This retrospective study evaluated pulse oximetry plethysmography in 451 adults with cardiac arrest across 497 CPR episodes at 14 Chinese tertiary hospitals. A hybrid spectral pattern during ongoing compressions with spontaneous circulation identified clinically documented return of spontaneous circulation (ROSC) with 100% specificity and positive predictive value of 1.000. During compression-only periods, waveform area was higher in stable than unstable ROSC groups (3232.2 versus 2769.6 PVPG; P=0.007). Disappearance of the plethysmography waveform despite a concurrent ECG signal identified pulseless electrical activity with 100% specificity.
Pulse oximetry waveform analysis may help recognize ROSC during ongoing compressions, but these retrospective diagnostic findings do not establish improved resuscitation outcomes.
Study limitation: The abstract reports no sensitivity estimates or confidence intervals for diagnostic performance, limiting interpretation of the reported perfect specificity.
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