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

Giuseppe Davide Caggegi¹, Alberto Peratoner¹, Michele Contadini¹

¹Prehospital Emergency Medical Service, Department of Anesthesia and Intensive Care, Cattinara Hospital, University of Trieste, Trieste, Italy.

|July 10, 2025

Abstract

None:

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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