End-tidal carbon dioxide and amplitude spectral area as non-invasive markers of coronary perfusion pressure

• US 9,949,686 B2
• Filed: 01/31/2017
• Issued: 04/24/2018
• Est. Priority Date: 05/30/2013
• Status: Active Grant

• Current Assignee: Zoll Medical Corporation (Asahi Kasei Corporation)
• Original Assignee: Zoll Medical Corporation (Asahi Kasei Corporation)
• Inventors: Lurie, Keith G.
• Primary Examiner(s): MAHMOOD, NADIA AHMAD
• Application Number:
  US15/420,653
• Publication Number:
  US 20170231557A1
• Time in Patent Office: 448 Days
• Field of Search: 607 6
• CPC Class Codes: A61B 5/082 Evaluation by breath analysis, e.g. determination of the chemical composition of exhaled breath A61B5/083, A61B5/091 take precedence
• CPC Class Codes: A61B 5/318 Heart-related electrical modalities, e.g. electrocardiography [ECG]
• CPC Class Codes: A61B 5/4836 Diagnosis combined with treatment in closed-loop systems or methods A61B5/0036 takes precedence
• CPC Class Codes: A61B 5/74 Details of notification to user or communication with user or patient indicating measured values G01D7/00; user input means input or output arrangements for computers G06F3/00
• CPC Class Codes: A61H 2230/206 used as a control parameter for the apparatus
• CPC Class Codes: A61H 31/00 Artificial respiration or heart stimulation, e.g. heart massage artificial respiration by treatment with gas or air, e.g. mouth-to-mouth respiration A61M16/00; applying electric currents by contact electrodes for stimulation, e.g. heart pace-makers A61N1/36 ; teaching or training models, demonstration models for medical purposes G09B23/288
• CPC Class Codes: A61H 31/005 with feedback for the user
• CPC Class Codes: A61N 1/3987 characterised by the timing or triggering of the shock

Abstract

End-tidal carbon dioxide (ETCO₂) measurements may be used alone as a guide to determine when to defibrillate an individual. Alternatively, ETCO₂ measurements may be used in combination with amplitude spectral area measurements as a guide to determine when to defibrillate an individual.

Claims

1. A method of guiding defibrillation therapy of an individual during resuscitation, comprising:

obtaining, by a defibrillation system, signals representing a non-invasive end-tidal carbon dioxide (ETCO₂) measurement of the individual during the resuscitation;

obtaining, by the defibrillation system, signals representing a non-invasive electrocardiogram (ECG) measurement of the individual during the resuscitation;

analyzing the signals representing the ETCO₂ measurement and the signals representing the ECG measurement to determine whether to deliver a defibrillation shock to the individual; and

providing, by the defibrillation system, a perceivable indication that designates a time to deliver a defibrillation shock to the individual, based upon the analyzed signals representing the ETCO₂ measurements and the analyzed signals representing the ECG measurement.

2. The method of claim 1,

wherein the perceivable indication is provided when the ETCO₂ measurement is less than or equal to a predetermined threshold value.

3. The method of claim 1,

wherein the perceivable indication is provided when the ETCO₂ measurement is greater than or equal to a predetermined threshold value.

4. The method of claim 1, wherein the perceivable indication is a visual indication that designates the time to deliver the defibrillation shock.

5. The method of claim 1, wherein the step of analyzing the signals representing the ECG measurement comprises deriving an amplitude spectrum area value, and wherein the amplitude spectrum area value provides an indication of the likelihood that the defibrillation shock will be successful.

10. The method of claim 1, wherein the perceivable indication is provided when the ETCO₂ measurement changes from a previously obtained measurement.

11. The method of claim 1, wherein the perceivable indication is provided when either:

the ETCO₂ measurement and the ECG measurement are less than or equal to a predetermined threshold value;

or

the ETCO₂ measurement and the ECG measurement are greater than or equal to a predetermined threshold value.

6. A method, comprising:

performing a cardiopulmonary resuscitation (CPR) procedure on an individual; and

delivering a defibrillation shock to the individual at a particular time based upon an indication provided by a computing system based on when a particular end-tidal carbon dioxide (ETCO₂) value derived from a non-invasive ETCO₂ measurement of the individual during the CPR procedure is determined by the computing system as less than or greater than a predetermined threshold value and on electrocardiogram (ECG) value derived from a non-invasive ECG measurement.

7. The method of claim 6, further comprising:

delivering the defibrillation shock to the individual upon perception of the indication provided by the computing system at the particular time based upon an amplitude spectrum area value derived from the ECG measurement and when the particular ETCO₂ value is determined as less than or equal to the predetermined threshold value.

8. The method of claim 6, further comprising:

delivering the defibrillation shock to the individual upon perception of the indication provided by the computing system at the particular time based upon an amplitude spectrum area value derived from the ECG measurement and when the particular ETCO₂ value is determined as greater than or equal to the predetermined threshold value.

9. The method of claim 6, wherein an amplitude spectrum area value derived from the ECG measurement provides an indication of the likelihood that the defibrillation shock will be successful.

12. The method of claim 6, wherein the indication is provided when either:

the ETCO₂ measurement is less than or equal to a predetermined threshold value;

or

the ETCO₂ measurement is greater than or equal to a predetermined threshold value.

13. The method of claim 6, wherein the indication is provided when the ETCO₂ measurement changes from a previously obtained measurement.

14. A defibrillation apparatus for guiding defibrillation therapy of an individual during resuscitation, comprising:

a first non-invasive sensor that acquires signals representing an end-tidal carbon dioxide (ETCO₂) measurement of the individual during the resuscitation;

a second non-invasive sensor that acquires signals representing an electrocardiogram (ECG) measurement of the individual during the resuscitation; and

a processor in communication with the sensors and configured to;

analyze the signals representing the ETCO₂ measurement and the signals representing the ECG measurement to determine whether to deliver a defibrillation shock to the individual, and

provide a perceivable indication that designates whether to deliver the defibrillation shock to the individual based upon the analyzed signals representing the ETCO₂ measurements and the analyzed signals representing the ECG measurement.

15. The apparatus of claim 14, further comprising one or more electrodes in communication with the processor for delivering a defibrillation shock.

16. The apparatus of claim 15, wherein the processor controls delivery of the defibrillation shock, and wherein the processor automatically delivers a defibrillation shock to the individual at the designated time.

17. The apparatus of claim 14, wherein the step of analyzing the signals representing the ECG measurement comprises deriving an amplitude spectrum area value, and wherein the amplitude spectrum area value provides an indication of the likelihood that the defibrillation shock will be successful.

18. The apparatus of claim 14, wherein the perceivable indication is provided when either:

the ETCO₂ measurement is less than or equal to a predetermined threshold value, or

the ETCO₂ measurement is greater than or equal to a predetermined threshold value.

19. The apparatus of claim 14, wherein the perceivable indication is a visual indication that designates the time to deliver the defibrillation shock.

20. The apparatus of claim 14, wherein the perceivable indication is provided when the ETCO₂ measurement changes from a previously obtained measurement.

21. The apparatus of claim 14, wherein the perceivable indication is provided when either:

the ETCO₂ measurement and the ECG measurement are less than or equal to a predetermined threshold value;

or

the ETCO₂ measurement and the ECG measurement are greater than or equal to a predetermined threshold value.