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• W2043764441 abstract "Emergency ultrasonography has a potential to identify reversible causes of cardiac arrest (CPA) at bedside and improve the effectiveness of cardiopulmonary resuscitation (CPR). However, very little is known about the efficacy of emergency ultrasonography during CPR. The aim of our study was to determine how effectively emergency physicians detect the etiology of CPA by using emergency ultrasonography. We conducted a retrospective chart review of adult patients with non-traumatic out-of-hospital cardiac arrest (OHCA), who were brought to an urban emergency department between April 2010 and March 2013 in Japan. To evaluate the diagnostic value of emergency ultrasonography, we compared the results of emergency ultrasonography performed by emergency physicians and the autopsy-proven diagnoses. Data were abstracted from records at Kobe City Medical Center General Hospital and the Medical Examiner's Office of Hyogo Prefecture. Only patients who underwent autopsy and who were examined with emergency ultrasonography during CPR were enrolled. The exclusion criteria were as follows: age below 18 years, traumatic injuries, known terminal illness, and prior completion of a “do not attempt resuscitation” form. A total of 217 patients with non-traumatic OHCA underwent autopsy. Of them, 163 patients (75%; 100 men and 63 women) were examined by emergency physicians using emergency ultrasonography. Mean age of the patients was 70.5 ± 15 years. The most common cause of OHCA was acute coronary syndrome (52 cases, 32 %), followed by arrhythmia (17 cases, 10%), aortic pathology (15 cases, 9%), and pulmonary embolism (7 cases, 4%). The following causes of OHCA were detected by emergency ultrasonography in 18 patients: cardiac tamponade in 14 cases; rupture of abdominal/thoracic aortic aneurysm in 3 cases, and pulmonary embolism in 1 case. Emergency ultrasonography identified cardiac tamponade with a sensitivity of 70.0% (95% confidence interval [CI], 54.6–77.0), specificity of 98.6% (95% CI, 96.5–99.6), positive predictive value (PPV) of 87.5% (95% CI, 68.3–96.3), negative predictive value (NPV) of 95.9% (95% CI, 93.8–96.9), and overall accuracy of 95.1% (95% CI, 91.3–96.8); abdominal/thoracic aortic aneurysm with a sensitivity of 75% (95% CI, 37.9–75.0), specificity of 100% (95% CI, 99.1–100), PPV of 100% (95% CI, 50.5–100), NPV of 99.4% (95%CI, 98.4–99.4), and overall accuracy of 99.4% (95% CI, 97.6–99.4); and pulmonary embolism with a sensitivity of 14.3% (95% CI, 3.0–14.3), specificity of 100% (95% CI, 99.5–100), PPV of 100% (95% CI, 21.1–100), NPV of 96.3% (95% CI, 95.8–96.3), and overall accuracy of 96.3% (95% CI, 95.4–96.3). Emergency ultrasonography identified potentially reversible causes of CPA with a high accuracy. The integration of emergency ultrasonography into advanced life support would improve the outcomes of patients with OHCA." @default.
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• W2043764441 date "2013-10-01" @default.
• W2043764441 modified "2023-09-26" @default.
• W2043764441 title "The Role of Emergency Ultrasonography in Cardiopulmonary Resuscitation" @default.
• W2043764441 doi "https://doi.org/10.1016/j.annemergmed.2013.07.073" @default.
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