Ultrasound use during cardiopulmonary resuscitation is associated with delays in chest compressions

Veld, Maite A. Huis in ‘t; Allison, Michael G.; Bostick, David S.; Fisher, Kiondra R.; Goloubeva, Olga; Witting, Michael D.; Winters, Michael E.

doi:10.1016/j.resuscitation.2017.07.021

Cited by 176 publications

(72 citation statements)

References 16 publications

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“…In 2017 and 2018, three studies demonstrated that use of ultrasound increases hands-off time during pulse checks [19][20][21]. Among these was a prospective cohort study by Huis and his colleagues where cameras were installed in the resuscitation room as a means of visually monitoring any and all interruptions during CPR [19]. Twenty-three patients were enrolled in the study with a total of 123 pulse checks.…”

Section: Ultrasound Should Not Delay Chest Compressionsmentioning

confidence: 99%

Bedside ultrasound in cardiac standstill: a clinical review

et al. 2019

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Patients with cardiac arrest present as a relatively frequent occurrence in the Emergency Department. Despite the advances in our understanding of the pathophysiology of cardiac arrest, managing the condition remains a stressful endeavor and currently implemented interventions, while beneficial, are still associated with a disappointingly low survivability. The majority of modern Advanced Life Support algorithms employ a standardized approach to best resuscitate the 'crashed' patient. However, management during resuscitation often encourages a 'one-size-fitsall' policy for most patients, with lesser attention drawn towards causality of the disease and factors that could alter resuscitative care. Life support providers are also often challenged by the limited bedside predictors of survival to guide the course and duration of resuscitation. Over the recent decades, point-of-care ultrasonography (PoCUS) has been gradually proving itself as a useful adjunct that could potentially bridge the gap in the recognition and evaluation of precipitants and end-points in resuscitation, thereby facilitating an improved approach to resuscitation of the arrested patient. Point-of-care ultrasound applications in the critical care field have tremendously evolved over the past four decades. Today, bedside ultrasound is a fundamental tool that is quick, safe, inexpensive and reproducible. Not only can it provide the physician with critical information on reversible causes of arrest, but it can also be used to predict survival. Of note is its utility in predicting worse survival outcomes in patients with cardiac standstill, i.e., no cardiac activity witnessed with ultrasound. Unfortunately, despite the increasing evidence surrounding ultrasound use in arrest, bedside ultrasound is still largely underutilized during the resuscitation process. This article reviews the current literature on cardiac standstill and the application of bedside ultrasound in cardiac arrests.

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Section: Ultrasound Should Not Delay Chest Compressionsmentioning

confidence: 99%

Bedside ultrasound in cardiac standstill: a clinical review

et al. 2019

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“…While the value of bedside transthoracic echocardiography (TTE) in cardiac arrest patients has been acknowledged, it is not without risk . Poor acoustic windows may lead to misinterpretation of imaging and prolonged interruption of cardiopulmonary resuscitation (CPR) during pulse checks may negatively affect cardiac arrest resuscitation . Transesophageal echocardiography (TEE) overcomes these limitations and offers numerous advantages over TTE.…”

Section: Introductionmentioning

confidence: 99%

RESCUE transesophageal echocardiography for monitoring of mechanical chest compressions and guidance for extracorporeal cardiopulmonary resuscitation cannulation in refractory cardiac arrest

Giorgetti

Chiricolo

Melniker

et al. 2019

J of Clinical Ultrasound

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There is a growing interest in using point‐of‐care transesophageal echocardiography (TEE) during cardiac arrest. TEE is effective at identifying the etiology of sudden cardiovascular collapse and guiding management during the resuscitation. In selected patients with refractory cardiac arrest, extracorporeal cardiopulmonary resuscitation (ECPR) can be considered. ECPR requires percutaneous vascular access for the implantation of veno‐arterial extracorporeal membrane oxygenation circuit. We present a case of prolonged cardiac arrest in which rescue TEE was pivotal in narrowing the differential diagnosis, monitoring of mechanical chest compression performance, and guiding cannulation for ECPR.

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“…TTE has several well‐known limitations: suboptimal images because of the patient's body habitus and the need to interrupt cardiopulmonary resuscitation (CPR) because the action of chest compressions limits the acquisition of optimal views . A recent study demonstrated that the use of TTE during cardiac arrest can lengthen the duration of pulse check times beyond the 10 seconds recommended by the American Heart Association and the European Resuscitation Council . Transesophageal echocardiography (TEE) does not have these limitations, and although it is unclear whether its use changes survival outcomes, it can add important information, including better visualization of pulmonary emboli, wall motion abnormalities, and aortic dissection and dynamic evaluation of chest compressions .…”

mentioning

confidence: 99%

The Use of Transesophageal Echocardiography During Cardiac Arrest Resuscitation: A Literature Review

Parker

Salerno

Euerle

2018

J of Ultrasound Medicine

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We propose that transesophageal echocardiography (TEE) can be used to guide cardiac arrest resuscitation. We undertook a literature search (Medline and EMBase) to assess articles on that topic. Our search yielded 55 articles falling into 3 categories: TEE used in operating rooms, TEE used in emergency departments, and TEE used in other settings. In many cases, TEE changed the direction of the resuscitation; however, it is unclear whether TEE changed patient‐oriented outcomes, such as neurologically intact survival. Few adverse events related to TEE have been documented. There is growing evidence that physicians can learn to use TEE during resuscitations and apply the findings to clinical decisions.

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Ultrasound use during cardiopulmonary resuscitation is associated with delays in chest compressions

Cited by 176 publications

References 16 publications

Bedside ultrasound in cardiac standstill: a clinical review

Bedside ultrasound in cardiac standstill: a clinical review

RESCUE transesophageal echocardiography for monitoring of mechanical chest compressions and guidance for extracorporeal cardiopulmonary resuscitation cannulation in refractory cardiac arrest

The Use of Transesophageal Echocardiography During Cardiac Arrest Resuscitation: A Literature Review

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