The AIR-CPR Study: AI-Guided Chest Compressions
Utilizing Artificial Intelligence to Optimize Chest Compression Region During Cardio-pulmonary Resuscitation for Patients With Out-of-hospital Cardiac Arrest.
Far Eastern Memorial Hospital
255 participants
Jan 6, 2025
OBSERVATIONAL
Conditions
Summary
The AIR-CPR project aims to improve survival rates for patients with Out-of-Hospital Cardiac Arrest (OHCA) by utilizing Artificial Intelligence (AI) to optimize chest compression locations. Current guidelines recommend a standardized compression point (the lower half of the sternum), yet recent research indicates that this position can compress the aortic valve in approximately 48.7% of patients, significantly reducing the chances of successful resuscitation. This study will develop a deep learning model based on YOLO v8 to analyze real-time arterial pressure waveforms to identify proper aortic valve opening and closing. By identifying specific waveform features that humans cannot easily distinguish, the AI will guide rescuers to adjust the compression site-typically toward the left ventricle-to ensure optimal blood output. The project seeks to transform CPR from a standardized "one-size-fits-all" approach into a personalized, precision medicine intervention.
Eligibility
Inclusion Criteria3
- Adults aged 20 years or older.
- Patients with out-of-hospital cardiac arrest (OHCA) undergoing 3.cardiopulmonary resuscitation (CPR) in the emergency department.
- Cardiac arrest caused by non-traumatic factors.
Exclusion Criteria9
- Pregnant patients.
- Patients with obvious signs of death.
- Patients with a signed "Do Not Resuscitate" (DNR) order.
- Patients requiring extracorporeal cardio-pulmonary resuscitation (ECPR).
- Patients requiring Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA).
- Cardiac arrest caused by massive hemorrhage, aortic emergencies, tension pneumothorax, cardiac tamponade, or pulmonary embolism.
- History of severe aortic valve disease or previous aortic valve surgery.
- Patients for whom TEE or femoral arterial catheterization is contraindicated.
- Situations where the medical team is unable to perform TEE or femoral arterial catheterization during CPR.
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Interventions
A deep learning application based on the YOLO v8 architecture that analyzes real-time arterial pressure waveforms from a femoral A-line. It identifies whether the current chest compression location is causing aortic valve compression (as confirmed by TEE) and provides immediate feedback to the resuscitation team.
When the AI application indicates aortic valve compression, the rescuer adjusts the mechanical chest compression (LUCAS) position. Based on literature and AI feedback, the adjustment typically involves moving the compression point downward and toward the left parasternal line to avoid the aortic valve and optimize left ventricular output.
Used as the "Gold Standard" throughout the study. TEE is performed during CPR to record the actual opening and closing of the aortic valve and the deformation of cardiac chambers, providing the labels for AI training and the verification for clinical testing.
Locations(1)
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NCT07431710