In:
Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 132, No. suppl_3 ( 2015-11-10)
Abstract:
Introduction: In-hospital cardiopulmonary arrest (CPA-IH) is a public health problem with high worldwide morbidity and mortality. Cases of non-shockable CPA rhythms, such as asystole and pulseless electrical activity (PEA), have remained unchanged over the last 30 years. Despite updates to resuscitation guidelines every five years, we have not been successful in increasing patient survival. Prognostic and diagnostic factors during CPA are necessary to increase survival among these patients and optimise available resources. Transthoracic echocardiography (TTE) provides valuable information about diagnosis and perhaps prognosis, through real-time images. Hypothesis: This study describes the use of TTE in patients with CPA with non-shockable rhythms in an intensive care unit (ICU), evaluating the prognostic factor of myocardial contractility in the return of spontaneous circulation (ROSC) and differential diagnoses Methods: This was a prospective cohort study conducted in an ICU of a university hospital with patients in CPA with asystole or PEA as their initial rhythm. Results: TTE performed by doctors highly trained in the method was included in the treatment protocol. In total, 49 patients were included in the study, 32 in PEA and 17 in asystole, of whom 27 patients in PEA had myocardial contractility. During the examination, the patients in PEA were subclassified into pseudo electromechanical dissociation (EMD) and true EMD. Of the 49 patients, 24 had ROSC, and two had survival 〉 360 days. The pseudo-EMD patients (contractility present and without central pulse) had a survival rate odds ratio of 2.99 (1.22 to 7.29; p = 0.016) compared with the other groups. Conclusions: Therefore, the presence of myocardial contractility may be a short- and long-term prognostic factor during CPA.
Type of Medium:
Online Resource
ISSN:
0009-7322
,
1524-4539
DOI:
10.1161/circ.132.suppl_3.9965
Language:
English
Publisher:
Ovid Technologies (Wolters Kluwer Health)
Publication Date:
2015
detail.hit.zdb_id:
1466401-X
