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Prognostic value of point-of-care ultrasound during cardiac arrest: a systematic review

BACKGROUND: Despite significant improvements in cardiopulmonary resuscitation, sudden cardiac arrest is one of the leading causes of mortality in the United States. Ultrasound is a widely available tool that can be used to evaluate the presence of cardiac wall motion during cardiac arrest. Several c...

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Autores principales: Kedan, Ilan, Ciozda, William, Palatinus, Joseph A., Palatinus, Helen N., Kimchi, Asher
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6958750/
https://www.ncbi.nlm.nih.gov/pubmed/31931808
http://dx.doi.org/10.1186/s12947-020-0185-8
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author Kedan, Ilan
Ciozda, William
Palatinus, Joseph A.
Palatinus, Helen N.
Kimchi, Asher
author_facet Kedan, Ilan
Ciozda, William
Palatinus, Joseph A.
Palatinus, Helen N.
Kimchi, Asher
author_sort Kedan, Ilan
collection PubMed
description BACKGROUND: Despite significant improvements in cardiopulmonary resuscitation, sudden cardiac arrest is one of the leading causes of mortality in the United States. Ultrasound is a widely available tool that can be used to evaluate the presence of cardiac wall motion during cardiac arrest. Several clinical studies have evaluated the use of ultrasound to visualize cardiac motion as a predictor of mortality in cardiac arrest patients. However, there are limited data summarizing the prognostic value of point of care ultrasound evaluation during resuscitation. We performed a systematic literature review of the existing evidence examining the clinical utility of point-of-care ultrasound evaluation of cardiac wall motion as a predictor of cardiac resuscitation outcomes. METHODS/RESULTS: We performed a systematic PubMed search of clinical studies up to July 23, 2019 evaluating point-of-care sonographic cardiac motion as a predictor of mortality following cardiac resuscitation. We included studies written in English that reviewed short-term outcomes and included adult populations. Fifteen clinical studies met inclusion criteria for assessing cardiac wall motion with point-of-care ultrasound and outcomes following cardiac resuscitation. Fourteen of the fifteen studies showed a statistically significant correlation between the presence of cardiac motion on ultrasound and short-term survival. This was most evident in patients with ventricular fibrillation or ventricular tachycardia as a presenting rhythm. Absence of cardiac motion non-survival. The data were pooled and the overall pooled odds ratio for return of spontaneous circulation in the presence of cardiac motion during CPR was 12.4 +/1 2.7 (p <  0.001). CONCLUSION: Evaluation of cardiac motion on transthoracic echocardiogram is a valuable tool in the prediction of short-term cardiac resuscitation outcomes. Given the safety and availability of ultrasound in the emergency department, it is reasonable to apply point-of-care ultrasound to cardiopulmonary resuscitation as long as its use does not interrupt resuscitation.
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spelling pubmed-69587502020-01-17 Prognostic value of point-of-care ultrasound during cardiac arrest: a systematic review Kedan, Ilan Ciozda, William Palatinus, Joseph A. Palatinus, Helen N. Kimchi, Asher Cardiovasc Ultrasound Review BACKGROUND: Despite significant improvements in cardiopulmonary resuscitation, sudden cardiac arrest is one of the leading causes of mortality in the United States. Ultrasound is a widely available tool that can be used to evaluate the presence of cardiac wall motion during cardiac arrest. Several clinical studies have evaluated the use of ultrasound to visualize cardiac motion as a predictor of mortality in cardiac arrest patients. However, there are limited data summarizing the prognostic value of point of care ultrasound evaluation during resuscitation. We performed a systematic literature review of the existing evidence examining the clinical utility of point-of-care ultrasound evaluation of cardiac wall motion as a predictor of cardiac resuscitation outcomes. METHODS/RESULTS: We performed a systematic PubMed search of clinical studies up to July 23, 2019 evaluating point-of-care sonographic cardiac motion as a predictor of mortality following cardiac resuscitation. We included studies written in English that reviewed short-term outcomes and included adult populations. Fifteen clinical studies met inclusion criteria for assessing cardiac wall motion with point-of-care ultrasound and outcomes following cardiac resuscitation. Fourteen of the fifteen studies showed a statistically significant correlation between the presence of cardiac motion on ultrasound and short-term survival. This was most evident in patients with ventricular fibrillation or ventricular tachycardia as a presenting rhythm. Absence of cardiac motion non-survival. The data were pooled and the overall pooled odds ratio for return of spontaneous circulation in the presence of cardiac motion during CPR was 12.4 +/1 2.7 (p <  0.001). CONCLUSION: Evaluation of cardiac motion on transthoracic echocardiogram is a valuable tool in the prediction of short-term cardiac resuscitation outcomes. Given the safety and availability of ultrasound in the emergency department, it is reasonable to apply point-of-care ultrasound to cardiopulmonary resuscitation as long as its use does not interrupt resuscitation. BioMed Central 2020-01-13 /pmc/articles/PMC6958750/ /pubmed/31931808 http://dx.doi.org/10.1186/s12947-020-0185-8 Text en © The Author(s). 2020 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Review
Kedan, Ilan
Ciozda, William
Palatinus, Joseph A.
Palatinus, Helen N.
Kimchi, Asher
Prognostic value of point-of-care ultrasound during cardiac arrest: a systematic review
title Prognostic value of point-of-care ultrasound during cardiac arrest: a systematic review
title_full Prognostic value of point-of-care ultrasound during cardiac arrest: a systematic review
title_fullStr Prognostic value of point-of-care ultrasound during cardiac arrest: a systematic review
title_full_unstemmed Prognostic value of point-of-care ultrasound during cardiac arrest: a systematic review
title_short Prognostic value of point-of-care ultrasound during cardiac arrest: a systematic review
title_sort prognostic value of point-of-care ultrasound during cardiac arrest: a systematic review
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6958750/
https://www.ncbi.nlm.nih.gov/pubmed/31931808
http://dx.doi.org/10.1186/s12947-020-0185-8
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