Browsing by Author "Tsai, Min-Shan"

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A NOVEL SYSTEM AND STATISTICAL ANALYSIS FOR PREDICTING DEFIBRILLATION TIMING DURING VENTRICULAR FIBRILLATION
(2018-01-01)
Tsai, Shang-Ho (Lawrence)
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Tsai, Min-Shan
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Jiang, Yu-Chen Fan
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電子工程學系及電子研究所
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Department of Electronics Engineering and Institute of Electronics
This work proposes a new algorithm and analytical methods for predicting the successful rate of a defibrillation during ventricular fibrillation. Accurate predictions help in improving outcomes of cardiopulmonary resuscitation. This also helps in finding a good defibrillation timing to avoid ineffective defibrillation, which leads to myocardial damages and thus a poor prognosis after the resuscitation. Simulation results show that the proposed algorithm outperforms conventional methods in terms of several commonly used performance indices; meanwhile, the proposed analysis also well matches the practical experimental results.
PREDICTING DEFIBRILLATION OUTCOME IN VENTRICULAR FIBRILLATION USING ECG WITH NEURAL NETWORK ALGORITHM
(2019-01-01)
Tsai, Shang-Ho (Lawrence)
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Tsai, Min-Shan
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Huang, Hsin-Chi
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Ling, Dean-Chang (Ash)
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電子工程學系及電子研究所
This work proposes a system to predict the outcomes of the defibrillation during the period of ventricular fibrillation. Accurate outcomes can avoid inefficient defibrillation that causes severe myocardial injury. In this system, we apply a neural network model and use the frequency components of ECG signals as training data to determine the neuron coefficients. The trained system is then validated (tested) using different set of data to justify the performance. Experimental results are provided to show superior performance of the proposed system.
Predicting the outcomes for out-of-hospital cardiac arrest patients using multiple biomarkers and suspension microarray assays
(2016-06-03)
Huang, Chien-Hua
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Tsai, Min-Shan
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Chien, Kuo-Liong
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Chang, Wei-Tien
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Wang, Tzung-Dau
Predicting the prognosis for cardiac arrest is still challenging. Combining biomarkers from diverse pathophysiological pathways may provide reliable indicators for the severity of injury and predictors of long-term outcomes. We investigated the feasibility of using a multimarker strategy with key independent biomarkers to improve the prediction of outcomes in cardiac arrest. Adult out-of-hospital cardiac arrest patients with sustained return of spontaneous circulation were prospectively enrolled in this study. Blood samples were taken at 2 and 24 hours after cardiac arrest. Suspension microarray assays were used to test 21 different biomarkers. A total of 99 patients were enrolled, 45 of whom survived to hospital discharge. We identified 11 biomarkers that, when combined with clinical variables and factors of APACHE II score and history of arrhythmia, were independent determinants for outcome of in-hospital mortality (concordance = 0.9249, standard error = 0.0779). Three biomarkers combined with APACHE II and age were independent determinants for favorable neurological outcome at hospital discharge (area under the receiver-operator characteristic curve, 0.938; 95% confidence interval, 0.854 similar to 1.0). In conclusion, a systemic multiple biomarker approach using suspension microarray assays can identify independent predictors and model the outcomes of cardiac arrest patients during the post-cardiac arrest period.
The difference in myocardial injuries and mitochondrial damages between asphyxial and ventricular fibrillation cardiac arrests
(2012-10-01)
Tsai, Min-Shan
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Huang, Chien-Hua
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Tsai, Shang-Ho
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Tsai, Chia-Ying
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Chen, Huei-Wen
Introduction: Ventricular fibrillation (VF) and asphyxia account for most cardiac arrests but differ in cardiac arrest course, neurologic deficit, and myocardial damage. In VF resuscitation, cardiac mitochondria were known to be damaged via excess generation of reactive oxygen species. This study evaluated the difference of cardiac mitochondrial damages between VF and asphyxial cardiac arrests. Methods: In the VF + electrical shock (ES) group, VF was induced and untreated for 5 minutes, followed by 1 minute of cardiopulmonary resuscitation (CPR) and 1 ES of 5 J. Animals were killed immediately after ES. In the asphyxia group, cardiac arrest was induced by airway obstruction, and then pulselessness was maintained for 5 minutes, followed by 1 minute of CPR. The animals were killed immediately after CPR. The histology and ultrastructural changes of myocardium and complex activities and respiration of mitochondria were evaluated. The mitochondrial permeability transition pore opening was measured based on mitochondrial swelling rate. Results: The histopathologic examinations showed myocardial necrosis and mitochondrial damage in both cardiac arrests. Instead of regional damages of myocardium in the VF + ES group, the myocardial injury in the asphyxia group distributed diffusely. The asphyxia group demonstrated more severe mitochondrial damage than the VF + ES group, which had a faster mitochondrial swelling rate, more decreased cytochrome c oxidase activity, and more impaired respiration. Conclusions: Both VF and asphyxial cardiac arrests caused myocardial injuries and mitochondrial damages. Asphyxial cardiac arrest presented more diffuse myocardial injuries and more severe mitochondrial damages than VF cardiac arrest. (c) 2012 Elsevier Inc. All rights reserved.