Document Detail


Does the presence or absence of sonographically identified cardiac activity predict resuscitation outcomes of cardiac arrest patients?
MedLine Citation:
PMID:  16032611     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
This study evaluated the ability of cardiac sonography performed by emergency physicians to predict resuscitation outcomes of cardiac arrest patients. A convenience sample of cardiac arrest patients prospectively underwent bedside cardiac sonography at 4 emergency medicine residency-affiliated EDs as part of the Sonography Outcomes Assessment Program. Cardiac arrest patients in pulseless electrical activity (PEA) and asystole underwent transthoracic cardiac ultrasound B-mode examinations during their resuscitations to assess for the presence or absence of cardiac kinetic activity. Several end points were analyzed as potential predictors of resuscitations: presenting cardiac rhythms, the presence of sonographically detected cardiac activity, prehospital resuscitation time intervals, and ED resuscitation time intervals. Of 70 enrolled subjects, 36 were in asystole and 34 in PEA. Patients presenting without evidence of cardiac kinetic activity did not have return of spontaneous circulation (ROSC) regardless of their cardiac rhythm, asystole, or PEA. Of the 34 subjects presenting with PEA, 11 had sonographic evidence of cardiac kinetic activity, 8 had ROSC with subsequent admission to the hospital, and 1 had survived to hospital discharge with scores of 1 on the Glasgow-Pittsburgh Cerebral Performance scale and 1 in the Overall Performance category. The presence of sonographically identified cardiac kinetic motion was associated with ROSC. Time interval durations of cardiac resuscitative efforts in the prehospital environment and in the ED were not accurate predictors of ROSC for this cohort. Cardiac kinetic activity, or lack thereof, identified by transthoracic B-mode ultrasound may aid physicians' decision making regarding the care of cardiac arrest patients with PEA or asystole.
Authors:
Philip Salen; Larry Melniker; Carolyn Chooljian; John S Rose; Janet Alteveer; James Reed; Michael Heller
Publication Detail:
Type:  Clinical Trial; Journal Article; Multicenter Study    
Journal Detail:
Title:  The American journal of emergency medicine     Volume:  23     ISSN:  0735-6757     ISO Abbreviation:  Am J Emerg Med     Publication Date:  2005 Jul 
Date Detail:
Created Date:  2005-07-20     Completed Date:  2005-10-07     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8309942     Medline TA:  Am J Emerg Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  459-62     Citation Subset:  IM    
Affiliation:
Department of Emergency Medicine, St. Lukes Hospital, St. Lukes Hospital EM Residency, Bethlehem, PA 18015, USA.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Aged, 80 and over
Area Under Curve
Cardiopulmonary Resuscitation / methods,  statistics & numerical data*
Cohort Studies
Female
Heart Arrest / therapy*,  ultrasonography*
Humans
Logistic Models
Male
Middle Aged
Outcome and Process Assessment (Health Care)
Predictive Value of Tests
Prospective Studies
Remission, Spontaneous
Survival Analysis

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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