Document Detail


Impact of modified treatment in echocardiographically confirmed pseudo-pulseless electrical activity in out-of-hospital cardiac arrest patients with constant end-tidal carbon dioxide pressure during compression pauses.
MedLine Citation:
PMID:  20926019     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
This study evaluated the ability of focused echocardiography (FE) and capnography to differentiate between pulseless electrical activity (PEA) and pseudo-PEA in out-of-hospital cardiac arrest, and the potential survival benefits with modified treatment. In PEA patients with stable end-tidal carbon dioxide pressure (P(et)CO(2)) during the compression pause and concomitant FE showing cardiac kinetic activity, the compression pause was prolonged for 15 s and an additional 20 IU vasopressin was administered. If pulselessness persisted, compressions were continued. Fifteen of the 16 patients studied (94%) achieved restoration of spontaneous circulation (ROSC); eight patients (50%) attained a good neurological outcome (Cerebral Performance Category 1 - 2). In an historical PEA group with stable P(et)CO(2) values (n = 48), ROSC was achieved in 26 patients (54%); four patients (8%) attained Cerebral Performance Category 1 - 2. Echocardiographical verification of the pseudo-PEA state enabled additional vasopressor treatment and cessation of chest compressions, and was associated with significantly higher rates of ROSC, survival to discharge and good neurological outcome.
Authors:
G Prosen; M Križmarić; J Završnik; S Grmec
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of international medical research     Volume:  38     ISSN:  0300-0605     ISO Abbreviation:  J. Int. Med. Res.     Publication Date:    2010 Jul-Aug
Date Detail:
Created Date:  2010-10-07     Completed Date:  2010-12-10     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0346411     Medline TA:  J Int Med Res     Country:  England    
Other Details:
Languages:  eng     Pagination:  1458-67     Citation Subset:  IM    
Affiliation:
Centre for Emergency Medicine Maribor, University of Maribor, Maribor, Slovenia. gregorprosen@gmail.com
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MeSH Terms
Descriptor/Qualifier:
Aged
Carbon Dioxide / metabolism*
Cardiopulmonary Resuscitation / methods*
Demography
Echocardiography
Electricity*
Female
Humans
Male
Middle Aged
Out-of-Hospital Cardiac Arrest / physiopathology*,  ultrasonography*
Pressure*
Pulse
Tidal Volume / physiology*
Chemical
Reg. No./Substance:
124-38-9/Carbon Dioxide

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


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