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• W2000957360 abstract "Many physicians incorporate bedside ultrasound as a guide to the futility of resuscitative efforts although the research to support this approach has never been evaluated systematically. We sought to determine if current evidence supports the use of focused trans-thoracic ultrasound during resuscitation as a predictor of outcome during cardiac arrest. A literature search was conducted of PubMed, EMBASE, CINAHL, and Cochrane databases, a hand search of references was performed and experts in the field were contacted. The initial search returned 2538 papers, 12 of which were determined to be relevant by 3 independent researchers. Studies were included for further appraisal and analysis only if the selection criteria and reference standards were met. Studies were included if they reported outcome data (return of spontaneous circulation) on cardiac arrest victims evaluated with a trans-thoracic view of the heart during resuscitation but in whom maneuvers were continued despite ultrasound findings. Case reports were excluded. Following appraisal and scoring by 2 independent reviewers using a modified QUADAS tool, 7 studies were included in the final analysis. The total number of patients in the combined data-set from 7 studies was 527, all of whom had cardiac ultrasound integrated into the resuscitation efforts to determine the presence or absence of kinetic cardiac activity, and were followed up to determine return of spontaneous circulation. Meta analysis of the data showed that as a test for death (the ability to predict failure of resuscitation) echo had a pooled sensitivity of 91.7% (95% CI 84.3 to 96.3%), and specificity was 80.3% (95% CI 76.0 to 84.1%). The positive likelihood ratio for return of spontaneous circulation was 4.48 (95% CI 2.42 to 8.31) and negative likelihood ratio was 0.17 (95% CI 0.10 to 0.32). The test for heterogeneity (sensitivity) was non-significant (chi squared = 8.50; p=0.131). There may be a role for the use of focused ultrasound as an adjunct to clinical assessment for the prediction of outcome during resuscitation for cardiac arrest. However, as many as 15.7% (lower 95% CI on sensitivity), will experience return of spontaneous circulation despite a lack of cardiac activity on ultrasound. To date, however, the test characteristics of ultrasound in life support have not been shown to be reliable enough to recommend its use as a guide to stopping CPR in cardiac arrest." @default.
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• W2000957360 date "2011-10-01" @default.
• W2000957360 modified "2023-09-26" @default.
• W2000957360 title "262 Does Cardiac Standstill Mean We Can Stop CPR? Focused Ultrasound as Predictor of Survival in Cardiac Arrest Patients: A Systematic Review" @default.
• W2000957360 doi "https://doi.org/10.1016/j.annemergmed.2011.06.292" @default.
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