Journal of Emergency Practice and Trauma

Relationship between cardiac ultrasound findings during cardiopulmonary resuscitation with the outcome of patients

Document Type : Original Article

Authors

Javad Seyedhosseini 1
Rasha Ahmadi 1
Ehsan Karimialavijeh 2
Mehrad Aghili 2

1 Emergency Medicine Department, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran

2 Emergency Medicine Department, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran

https://doi.org/10.34172/jept.2022.32
Abstract
Objective: Cardiopulmonary arrest is a devastating outcome of some clinical situations
and requires strict implementation of cardiopulmonary resuscitation (CPR) protocols.
Since ultrasound is one of the recommended tools to determine the presence of cardiac
movements and may be a predictor of the outcome, this study examined the relationship
between echocardiographic findings during CPR with patients’ outcomes.
Methods: This cross-sectional prospective observational study was conducted on patients
with cardio-respiratory arrest in the emergency department of Shariaty hospital during
2019. sampling method was random. Echocardiography was done at the patient’s bedside
during the CPR process in accordance with the last advanced cardiac life support (ACLS)
guidelines, on two points, after the end of the second and 10th minutes from the start of
CPR. The echocardiography findings (cardiac movement vs standstill) were recorded, and
patient outcomes were followed. Thirty-two patients enrolled in this study with a mean
age of 56.9±15.3 years. Chi-square and Mann-Whitney U tests were used to calculate the
association between heart contractions during resuscitation and the outcomes via SPSS
V.22. Fisher’s exact test and Kruskal-Wallis test were used to evaluate the relationship
between heart rhythm in the second and tenth minutes with the outcomes of CPR.
Results: The presence of cardiac movement in the 10th minute of CPR, in contrast to the
findings of the second minute, had a significant correlation with the success rate of CPR
and outcomes (P<0.05). Moreover, patients with ventricular tachycardia (VT)/ventricular
fibrillation (VF) cardiac rhythm had a better resuscitation rate, 24-hour survival rate, and
better outcome than patients with other cardiac rhythms and asystole (P<0.05).
Conclusion: Echocardiographic findings in the 10th minute of the CPR process can be
used as a prognostic factor for cardiac arrest

Keywords

Cardiac arrest
Cardiopulmonary resuscitation
2D Echocardiography
Subjects
1. Long B, Alerhand S, Maliel K, Koyfman A. Echocardiography in cardiac arrest: an emergency medicine review. Am J Emerg Med. 2018;36(3):488-93. doi: 10.1016/j.ajem.2017.12.031.
2. Javaherforoosh Zadeh F, Akbari T, Deris Zayeri Z, Samimi A, Davari N, Rezaeeyan H. The role of molecular mechanism
of Ten-Eleven Translocation2 (TET2) family proteins in pathogenesis of cardiovascular diseases (CVDs). Mol Biol Rep. 2020;47(7):5503-9. doi: 10.1007/s11033-020-05602-4.
3. Yan S, Gan Y, Jiang N, Wang R, Chen Y, Luo Z, et al. The global survival rate among adult out-of-hospital cardiac arrestpatients who received cardiopulmonary resuscitation: a
systematic review and meta-analysis. Crit Care. 2020;24(1):61.doi: 10.1186/s13054-020-2773-2.
4. Holmberg MJ, Geri G, Wiberg S, Guerguerian AM, Donnino
MW, Nolan JP, et al. Extracorporeal cardiopulmonary
resuscitation for cardiac arrest: a systematic review.
Resuscitation. 2018;131:91-100. doi: 10.1016/j.
resuscitation.2018.07.029.
5. Prosen G, Križmarić M, Završnik J, Grmec S. 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. J Int Med Res. 2010;38(4):1458-
67. doi: 10.1177/147323001003800428.
6. Kim HB, Suh JY, Choi JH, Cho YS. Can serial focussed
echocardiographic evaluation in life support (FEEL) predict
resuscitation outcome or termination of resuscitation (TOR)?
A pilot study. Resuscitation. 2016;101:21-6. doi: 10.1016/j.
resuscitation.2016.01.013.
7. Stern KWD, Emani SM, Peek GJ, Geva T, Kutty S. Epicardial
echocardiography in pediatric and congenital heart surgery.
World J Pediatr Congenit Heart Surg. 2019;10(3):343-50. doi:
10.1177/2150135119838414.
8. Singh Y, Katheria A, Tissot C. Functional echocardiography
in the neonatal intensive care unit. Indian Pediatr.
2018;55(5):417-24.
9. Hussein L, Rehman MA, Sajid R, Annajjar F, Al-Janabi T.
Bedside ultrasound in cardiac standstill: a clinical review.
Ultrasound J. 2019;11(1):35. doi: 10.1186/s13089-019-0150-
7.
10. Javaherforoosh Zadeh F, Ghasemi Y, Bagheri S, Maleknia
M, Davari N, Rezaeeyan H. Do exosomes play role in
cardiovascular disease development in hematological
malignancy? Mol Biol Rep. 2020;47(7):5487-93. doi: 10.1007/
s11033-020-05453-z.
11. Link MS, Berkow LC, Kudenchuk PJ, Halperin HR, Hess
EP, Moitra VK, et al. Part 7: adult advanced cardiovascular
life support: 2015 American Heart Association guidelines
update for cardiopulmonary resuscitation and emergency
cardiovascular care. Circulation. 2015;132(18 Suppl 2):S444-
64. doi: 10.1161/cir.0000000000000261.
12. Bolvardi E, Pouryaghobi SM, Farzane R, Mohammad Jafari
Chokan N, Ahmadi K, Reihani H. The prognostic value of
using ultrasonography in cardiac resuscitation of patients with
cardiac arrest. Int J Biomed Sci. 2016;12(3):110-4.
13. Tomruk O, Erdur B, Cetin G, Ergin A, Avcil M, Kapci M.
Assessment of cardiac ultrasonography in predicting outcome
in adult cardiac arrest. J Int Med Res. 2012;40(2):804-9. doi:
10.1177/147323001204000247.
14. Kedan I, Ciozda W, Palatinus JA, Palatinus HN, Kimchi
A. Prognostic value of point-of-care ultrasound during
cardiac arrest: a systematic review. Cardiovasc Ultrasound.
2020;18(1):1. doi: 10.1186/s12947-020-0185-8.
15. Arntfield RT, Millington SJ. Point of care cardiac ultrasound
applications in the emergency department and intensive care
unit--a review. Curr Cardiol Rev. 2012;8(2):98-108. doi:
10.2174/157340312801784952.
16. Gaspari R, Weekes A, Adhikari S, Noble V, Nomura JT,
Theodoro D, et al. A retrospective study of pulseless electrical
activity, bedside ultrasound identifies interventions during
resuscitation associated with improved survival to hospital
admission. A REASON Study. Resuscitation. 2017;120:103-7.
doi: 10.1016/j.resuscitation.2017.09.008.
17. Cebicci H, Salt O, Gurbuz S, Koyuncu S, Bol O. Benefit of
cardiac sonography for estimating the early term survival
of the cardiopulmonary arrest patients. Hippokratia.
2014;18(2):125-9.
18. Merchant RM, Topjian AA, Panchal AR, Cheng A, Aziz K, Berg
KM, et al. Part 1: executive summary: 2020 American Heart
Association guidelines for cardiopulmonary resuscitation and
emergency cardiovascular care. Circulation. 2020;142(16
Journal of Emergency Practice and Trauma
Volume 9, Issue 1
January 2023
Pages 32-37

  • Receive Date 14 February 2023

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