The predictive value of bedside ultrasound to restore spontaneous circulation in patients with pulseless electrical activity: A systematic review and meta-analysis

Wu, Chun-Ho; Zheng, Zongheng; Jiang, Libing; Gao, Ya; Xu, Jing; Jin, Xiaohong; Chen, Qijiang; Zhang, Mao

doi:10.1371/journal.pone.0191636

Cited by 32 publications

(14 citation statements)

References 24 publications

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“…A recent systematic review of 11 studies included 777 patients with PEA and demonstrated that patients with cardiac activity on ultrasonography were more likely to have a ROSC. Possible added value of this ultrasonographic finding derives from the fact that it may encourage continuation of resuscitative efforts [73].…”

Section: Cce Following Cardiac Arrestmentioning

confidence: 99%

A decade of progress in critical care echocardiography: a narrative review

et al. 2019

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Introduction: This narrative review focusing on critical care echocardiography (CCE) has been written by a group of experts in the field, with the aim of outlining the state of the art in CCE in the 10 years after its official recognition and definition. Results: In the last 10 years, CCE has become an essential branch of critical care ultrasonography and has gained general acceptance. Its use, both as a diagnostic tool and for hemodynamic monitoring, has increased markedly, influencing contemporary cardiorespiratory management. Recent studies suggest that the use of CCE may have a positive impact on outcomes. CCE may be used in critically ill patients in many different clinical situations, both in their early evaluation of in the emergency department and during intensive care unit (ICU) admission and stay. CCE has also proven its utility in perioperative settings, as well as in the management of mechanical circulatory support. CCE may be performed with very simple diagnostic objectives. This application, referred to as basic CCE, does not require a high level of training. Advanced CCE, on the other hand, uses ultrasonography for full evaluation of cardiac function and hemodynamics, and requires extensive training, with formal certification now available. Indeed, recent years have seen the creation of worldwide certification in advanced CCE. While transthoracic CCE remains the most commonly used method, the transesophageal route has gained importance, particularly for intubated and ventilated patients. Conclusion: CCE is now widely accepted by the critical care community as a valuable tool in the ICU and emergency department, and in perioperative settings.

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Section: Cce Following Cardiac Arrestmentioning

confidence: 99%

A decade of progress in critical care echocardiography: a narrative review

et al. 2019

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“…No pulse is palpable in pseudo‐PEA but there is some cardiac activity demonstrated with TTE. Pseudo‐PEA should encourage more aggressive resuscitation as was done in our case 15 …”

Section: Discussionmentioning

confidence: 67%

A long pre‐hospital resuscitation and evacuation of a skier with cardiac arrest—A case report

Mannerkorpi

Raatiniemi

Kaikkonen

et al. 2020

Acta Anaesthesiol Scand

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The prognosis for patients with refractory cardiac arrest transferred to hospital during ongoing resuscitation is poor. 1 Additionally in remote areas, the response time of the emergency medical services (EMS) may be long, which further decreases the likelihood of a good outcome. The most common reason for sudden death during cross-country skiing is acute coronary artery syndrome and subsequent ventricular fibrillation (VF). 2 We describe a patient who suffered a cardiac arrest during a long-distance cross-country skiing competition in northern Finland. He was transported to a university hospital and underwent a percutaneous coronary intervention supported by a mechanical chest compression device while still in cardiac arrest. He made a full recovery.

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“…First, the physician should differentiate true PEA from pseudo-PEA 5 : the latter shows residual wall motion and may benefit from longer resuscitation, while true PEA has a poorer outcome. 6 Ultrasound should then differentiate potential treatable causes of CA. 4,5 Ultrasound may identify an acutely dilated RV corresponding to acute cor pulmonale, severely impaired LV frequently associated with ischemic disease, small and hyperkinetic ventricles indicating severe hypovolemia, or tamponade of the right-hand cavities by a pericardial effusion.…”

Section: Discussionmentioning

confidence: 99%

Ultrasound Diagnosis of Cardiac Arrest in a Patient With Hematologic Disease

Mongodi

Luperto

Roldi

et al. 2019

Chest

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A 52-year-old woman suffered cardiac arrest (CA) while hospitalized in a hematologic ward. Her past medical history included breast cancer treated with radiotherapy and hormonal therapy, and acquired von Willebrand disease; she was undergoing testing for a newly detected severe thrombocytosis. Chest compressions were started immediately by nurses, followed by advanced cardiac life support (ACLS) started 4 min later, after the arrival of the intensivist. All rhythm checks showed nonshockable pulseless electrical activity (PEA) rhythm. Ultrasound was not available at that moment. Return to spontaneous circulation (ROSC) was obtained after 25 min; five doses of epinephrine were administered during resuscitation efforts. After ROSC, an ECG was negative for acute myocardial infarction and the patient was transferred to the ICU, intubated, and hemodynamically stable with no pharmacologic support. Once admitted to the ICU, while awaiting diagnostic in-depth analysis, she had a second CA; the cardiac monitor showed PEA. ACLS was immediately started and focused ultrasound was performed at the first pulse check pause.

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The predictive value of bedside ultrasound to restore spontaneous circulation in patients with pulseless electrical activity: A systematic review and meta-analysis

Cited by 32 publications

References 24 publications

A decade of progress in critical care echocardiography: a narrative review

A decade of progress in critical care echocardiography: a narrative review

A long pre‐hospital resuscitation and evacuation of a skier with cardiac arrest—A case report

Ultrasound Diagnosis of Cardiac Arrest in a Patient With Hematologic Disease

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