PHYSIOLOGICAL MEASUREMENT OF THE VENTRICULAR-FIBRILLATION ECG SIGNAL - ESTIMATING THE DURATION OF VENTRICULAR-FIBRILLATION

被引:38
作者
BROWN, CG
DZWONCZYK, R
MARTIN, DR
机构
[1] Department of Emergency Medicine, The Ohio State University, Columbus
[2] Department of Anesthesiology, The Ohio State University, Columbus
关键词
ventricular fibrillation;
D O I
10.1016/S0196-0644(05)80253-7
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Estimating the duration of ventricular fibrillation may help determine the best initial therapy and provide estimates of the most appropriate dose of epinephrine to administer during cardiac arrest and resuscitation. In addition, estimating this time can provide a more sound methodologic approach to stratifying patients in the analysis of cardiac arrest studies. In an initial series of studies in swine, we attempted to determine whether changes in the frequency or amplitude (power) of the ventricular fibrillation ECG signal during cardiac arrest could be used to estimate this time. These studies characterized the dynamics of both the total power and the frequency distribution of the power in the ECG over time during ventricular fibrillation in swine. Our purpose was to determine wether sufficient information existed in either parameter to estimate the duration of ventricular fibrillation. The median frequency of the power spectrum was used to track power distribution. Both parameters followed a dynamic and repeatable pattern. A mathematical model of median frequency was developed and used with data obtained from additional swine to estimate the duration of ventricular fibrillation. The model estimated the duration of ventricular fibrillation to within ± 1.3 minutes of the actual duration from one to ten minutes after the onset of ventricular fibrillation. We recently characterized the time course of the median frequency during ventricular fibrillation in human beings. The median frequency was extracted from each four-second segment of the ventricular fibrillation ECG recordings and plotted versus time from the onset of cardiac arrest. The median frequency in human beings followed a repeatable time course during ventricular fibrillation. These preliminary data in human beings demonstrate that a characteristic pattern of median frequency exists that can be used to estimate the duration of ventricular fibrillation. © 1993 American College of Emergency Physicians.
引用
收藏
页码:70 / 74
页数:5
相关论文
共 20 条
  • [1] Standards and guidelines for cardiopulmonary resuscitation (CPR) and emergency cardiac care (ECC), JAMA: The Journal of the American Medical Association, 255, pp. 2905-2914, (1986)
  • [2] Eisenberg, Bergner, Hallstrom, Et al., Sudden cardiac death, Sci Am, 254, pp. 37-43, (1986)
  • [3] Yakaitis, Ewy, Otto, Et al., Influence of time and therapy on ventricular fibrillation in dogs, Crit Care Med, 8, pp. 157-163, (1980)
  • [4] Weaver, Cobb, Dennis, Et al., Amplitude of ventricular fibrillation waveform and outcome after cardiac arrest, Ann Intern Med, 102, pp. 53-55, (1985)
  • [5] Neumar, Brown, Van Ligten, Et al., Estimation of myocardial ischemic injury during ventricular fibrillation with total circulatory arrest using high-energy phosphate and lactate as metabolic markers, Ann Emerg Med, 20, pp. 222-229, (1991)
  • [6] Braunwald, Control of myocardial oxygen consumption, Am J Cardiol, 27, pp. 416-432, (1971)
  • [7] Ewy, Taren, Bangert, Et al., Comparison of myocardial damage from defibrillator discharges at various dosages, Med Instrum, 14, pp. 9-12, (1980)
  • [8] Knox, Hughes, Tyers, Et al., The induction of myocardial damage by open-chest low-energy countershuck, Med Instrum, 14, pp. 63-66, (1980)
  • [9] Niemann, Adomian, Garner, Et al., Endocardial and transcutaneous pacing, calcium chloride, and epinephrine in postcountershock asystole and bradycardias, Crit Care Med, 13, pp. 699-704, (1985)
  • [10] Niemann, Cairns, Sharma, Et al., Treatment of prolonged ventricular fibrillation: Immediate countershock versus high-dose epinephrine and CPR preceding countershock, Circulation, 85, pp. 281-287, (1992)