Abstract 15357: Using Biometric Analysis to Identify Patient Characteristics Which Affect the Quality of Cardiopulmonary Resuscitation
Introduction: In-hospital cardiac arrest is a source of significant morbidity and mortality, with survival to discharge as low as 11%. Cardiopulmonary resuscitation (CPR) guidelines have focused on optimizing compression rate, depth, and chest recoil in an effort to improve survival rates and neurologic outcomes. Obesity rates in the United States are increasing; this is mirrored in hospitalized patients and presents technical challenges to performing high quality chest compressions. We hypothesize that patient characteristics, weight in particular, affect the quality of CPR.
Methods: At the University of Illinois at Chicago we have implemented real-time biometric analysis as a means of monitoring and improving the quality of CPR during in-hospital cardiac arrest in adult patients. We have recorded compression rate and depth for each resuscitation attempt using this technology to analyze the quality of chest compressions and correlated this with anthropomorphic data obtained from patient medical records.
Results: Our initial data has recorded 53 resuscitation attempts. Mean compression rate and ratio were both satisfactory, 116 beats per min (bpm) and 91% respectively. Depth of compression and percent of compressions at target depth were lower than expected, 1.7 inches and 8.7%. Depth of compression was greater in subjects weighing more than 90 kg (n = 19) compared to subjects weighing less than 90 kg (n = 34), 2.0 inches versus 1.5 inches respectively (p = 0.04), while compression rate was similar (113 bpm vs 117 bpm (p = 0.11). There was a direct correlation (r = 0.408, p = 0.04) between weight and depth of compression in subjects that had cardiac arrest in the medical ICU while there is an inverse correlation (r = -0.343, p = 0.047) with compression rate.
Conclusions: Our initial results show superior depth of chest compressions in heavier subjects during in-hospital cardiac arrest. We suspect that providers are accounting for increased patient size by using greater force of compressions. In the ICU, depth directly correlates with weight, while compression rate decreases as weight increases. This suggests that increasing depth and force of compressions in heavier patients comes at the expense of compression rate, though rate remains adequate in both groups.
Author Disclosures: B.R. Rao: None. C.M. Kapp: None. J.M. Loeb: None. J. Birchak: None. M. Nehmer: None. T.T. Yamanaka: None. A.K. Ardati: None. D.R. Fraidenburg: None.
- © 2016 by American Heart Association, Inc.