Evidence map›Paper›PMID 31910501›Full record

ArticleClinical and experimental emergency medicine2019

Determination of the theoretical personalized optimum chest compression point using anteroposterior chest radiography.

Shinwoo Kim, Sung-Bin Chon, Won Sup Oh, Sunho Cho

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Article in Clinical and experimental emergency medicine, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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1citing papers in PubMed
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1 · What the graph read from it

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3 · Its place in the literature

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1 citing paper in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

4 authors.

Shinwoo KimDepartment of Emergency Medicine, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Korea.
Sung-Bin ChonDepartment of Emergency Medicine, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Korea.
Won Sup OhDepartment of Internal Medicine, Kangwon National University School of Medicine, Chuncheon, Korea.
Sunho ChoDepartment of Emergency Medicine, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Korea.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveThere is a traditional assumption that to maximize stroke volume, the point beneath which the left ventricle (LV) is at its maximum diameter (P_max.LV) should be compressed. Thus, we aimed to derive and validate rules to estimate P_max.LV using anteroposterior chest radiography (chest_AP), which is performed for critically ill patients urgently needing determination of their personalized P_max.LV.

methodsA retrospective, cross-sectional study was performed with non-cardiac arrest adults who underwent chest_AP within 1 hour of computed tomography (derivation:validation=3:2). On chest_AP, we defined cardiac diameter (CD), distance from right cardiac border to midline (RB), and cardiac height (CH) from the carina to the uppermost point of left hemi-diaphragm. Setting point zero (0, 0) at the midpoint of the xiphisternal joint and designating leftward and upward directions as positive on x- and y-axes, we located P_max.LV (x_max.LV, y_max.LV). The coefficients of the following mathematically inferred rules were sought: x_max.LV=α0*CD-RB; y_max.LV=β0*CH+γ0 (α0: mean of [x_max.LV+RB]/CD; β0, γ0: representative coefficient and constant of linear regression model, respectively).

resultsAmong 360 cases (52.0±18.3 years, 102 females), we derived: x_max.LV=0.643*CD-RB and y_max.LV=55-0.390*CH. This estimated P_max.LV (19±11 mm) was as close as the averaged P_max.LV (19±11 mm, P=0.13) and closer than the three equidistant points representing the current guidelines (67±13, 56±10, and 77±17 mm; all P<0.001) to the reference identified on computed tomography. Thus, our findings were validated.

conclusionPersonalized P_max.LV can be estimated using chest_AP. Further studies with actual cardiac arrest victims are needed to verify the safety and effectiveness of the rule.

Indexed as

Cardiopulmonary resuscitationHeart arrestIntensive care unitsRadiography, thoracicTomography, X-ray computed

Identifiers

PMID31910501
PMCPMC6952631

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