Association of ultrasound-related interruption during cardiopulmonary resuscitation with adult cardiac arrest outcomes: A video-reviewed retrospective study

Cardiac arrest: An interdisciplinary scoping review of clinical literature from 2020

“…Another study emphasizing the importance of high‐quality chest compressions found that when echocardiogram‐related interruptions in chest compressions were limited to less than 3 events, rates of return of spontaneous circulation (ROSC) (odds ratio [OR], 5.55; 95% CI, 2.44–12.61; P < 0.001) and survival to hospital discharge improved (OR, 7.31; 95% CI, 1.59–33.59; P = 0.01) 18 . Patients with non‐echocardiogram‐related interruptions totaling less than 43 seconds also had significantly increased rates of ROSC and survival, in keeping with current AHA recommendations to limit interruptions in chest compressions 18,21 . A separate meta‐analysis found that cardiac motion detected on ultrasound was positively associated with ROSC, especially in patients with shockable initial rhythms, although no specific or objective threshold was identified 22 …”

“…Times to specific endpoints were the primary outcomes of interest in 9 articles 11–20 . Endpoints included time elapsed until recognition of cardiac arrest, contact with first responders, defibrillation, establishment of vascular access, epinephrine administration, resumption of chest compressions after pulse check, and definitive care in a hospital 11–20 . Overall, although a reduced time to each intervention during resuscitation was not uniformly shown to improve survival or neurologic outcome, no harms from more rapid intervention for each of the parameters listed above were noted.…”

“…A common theme of the prehospital literature from 2020 was the focus on timeliness in cardiac arrest management. Times to specific endpoints were the primary outcomes of interest in 9 articles 11–20 . Endpoints included time elapsed until recognition of cardiac arrest, contact with first responders, defibrillation, establishment of vascular access, epinephrine administration, resumption of chest compressions after pulse check, and definitive care in a hospital 11–20 .…”

“…[11][12][13][14][15][16][17][18][19][20] Endpoints included time elapsed until recognition of cardiac arrest, contact with first responders, defibrillation, establishment of vascular access, epinephrine administration, resumption of chest compressions after pulse check, and definitive care in a hospital. [11][12][13][14][15][16][17][18][19][20] Overall, although a reduced time to each intervention during resuscitation was not uniformly shown to improve survival or neurologic outcome, no harms from more rapid intervention for each of the parameters listed above were noted. Moreover, delays in arrival or in initiation of a given therapy continued to demonstrate increased odds of poor outcomes as measured by cerebral performance category (CPC).…”

Carotid Artery Ultrasound in the (peri-) Arrest Setting—A Prospective Pilot Study

“…Point-of-care US (POCUS) is commonly used during CPR [9,10]. When practiced by a skilled provider, its use is positively associated with ROSC [11]. However, carotid US during CA is still a debated topic.…”