Effectiveness of Smartwatch Guidance for High-Quality Infant Cardiopulmonary Resuscitation: A Simulation Study

Enhancing Cardiopulmonary Resuscitation Quality Using a Smartwatch: Neural Network Approach for Algorithm Development and Validation

BACKGROUND

Sudden cardiac arrest is a major cause of mortality, necessitating immediate and high-quality cardiopulmonary resuscitation (CPR) for improved survival rates. High-quality CPR is defined by chest compressions at a rate of 100-120 per minute and a depth of 50-60 mm. Monitoring and maintaining these parameters in real time during emergencies remain a challenge.

OBJECTIVE

This study introduces a neural network model designed to predict and assess CPR quality using accelerometer data from a smartwatch.

METHODS

The study involved 83 participants performing CPR on mannequins, with accelerometer data collected via smartwatches worn by the participants. These data were aligned with gold-standard data from the mannequins. The accelerometer-derived compression data were segmented into 5-second intervals for training the neural network models. A total of 1226 neural network models were developed, incorporating variations in hyperparameters and dataset configurations to optimize performance.

RESULTS

The optimal model demonstrated the capability to accurately predict the number of compressions and the average compression depth within a 5-second interval. The model achieved an accuracy of ±3.8 mm for compression depth and an average deviation of 0.8 compressions. The results indicated that the neural network model could accurately assess CPR quality metrics, surpassing other models discussed in the literature. The large and diverse dataset used in this study contributed to the robustness and reliability of the model.

CONCLUSIONS

This study validates the efficacy of a neural network model in accurately predicting CPR metrics using smartwatch accelerometer data. The model outperforms previous methods and shows promise for real-time feedback during CPR. Future work involves deploying the model directly on smartwatches for real-time application, potentially improving sudden cardiac arrest survival rates through immediate and accurate feedback on CPR quality.

2023 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations: Summary From the Basic Life Support; Advanced Life Support; Pediatric Life Support; Neonatal Life Support; Education, Implementation, and Teams; and First Aid Task Forces

The International Liaison Committee on Resuscitation engages in a continuous review of new, peer-reviewed, published cardiopulmonary resuscitation and first aid science. Draft Consensus on Science With Treatment Recommendations are posted online throughout the year, and this annual summary provides more concise versions of the final Consensus on Science With Treatment Recommendations from all task forces for the year. Topics addressed by systematic reviews this year include resuscitation of cardiac arrest from drowning, extracorporeal cardiopulmonary resuscitation for adults and children, calcium during cardiac arrest, double sequential defibrillation, neuroprognostication after cardiac arrest for adults and children, maintaining normal temperature after preterm birth, heart rate monitoring methods for diagnostics in neonates, detection of exhaled carbon dioxide in neonates, family presence during resuscitation of adults, and a stepwise approach to resuscitation skills training. Members from 6 International Liaison Committee on Resuscitation task forces have assessed, discussed, and debated the quality of the evidence, using Grading of Recommendations Assessment, Development, and Evaluation criteria, and their statements include consensus treatment recommendations. Insights into the deliberations of the task forces are provided in the Justification and Evidence-to-Decision Framework Highlights sections. In addition, the task forces list priority knowledge gaps for further research. Additional topics are addressed with scoping reviews and evidence updates.

2023 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations: Summary From the Basic Life Support; Advanced Life Support; Pediatric Life Support; Neonatal Life Support; Education, Implementation, and Teams; and First Aid Task Forces

The International Liaison Committee on Resuscitation engages in a continuous review of new, peer-reviewed, published cardiopulmonary resuscitation and first aid science. Draft Consensus on Science With Treatment Recommendations are posted online throughout the year, and this annual summary provides more concise versions of the final Consensus on Science With Treatment Recommendations from all task forces for the year. Topics addressed by systematic reviews this year include resuscitation of cardiac arrest from drowning, extracorporeal cardiopulmonary resuscitation for adults and children, calcium during cardiac arrest, double sequential defibrillation, neuroprognostication after cardiac arrest for adults and children, maintaining normal temperature after preterm birth, heart rate monitoring methods for diagnostics in neonates, detection of exhaled carbon dioxide in neonates, family presence during resuscitation of adults, and a stepwise approach to resuscitation skills training. Members from 6 International Liaison Committee on Resuscitation task forces have assessed, discussed, and debated the quality of the evidence, using Grading of Recommendations Assessment, Development, and Evaluation criteria, and their statements include consensus treatment recommendations. Insights into the deliberations of the task forces are provided in the Justification and Evidence-to-Decision Framework Highlights sections. In addition, the task forces list priority knowledge gaps for further research. Additional topics are addressed with scoping reviews and evidence updates.

Chest compressions in newborn infants: a scoping review

AIM

The International Liaison Committee on Resuscitation Neonatal Life Support Task Force undertook a scoping review of the literature to identify evidence relating to neonatal cardiopulmonary resuscitation.

METHODS

MEDLINE complete, EMBASE and Cochrane database of Systematic reviews were searched from inception to November 2021. Two authors screened titles and abstracts and full text reviewed. Studies were eligible for inclusion if they were peer-reviewed and assessed one of five aspects of chest compression in the newborn infant including: (1) heart rate thresholds to start chest compressions (CC), (2) compression to ventilation ratio (C:V ratio), (3) CC technique, (4) oxygen use during CC and 5) feedback devices to optimise CC.

RESULTS

Seventy-four studies were included (n=46 simulation, n=24 animal and n=4 clinical studies); 22/74 were related to compression to ventilation ratios, 29/74 examined optimal technique to perform CC, 7/74 examined oxygen delivery and 15/74 described feedback devices during neonatal CC.

CONCLUSION

There were very few clinical studies and mostly manikin and animal studies. The findings either reinforced or were insufficient to change previous recommendations which included to start CC if heart rate remains <60/min despite adequate ventilation, using a 3:1 C:V ratio, the two-thumb encircling technique and 100% oxygen during CC.