The use of echocardiography (echo) during cardiac arrest has been widely adopted amongst
emergency and critical care clinicians over the past 20 years.
1.
It is possible to obtain transthoracic cardiac images in nearly all arrest patients
without prolonging compression pause time.
2.
,
3.
In a consensus statement from 2010, the American Society of Echocardiography and
the American College of Emergency Physicians recommended focused cardiac ultrasound
to assess patients in cardiac arrest, specifically to differentiate between asystole,
pulseless electrical activity (PEA) and pseudo-PEA, a state where no pulse is palpated
yet the patient has organized ventricular contractions on echo.
4.
However, more recent consensus statements by both the American Heart Association
and the European Resuscitation Council discouraged the use of echo for prognostication
during cardiac arrest.
5.
,
6.
Both cite a 2020 review in Resuscitation by Reynolds et al. that concludes that the evidence for the use of echo as a prognostic
tool during cardiac arrest is limited and biased.
7.
So what does echo during cardiac arrest really add? Does it provide any additional
prognostic information when combined with current modes of patient assessment such
as electrocardiogram (ECG) and palpation of a pulse?To read this article in full you will need to make a payment
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References
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Article info
Publication history
Published online: November 15, 2021
Accepted:
October 2,
2021
Received:
September 30,
2021
Identification
Copyright
© 2021 Elsevier B.V. All rights reserved.
ScienceDirect
Access this article on ScienceDirectLinked Article
- Comparison of outcomes between pulseless electrical activity by electrocardiography and pulseless myocardial activity by echocardiography in out-of-hospital cardiac arrest; secondary analysis from a large, prospective studyResuscitationVol. 169
- PreviewBetween 350,000 and 400,000 cardiac arrest cases are managed in Emergency Departments annually in the United States.1 Survival to hospital discharge following out of hospital cardiac arrest has been reported between 3% and 22% and is influenced by many clinical, geographical and interventional factors.1,2 Echocardiography (echo) has been suggested as a tool to assist in cardiac arrest resuscitation.3,4 Initial suggestions that echo could prognosticate outcomes with a high degree of accuracy5–7 have not been supported with larger, better designed studies.
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