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Correlation of EEG-based brain resuscitation index and end-tidal carbon dioxide in porcine cardiac arrest model

  • Dong Sun Choi1,2,3,†
  • Heejin Kim4,†
  • Ki Jeong Hong2,5,6,*,
  • Sang Do Shin2,6
  • Hee Chan Kim3,7
  • Yong Joo Park8
  • Tae Han Kim2,9
  • Young Sun Ro2
  • Kyoung Jun Song2,10
  • Ki Hong Kim2,10

1Department of Emergency Medicine, Uijeongbu Eulji Medical Center, 11759 Uijeongbu, Republic of Korea

2Laboratory of Emergency Medical Services, Biomedical Research Institute, Seoul National University Hospital, 03080 Seoul, Republic of Korea

3Department of Emergency Medicine, College of Medicine, Eulji University, 34824 Daejeon, Republic of Korea

4Clinical Trial Center, Seoul National University Hospital, 03080 Seoul, Republic of Korea

5Department of Emergency Medicine, Seoul National University Hospital, 03080 Seoul, Republic of Korea

6Department of Emergency Medicine, College of Medicine, Seoul National University, 03080 Seoul, Republic of Korea

7Department of Biomedical Engineering, College of Medicine, Seoul National University, 03080 Seoul, Republic of Korea

8Department of Emergency Medicine, Gyeongsang National University Changwon Hospital, 51472 Changwon, Republic of Korea

9Department of Emergency Medicine, Seoul National University Boramae Medical Center, 07061 Seoul, Republic of Korea

10Seoul National University Hospital Biomedical Research Institute, 03080 Seoul, Republic of Korea

DOI: 10.22514/sv.2021.226 Vol.18,Issue 3,May 2022 pp.128-136

Submitted: 29 June 2021 Accepted: 18 August 2021

Published: 08 May 2022

*Corresponding Author(s): Ki Jeong Hong E-mail:;

† These authors contributed equally.


Evaluation and monitoring perfusion of vital organs is important during resuscitation from cardiac arrest. We developed a non-invasive electroencephalogram (EEG) based brain resuscitation index (EBRI) as a physiologic indicator measuring organ perfusion during cardiopulmonary resuscitation (CPR) and evaluated the correlation of EBRI and end-tidal carbon dioxide (ETCO2). A randomized crossover experimental study using a porcine cardiac arrest model was designed. After 1 minute of untreated ventricular fibrillation, 10 periods of higher-quality CPR (compression depth 5 cm and compression rate 100/min) for 50 seconds and lower-quality CPR (compression depth 3 cm and compression rate 60/min) for 50 seconds were performed in alternation. EBRI was calculated from the single EEG channel with the lowest noise. Mixed-model analysis was conducted to compare the differences of hemodynamic parameters, ETCO2, and EBRI between higher-quality CPR periods and lower-quality CPR periods. Pearson’s correlation coefficient was calculated to assess correlation between EBRI and ETCO2. The experiment was performed on 5 female swine (44.6 ± 2.8 kg). Higher-quality CPR showed significantly higher delta EBRI (median [IQR] 0.1 [0.0–0.2]) than did lower-quality CPR (median [IQR] –0.1 [–0.2–0.0], p < 0.01). EBRI had a statistically moderate positive correlation with ETCO2 (r = 0.51). In this porcine cardiac arrest model, EBRI was successfully obtained during resuscitation and had a statistically moderate correlation with ETCO2.


Cardiopulmonary resuscitation; Electroencephalogram; End-tidal CO2

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Dong Sun Choi,Heejin Kim,Ki Jeong Hong,Sang Do Shin,Hee Chan Kim,Yong Joo Park,Tae Han Kim,Young Sun Ro,Kyoung Jun Song,Ki Hong Kim. Correlation of EEG-based brain resuscitation index and end-tidal carbon dioxide in porcine cardiac arrest model. Signa Vitae. 2022. 18(3);128-136.


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