Determination of the theoretical personalized optimum chest compression point using anteroposterior chest radiography
Clinical and Experimental Emergency Medicine
;
(4): 303-313, 2019.
Article
in English
| WPRIM
| ID: wpr-785632
ABSTRACT
OBJECTIVE:
There 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.METHODS:
A retrospective, cross-sectional study was performed with non-cardiac arrest adults who underwent chest_AP within 1 hour of computed tomography (derivationvalidation=32). 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).RESULTS:
Among 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.CONCLUSION:
Personalized 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.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Stroke Volume
/
Thorax
/
Radiography
/
Radiography, Thoracic
/
Tomography, X-Ray Computed
/
Linear Models
/
Cross-Sectional Studies
/
Retrospective Studies
/
Critical Illness
/
Cardiopulmonary Resuscitation
Type of study:
Diagnostic study
/
Observational study
/
Prevalence study
/
Prognostic study
/
Risk factors
Limits:
Adult
/
Humans
Language:
English
Journal:
Clinical and Experimental Emergency Medicine
Year:
2019
Type:
Article
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