Introduction:
Effective ventilation during 30:2 CPR has been linked to improved outcomes, but definitive evidence is lacking. We developed a method to identify thoracic bioimpedance ventilation waveforms from defibrillator recordings.
Hypothesis:
Bioimpedance ventilation waveform amplitude is proportional to tidal volume. It is possible to identify a minimum amplitude for a valid ventilation waveform.
Methods:
To determine the relationship between tidal volume and bioimpedance waveform amplitude, we studied 26 healthy volunteers (12 males and 14 females). Volunteers breathed fixed positive pressure tidal volumes (250mL, 300 mL, 400 mL, 600 mL, and 800 mL) given by a Maquet SERVO-I ventilator (Getinge US Sales, Wayne, NJ, USA) through a mouthpiece while a Lifepak12 (Physio-Control, Redmond, WA) defibrillator recorded thoracic bioimpedance through electrode pads placed on the chest. We measured the impedance amplitudes of six breaths at each tidal volume and the weight and height of each volunteer. We set the minimum effective tidal volume at 250 mL.
Results:
For males and females, respectively, mean (±SD) was 180.1±8 cm vs. 164±3.5 cm, and mean weight was 85.6±9.6 kg vs. 58.3±8.6 kg. Median (IQR) bioimpedance amplitude for each tidal volume split by sex is shown in the Figure (Y-axis, 1 mm = 0.25 Ohm).
Conclusion:
Bioimpedance amplitude is proportional to tidal volume and also varies by height, weight, and sex. Sex may be a possible surrogate for height and weight. The minimum amplitude is 0.375 Ohm for a valid bioimpedance ventilation waveform.