Evidence map›Paper›PMID 34506874›Full record

ArticleResuscitation2021

Novel application of thoracic impedance to characterize ventilations during cardiopulmonary resuscitation in the pragmatic airway resuscitation trial.

Michelle M J Nassal, Xabier Jaureguibeitia, Elisabete Aramendi, Unai Irusta, Ashish R Panchal, Henry E Wang, Ahamed Idris

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Resuscitation, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
2.2field-weighted citation impact, top 12% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 12 citations in OpenAlex.

  1. Article
  2. Contemporary issues in pediatric prehospital airway management.Expert review of respiratory medicine · 2026
    Review
  3. Article
  4. Article
  5. Article
  6. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 3 institutions in 2 countries.

Michelle M J NassalDepartment of Emergency Medicine, The Ohio State University, Columbus, OH, USA.
Xabier JaureguibeitiaDepartment of Communication Engineering, BioRes Group, University of the Basque Country, Bilbao, Spain.
Elisabete AramendiDepartment of Communication Engineering, BioRes Group, University of the Basque Country, Bilbao, Spain.
Unai IrustaDepartment of Communication Engineering, BioRes Group, University of the Basque Country, Bilbao, Spain.
Ashish R PanchalDepartment of Emergency Medicine, The Ohio State University, Columbus, OH, USA.
Henry E WangDepartment of Emergency Medicine, The Ohio State University, Columbus, OH, USA.
Ahamed IdrisDepartment of Emergency Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA.
The Ohio State University · USUniversity of the Basque Country · ESThe University of Texas Southwestern Medical Center · US

Funding

Pragmatic Trial of Airway Management in Out-of-Hospital Cardiac ArrestUH3HL125163 · NHLBI · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI KERBY, JEFFREY D, WANG, HENRY E. · 2015 to 2018
$2.7M
Pragmatic Trial of Airway Management in Out-of-Hospital Cardiac ArrestUH2HL125163 · NHLBI · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI WANG, HENRY E. · 2014 to 2014
$481k
NHLBI NIH HHS UH2 HL125163NHLBI NIH HHS UH3 HL125163
6 · The paper itself

Abstract

backgroundSignificant challenges exist in measuring ventilation quality during out-of-hospital cardiopulmonary arrest (OHCA) outcomes. Since ventilation is associated with outcomes in cardiac arrest, tools that objectively describe ventilation dynamics are needed. We sought to characterize thoracic impedance (TI) oscillations associated with ventilation waveforms in the Pragmatic Airway Resuscitation Trial (PART).

methodsWe analyzed CPR process files collected from adult OHCA enrolled in PART. We limited the analysis to cases with simultaneous capnography ventilation recordings at the Dallas-Fort Worth site. We identified ventilation waveforms in the thoracic impedance signal by applying automated signal processing with adaptive filtering techniques to remove overlying artifacts from chest compressions. We correlated detected ventilations with the end-tidal capnography signals. We determined the amplitudes (Ai, Ae) and durations (Di, De) of both insufflation and exhalation phases. We compared differences between laryngeal tube (LT) and endotracheal intubation (ETI) airway management during mechanical or manual chest compressions using Mann-Whitney U-test.

resultsWe included 303 CPR process cases in the analysis; 209 manual (77 ETI, 132 LT), 94 mechanical (41 ETI, 53 LT). Ventilation Ai and Ae were higher for ETI than LT in both manual (ETI: Ai 0.71 Ω, Ae 0.70 Ω vs LT: Ai 0.46 Ω, Ae 0.45 Ω; p < 0.01 respectively) and mechanical chest compressions (ETI: Ai 1.22 Ω, Ae 1.14 Ω VS LT: Ai 0.74 Ω, Ae 0.68 Ω; p < 0.01 respectively). Ventilations per minute, duration of TI amplitude insufflation and exhalation did not differ among groups.

conclusionCompared with LT, ETI thoracic impedance ventilation insufflation and exhalation amplitude were higher while duration did not differ. TI may provide a novel approach to characterizing ventilation during OHCA.

Indexed as

Cardiopulmonary ResuscitationOut-of-Hospital Cardiac ArrestAdultAirway ManagementElectric ImpedanceHumansVentilationCardiac arrestResuscitationThoracic impedanceVentilation

Identifiers

PMID34506874
PMCPMC8928139
OpenAlexW3196806481

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.