Cardiac arrest & resuscitation
Spectral characteristics and parameters of pulse oximetry waveforms for assessing resuscitation status
Authors' conclusion
Pulse oximetry plethysmography waveform analysis-using signals already available on standard monitors-may provide a non-invasive, real-time approach that may help identify ROSC during ongoing compressions and distinguish between stable and unstable circulation.
Study context
- Population
- Adult patients with cardiac arrest from 14 Chinese tertiary hospitals (2013–2018), Out-of-Hospital Cardiac Arrest (OHCA) episodes with monitoring continued upon ED arrival and In-Hospital Cardiac Arrest (IHCA) episodes occurring in the EDadult patients with cardiac arrest (497 cardiopulmonary resuscitation (CPR) episodes) · OHCA episodes 158 · IHCA episodes 339
- Participants
- 451 patients
- Exposure
- Time-domain (area under the pulse oximetry plethysmography (POP) curve [POPAUC]) and frequency-domain spectral features evaluated against clinically documented ROSC
- Outcome
- Frequency-domain "hybrid" pattern during CC + ROSC for identifying ROSC
Main finding
As reported in the abstract
Specificity
100%
PPV
1.000
Observational data: associations, not effects.
Further findings
| Outcome | CC + ROSC | SC | P value |
|---|---|---|---|
| POPAUC in CC status, stable-ROSC vs unstable-ROSCHigher in stable-ROSC | P = 0.007 | ||
| POPAUC, CC + ROSC vs SC status, stable-ROSCLower in CC + ROSC | 2768.2 ± 997.8 PVPG | 3335.8 ± 842.4 PVPG | P = 0.001 |
| POPAUC, CC + ROSC vs SC status, unstable-ROSCReverse observed (higher in CC + ROSC) | 2697.5 ± 941.0 PVPG | 1338.1 ± 952.6 PVPG | P < 0.001 |
- POPAUC in CC status, stable-ROSC vs unstable-ROSC: stable-ROSC 3232.2 ± 1008.2 PVPG
- POPAUC in CC status, stable-ROSC vs unstable-ROSC: unstable-ROSC 2769.6 ± 1013.0 PVPG
POP waveforms disappearance with concurrent ECG presence for identifying pulseless electrical activity
- Specificity
- 100%
Original publication
Spectral characteristics and parameters of pulse oximetry waveforms for assessing resuscitation status. Resuscitation. Published 7 October 2026. doi:10.
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