EEG-Based Prediction of the Recovery of Carotid Blood Flow during Cardiopulmonary Resuscitation in a Swine Model

The recovery of cerebral circulation during cardiopulmonary resuscitation (CPR) is important to improve the neurologic outcomes of cardiac arrest patients. To evaluate the feasibility of an electroencephalogram (EEG)-based prediction model as a CPR feedback indicator of high- or low-CBF carotid blood flow (CBF), the frontal EEG and hemodynamic data including CBF were measured during animal experiments with a ventricular fibrillation (VF) swine model. The most significant 10 EEG parameters in the time, frequency and entropy domains were determined by neighborhood component analysis and Student's t-test for discriminating high- or low-CBF recovery with a division criterion of 30%. As a binary CBF classifier, the performances of logistic regression, support vector machine (SVM), k-nearest neighbor, random forest and multilayer perceptron algorithms were compared with eight-fold cross-validation. The three-order polynomial kernel-based SVM model showed the best accuracy of 0.853. The sensitivity, specificity, F1 score and area under the curve of the SVM model were 0.807, 0.906, 0.853 and 0.909, respectively. An automated CBF classifier derived from non-invasive EEG is feasible as a potential indicator of the CBF recovery during CPR in a VF swine model.