cardiopulmonary resuscitation and emergency cardiovascular care, Part 4: The automated external defibrillator. Circulation 102, suppl 1, 1-60-1-76.2000.
[19] HARGARTEN, K. M., STUEVEN, H. A. WAITE, E.M. (1990). Prehospital experience with defibrillation of coarse ventricular fibrillation: a ten-year review, Ann Emerg Med, 19, pp. 157-162 doi:10.1016/S0196-0644(05)81801-3
[20] HERLITZ, J., BAHR, J. FISCHER, NI. (1999). Resuscitation in Europe: a tale of five European regions, Resuscitation, 41, pp. 121-131 doi:10.1016/S0300-9572(99)00045-3
[21] HUSØY, H., EILEVSTJØNN, J, EFTESTØL, T., AASE, S.O., MYKLEBUST, H. STEEN. P. A. (2002). Removal of cardiopulmonary resuscitation artifacts from human ECG using an efficient matching pursuit-like algorithm, IEEE Trans BME, 4.11, pp. 1287-1298.
[22] KOVALERCHUK, B., VITYAEV, E. RUIZ, J. F. (2000). Consistent knowledge discovery in medical diagnosis, IEEE Engineering in Medicine and Biology Magazine, 1.4, pp. 26-37 doi:10.1109/51.853479
[23] LANGHELLE, A., EFTESTØL T. MYKLEBUST, H. (2001). Reducing CPR artefacts in ventricular fibrillation in vitro, Resuscitation, 48, pp. 279-291 doi:10.1016/S0300-9572(00)00259-8
[24] LARSEN, NI. P., EISENBERG, M. S., CUMMINS, R.O. HALLSTROM, A. P. (1993). Predicting survival from out-of-hospital cardiac arrest: a graphic model, Ann Ethers Med, 22, pp. 1652-1658. 1999;281 :1182-1188.
[25] MARENCO, J. P., WANG, P. J., LINK, M.S., HOMUD, M. K. ESTES, N. A. M. (2001). Improving survival from sudden cardiac arrest: The role of the automated defibrillator, JAMA, 28.9, pp. 1193-1200 doi:10.1001/jama.285.9.1193
[26] MITRA, S., PAL, S. K. MITRA, P. (2002). Data mining in soft computing framework: A survey, IEEE Transactions on Neural Networks, 1.1, pp. 3-14 doi:10.1109/72.977258
[27] MONSIEURS, K. G., DE CAUWER, H. WUYTS, F. L. (1998). A rule for early outcome classification of out-of-hospital cardiac arrest patients presenting with ventricular fibrillation, Resuscitation 36, pp. 37-44 doi:10.1016/S0300-9572(97)00079-8
[28] NOC, M., WEILL, M. H. TANG, W. (1999). Electrocardiographic prediction of the success of cardiac resuscitation, Crit Care Med, 2.4, pp. 708-714 doi:10.1097/00003246-199904000-00021
[29] POVOAS, H. P., WEIL, M. H., TANG, W., BISERA, J., KLOUCHE, K. BARBATIS, A. (2002). Predicting the success of defibrillation by electrocardiographic analysis, Resuscitation, 53, pp. 77-82 doi:10.1016/S0300-9572(01)00488-9
[30] PELLIS, T., BISERA, J., TANG, W. WEIL, M. H. (2002). Expanding automatic external defibrillators to include automated detection of cardiac, respiratory, and cardiorespiratory arrest, Crit Care Med, 3.4, pp. S176-S178 doi:10.1097/00003246-200204001-00012
[31] RISDAL, M., LOSERT, H., NYSÆTER, J., EFTESTØL, T., STERZ, F. AASE, S.O. (2005). Examining the potential of using thorax impedance measured by automated external defibrillators for quantification of circulation, In Proc. Computers in Cardiology ´05, Lyon, France, September 2005.
[32] RISDAL, M., LOSERT, H., NYSÆTER, J., EFTESTØL, T., STERZ, F. AASE, S.O. (2005). Non-invasive ventilation monitoring during cardipulmonary resuscitation by means of thoracic impedance, In Proc. 3rd European Medical and Biological Engineering Conference ´05, Prague, Czech Repeublic, November 2005.
