A transition to PEA during resuscitation should encourage the resuscitation team to continue resuscitative efforts.Ĭardiopulmonary resuscitation (CPR) Dynamics Electrocardiography (ECG) Pulseless electrical activity (PEA) Return of spontaneous circulation (ROSC).Ĭopyright © 2022 The Author(s). The four distinct presentations of PEA behave differently on important characteristics. PEA is a crossroad in which the subsequent course is determined. Much higher transition intensities to ROSC, average of 0.15 per min, were observed for secondary PEA after VF/VT (n = 83) or after ROSC (n = 134). Time average transition intensities to ROSC from primary PEA (n = 230) and secondary PEA after ASY (n = 72) were 0.1 per min, peaking at 4 and 7 minutes, respectively thus, a patient in these types of PEA showed a 10% chance of achieving ROSC in one minute. Most patients experienced PEA at least once before achieving ROSC or being declared dead. We quantified the transition intensities, i.e., the propensity to change from PEA to another clinical state using time-to-event statistical methods. Each event was manually annotated using a graphical application. During resuscitation ECG, chest compressions, and ventilations were recorded by defibrillators. hospitals at different time periods between 20. We analyzed 700 IHCA episodes at one Norwegian hospital and three U.S. The aim of this study was to explore and quantify the evolution from primary/secondary PEA to ROSC in adults during in-hospital cardiac arrest (IHCA). PEA is often seen during resuscitation, either as the presenting clinical state in cardiac arrest or as a secondary rhythm following transient return of spontaneous circulation (ROSC), ventricular fibrillation/tachycardia (VF/VT), or asystole (ASY). 10 Department of Mathematics and Physics, University of Stavanger, Stavanger, Norway.9 Center for Resuscitation Science, Department of Emergency Medicine, University of Pennsylvania, Philadelphia, USA.8 Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway Department of Anesthesia and Intensive Care Medicine, St Olav University Hospital, Trondheim, Norway.7 University of the Basque Country, Engineering School of Bilbao, BioRes Group, Bilbao, Spain. Background: Pulseless electrical activity (PEA) is a frequent initial rhythm in cardiac arrest, and ECG characteristics have been linked to prognosis.6 Department of Electrical Engineering and Computer Science, University of Stavanger, Stavanger, Norway.5 Department of Pulmonary and Critical Care Medicine, Respiratory Institute, Cleveland Clinic Foundation, Cleveland, OH, USA.4 Department of Emergency Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA.3 Department of Anesthesia and Intensive Care Medicine, St Olav University Hospital, Trondheim, Norway.Electronic address: 2 Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway. 1 Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway Department of Anesthesia and Intensive Care Medicine, St Olav University Hospital, Trondheim, Norway.
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