ArticlePloS one2018
Enhancing ventilation detection during cardiopulmonary resuscitation by filtering chest compression artifact from the capnography waveform.
Article in PloS one, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed, 12 citations in OpenAlex.
- Ventilation Rates and Capnography in Pediatric Out-of-Hospital Cardiac Arrest with Advanced Airways.Prehospital emergency care · 2025Article
- Rationale and development of a prehospital goal-directed bundle of care to prevent rearrest after return of spontaneous circulation.Journal of the American College of Emergency Physicians open · 2024Article
- The Role of Chest Compressions on Ventilation during Advanced Cardiopulmonary Resuscitation.Journal of clinical medicine · 2023Article
- A review of ventilation in adult out-of-hospital cardiac arrest.Journal of the American College of Emergency Physicians open · 2020Review
- Modeling the impact of ventilations on the capnogram in out-of-hospital cardiac arrest.PloS one · 2020Article
- Ventilation Rates and Pediatric In-Hospital Cardiac Arrest Survival Outcomes.Critical care medicine · 2019Observational
Corrections and comments
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Authors and funding
9 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDuring cardiopulmonary resuscitation (CPR), there is a high incidence of capnograms distorted by chest compression artifact. This phenomenon adversely affects the reliability of automated ventilation detection based on the analysis of the capnography waveform. This study explored the feasibility of several filtering techniques for suppressing the artifact to improve the accuracy of ventilation detection. MATERIALS AND
methodsWe gathered a database of 232 out-of-hospital cardiac arrest defibrillator recordings containing concurrent capnograms, compression depth and transthoracic impedance signals. Capnograms were classified as non-distorted or distorted by chest compression artifact. All chest compression and ventilation instances were also annotated. Three filtering techniques were explored: a fixed-coefficient (FC) filter, an open-loop (OL) adaptive filter, and a closed-loop (CL) adaptive filter. The improvement in ventilation detection was assessed by comparing the performance of a capnogram-based ventilation detection algorithm with original and filtered capnograms.
resultsSensitivity and positive predictive value of the ventilation algorithm improved from 91.9%/89.5% to 97.7%/96.5% (FC filter), 97.6%/96.7% (OL), and 97.0%/97.1% (CL) for the distorted capnograms (42% of the whole set). The highest improvement was obtained for the artifact named type III, for which performance improved from 77.8%/74.5% to values above 95.5%/94.5%. In addition, errors in the measurement of ventilation rate decreased and accuracy in the detection of over-ventilation increased with filtered capnograms.
conclusionsCapnogram-based ventilation detection during CPR was enhanced after suppressing the artifact caused by chest compressions. All filtering approaches performed similarly, so the simplicity of fixed-coefficient filters would take advantage for a practical implementation.
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