[33] RISDAL, M., LOSERT, H., NYSÆTER, J., EFTESTØL, T., STERZ, F, AASE, S.O. (2005). Ventilation classification for cardiopulmonary resuscitation quality monitoring using thoracic impedance, In Proc. 3rd European Medical and Biological Engineering Conference ´05, Prague, Czech Repcublic, November 2005.
[34] RISDAL, M., SLEVELAND, T., STEEN, P. A., KRAMER-JOHANSEN, J., WIK, L, STERZ, F., LOSERT, H., EFTESTØL, T. AASE, S.O. (2005). Improving rhythm classification using electrocardiogram and thorax impedance recorded by automated external defibrillators, In Proc. NORSIG ´05, Stavanger, Norway, September 2005.
[35] SATO, Y., WEIL, M. H. SUN, S, (1997). Adverse effects of interrupting precordial compression during cardiopulmonary resuscitation, Crit Care Med, 25, pp. 733-736 doi:10.1097/00003246-199705000-00005
[36] SMALL, M., YU, D. J. CLAYTON, R. (2001). Temporal evolution of nonlinear dynamics in ventricular arrhythmia, International Journal of Bifurcations and Chaos, 1.10, pp. 2531-2548 doi:10.1142/S0218127401003590
[37] STROHMENGER, H. U., EFTESTØL, T. SUNDE, K. (2001). Predictive value of ventricular fibrillation ECG signal frequency and amplitude parameters in patients with out-of-hospital cardiac arrest, Anasthesia and Analgesia, 93, pp. 1428-1433 doi:10.1097/00000539-200112000-00016
[38] STROHMENGER, H. U., LINDNDER, K.H., LINDNER, I.M., PFENNIGER, E.G. BOTHNER, U. (1996). Spectral analysis of ventricular fibrillation and closed-chest cardiopulmonary resuscitation, Resuscitation, 33(2), pp. 155-161 doi:10.1016/S0300-9572(96)01003-9
[39] SUNDE, K., EFTESTØL, T. ASCHENBERG, C. (1999). Quality assessment of defibrillation and ALS using data from the medical control module of the defibrillator, Resuscitation 41, pp. 237-24 doi:10.1016/S0300-9572(99)00059-3
[40] SUNDE, K., FREMSTAD, K.O., FURUHEIM, J STEEN, P. A. (2001). Ambulance response intervals in connection with cardiac arrest in Oslo Tidsskr Nor Lageforen, 121, pp. 900-903.
[41] VAN HOEYWEGEN, R. J., BOSSAERT, L. L. MULLIE, A. (1993). Belgian cerebral resuscitation study group: Quality and efficiency of bystander CPR, Resuscitation, 26, pp. 47-52.
[42] VÄRRI, A., KEMP, B., PENZEL, T. SCLÖGL, A. (2001). Standards for biomedical signal databases, IEEE Engineering in Medicine and Biology Magazine, 2.3, pp. 33-37 doi:10.1109/51.932722
[43] WATSON, J. N., ADDISON, P. S. CLEGG, G. R. (2000). A novel wavelet transform based analysis reveals hidden structure in ventricular fibrillation, Resuscitation, 43, pp. 121-127 doi:10.1016/S0300-9572(99)00127-6
[44] WIK, L., BRENNAN, R. T. BRASLOW, A. (1995). A peer-training model for instruction of basic life support, Resuscitation. 29, pp. 119-128 doi:10.1016/0300-9572(94)00835-4
[45] WIK, L., HANSEN, T. B. FYLLING, F. (2003). Delaying defibrillation to give basic cardiopulmonary resuscitation to patients with out-of-hospital ventricular fibrillation: A randomized trial, JAMA, 28.11, pp. 1389-1395 doi:10.1001/jama.289.11.1389
[46] YU, T., WEIL, M.H. TANG, W. (2002). Adverse outcomes of interupted precordial compression during automated defibrillation circulation, 106, pp. 368-372.


BibTeX:
@article{MIC-2005-4-3,
  title={{Advanced life support therapy and on out-of-hospital cardiac arrest patients: Applying signal processing and pattern recognition methods}},
  author={Eftestøl, Trygve and Risdal, Martin and Eilevstjønn, Joar and Steen, Petter A.},
  journal={Modeling, Identification and Control},
  volume={26},
  number={4},
  pages={221--235},
  year={2005},
  doi={10.4173/mic.2005.4.3},
  publisher={Norwegian Society of Automatic Control}
};