Transthoracic impedance waveform to distinguish pseudo-PEA from true-PEA.

Caggegi, Giuseppe Davide; Peratoner, Alberto; Contadini, Michele; Musian, Moreno; Ristagno, Giuseppe · Resuscitation · 2025

case_series · Level IV

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Abstract

Pulseless electrical activity (PEA) presents with electrical cardiac activity without a pulse and often carries a poor prognosis. Pseudo-PEA mimics true-PEA but has residual cardiac motion detectable by ultrasound. This pilot study suggests thoracic transthoracic impedance (TTI), a defibrillator-based measure, may help differentiate pseudo-PEA from true-PEA. Among 10 reviewed cases, TTI showed waveform fluctuations only in pseudo-PEA, indicating potential for improved identification and targeted resuscitation strategies.

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