ISSN 0975-3583

Journal of Cardiovascular Disease Research

    Prognosticating return of spontaneous circulationusing ultrasonography in cardiac arrest patients undergoing cardiopulmonary resuscitation

    Prasanth Ravinthiran, Waseem Ahmed.M
    JCDR. 2023: 871-878


    There has been limited research assessing the usage of USG, its benefits and harms during cardiopulmonary resuscitation. Various studies showed presence of sonographic cardiac activity at the resuscitation was significantly associated with a successful outcome in patients without cardiac activity at the beginning of resuscitation. This study was planned to assess the prognostic value of using USG in cardiac resuscitation of patients with cardiac arrest and to evaluate the prognostic value of using ultrasound in cardiac resuscitation for patients with cardiac arrest and to determine reversible causes found in patients attaining Return ofSpontaneous circulation (ROSC). Materials and methods: A hospital based prospective study with 52 patients was conducted on all patients who presented to the emergency department with discernible/no signs of life. The principal investigator will be given hands-on training with cardiac ultrasound in SMF prior to the start of study. During the training, he will be trained to assess cardiac activity so as to be able to differentiate between the presence or absence of cardiac activity. Following were considered as positive outcomes after successful resuscitation were a) successful ROSC and pulse preserved for more than 20 minutes, b) returning of breathing (excluding gasping, coughing and sudden movement), c) evidence of palpable pulse, and d) measureable blood pressure. Results: Out of 52 patients, 12% cases were in-hospital arrest and 88% cases were out-hospital arrest. 25% had a cardiac arrest witnessed by someone whereas 75% had an unwitnessed cardiac arrest. Out of 52 patients examined, 11 patients had presence of cardiac activity witnessed by the ventricular wall motion using POCUS and 41 patients had no cardiac activity in POCUS. Among 52 patients with cardiac arrest, effective cardiopulmonary resuscitation resulted in return of spontaneous circulation among 8 patients (15%). 44 patients (85%) did not have ROSC after CPR. 6 patients got admitted in the hospital and 2 got discharged / transfer out. In this study, we obtained 75.0% sensitivity, 88.6% specificity, 5 4 . 5 % PPV, and 9 5 . 1 % NPV of the POCUS in detection of cardiac activity. Conclusion: Employing an easy-to-use device as a highly reproducible predictor of survival in cardiac arrest patients would be of high value for the emergency physician deciding whether to continue resuscitative efforts



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