Carotid Artery Ultrasound in the (peri-) Arrest Setting—A Prospective Pilot Study

Abstract

Point-of-care ultrasounds (US) are used during cardiopulmonary resuscitation (CPR) and after return of spontaneous circulation (ROSC). Carotid ultrasounds are a potential non-invasive monitoring tool for chest compressions, but their general value and feasibility during CPR are not fully determined. In this prospective observational study, we performed carotid US during conventional- and extracorporeal CPR and after ROSC with at least one transverse and coronal image, corresponding loops with and without color doppler, and pulsed-wave doppler loops. The feasibility of carotid US during (peri-)arrest and type and frequency of diagnostic findings were examined. We recruited 16 patients and recorded utilizable US images in 14 cases (88%; complete imaging protocols in 11 patients [69%]). In three of all patients (19%) and in 60% (3/5) of cases during CPR plus a full imaging protocol, we observed: (i) in one patient a collapse of the common carotid artery linked to hypovolemia, and (ii) in two patients a biphasic flow during CPR linked to prolonged low-flow time prior to admission and adverse outcome. Carotid artery morphology and carotid blood flow characteristics may serve as therapeutic target and prognostic parameters. However, future studies with larger sample sizes are needed.

Femoral artery collapse ratio as an indicator of chest compression quality during cardiopulmonary resuscitation in a porcine cardiac arrest model

“…Several studies have used the carotid artery to compare CPR quality using POCUS. Two studies reported that sonographic blood flow measurement of the carotid artery is a non-invasive and useful method for ensuring high-quality CPR during chest compression [21,22]; however, one study reported a weak correlation between PSV and ETCO 2 values in CPR [23].…”