BACKGROUND: We previously developed a US-CAB protocol for evaluation of circulatory-airway-breathing status during cardiopulmonary resuscitation (CPR). This study aimed at validating its application in real CPR scenarios and the potential impact on CPR outcomes. METHODS: The US-CAB protocol was implemented at the emergency department of National Taiwan University Hospital since January 2016. The US images, initiation time and operation duration of each US-CAB procedure, and relevant CPR information were recorded for analysis. RESULTS: From January 2016 to March 2017, 177 cardiac arrest patients receiving US-CAB were included. The durations of US-C-A-B procedure were 9.0 ± 1.4, 7.5 ± 1.5, and 16.0 ± 1.9 s, respectively. Cardiac activity was identified in 47 cases (26.6%), with higher rates of return of spontaneous circulation (ROSC) (95.7% vs. 21.5%, p < .0001) and survival to hospital discharge (25.5% vs. 10.0%, p < .01). Detection of cardiac activity after 10 min of CPR exhibited 100% sensitivity, specificity, positive and negative predictive value for ROSC. Cardiac tamponade was noted in eight patients. ROSC was achieved in two (25.0%) after pericardiocentesis, and aortic dissection was diagnosed in one (12.5%). Confirmation of correct intubation was significantly faster by US than by capnography (7.4 ± 1.4 vs. 38.3 ± 110.2 s, p < .001). US detected 21 (11.9%) esophageal intubations and 3 (1.7%) one-lung intubations. All were promptly corrected. CONCLUSION: The US-CAB protocol is feasible in real CPR scenarios. It confers diagnostic value and prognostic implications which potentially impact the efficacy and outcomes of CPR. However, a future prospective multi-center study to validate its feasibility and indicate the need of structured training is mandated.
BACKGROUND: We previously developed a US-CAB protocol for evaluation of circulatory-airway-breathing status during cardiopulmonary resuscitation (CPR). This study aimed at validating its application in real CPR scenarios and the potential impact on CPR outcomes. METHODS: The US-CAB protocol was implemented at the emergency department of National Taiwan University Hospital since January 2016. The US images, initiation time and operation duration of each US-CAB procedure, and relevant CPR information were recorded for analysis. RESULTS: From January 2016 to March 2017, 177 cardiac arrestpatients receiving US-CAB were included. The durations of US-C-A-B procedure were 9.0 ± 1.4, 7.5 ± 1.5, and 16.0 ± 1.9 s, respectively. Cardiac activity was identified in 47 cases (26.6%), with higher rates of return of spontaneous circulation (ROSC) (95.7% vs. 21.5%, p < .0001) and survival to hospital discharge (25.5% vs. 10.0%, p < .01). Detection of cardiac activity after 10 min of CPR exhibited 100% sensitivity, specificity, positive and negative predictive value for ROSC. Cardiac tamponade was noted in eight patients. ROSC was achieved in two (25.0%) after pericardiocentesis, and aortic dissection was diagnosed in one (12.5%). Confirmation of correct intubation was significantly faster by US than by capnography (7.4 ± 1.4 vs. 38.3 ± 110.2 s, p < .001). US detected 21 (11.9%) esophageal intubations and 3 (1.7%) one-lung intubations. All were promptly corrected. CONCLUSION: The US-CAB protocol is feasible in real CPR scenarios. It confers diagnostic value and prognostic implications which potentially impact the efficacy and outcomes of CPR. However, a future prospective multi-center study to validate its feasibility and indicate the need of structured training is mandated.
Authors: Diana Ávila-Reyes; Andrés O Acevedo-Cardona; José F Gómez-González; David R Echeverry-Piedrahita; Mateo Aguirre-Flórez; Adrian Giraldo-Diaconeasa Journal: Ultrasound J Date: 2021-12-02
Authors: Carsten Lott; Anatolij Truhlář; Anette Alfonzo; Alessandro Barelli; Violeta González-Salvado; Jochen Hinkelbein; Jerry P Nolan; Peter Paal; Gavin D Perkins; Karl-Christian Thies; Joyce Yeung; David A Zideman; Jasmeet Soar Journal: Notf Rett Med Date: 2021-06-10 Impact factor: 0.826
Authors: Jasmeet Soar; Katherine M Berg; Lars W Andersen; Bernd W Böttiger; Sofia Cacciola; Clifton W Callaway; Keith Couper; Tobias Cronberg; Sonia D'Arrigo; Charles D Deakin; Michael W Donnino; Ian R Drennan; Asger Granfeldt; Cornelia W E Hoedemaekers; Mathias J Holmberg; Cindy H Hsu; Marlijn Kamps; Szymon Musiol; Kevin J Nation; Robert W Neumar; Tonia Nicholson; Brian J O'Neil; Quentin Otto; Edison Ferreira de Paiva; Michael J A Parr; Joshua C Reynolds; Claudio Sandroni; Barnaby R Scholefield; Markus B Skrifvars; Tzong-Luen Wang; Wolfgang A Wetsch; Joyce Yeung; Peter T Morley; Laurie J Morrison; Michelle Welsford; Mary Fran Hazinski; Jerry P Nolan Journal: Resuscitation Date: 2020-10-21 Impact factor: 5.262
Authors: David Yamane; Patrick McCarville; Natalie Sullivan; Evan Kuhl; Carolyn Robin Lanam; Christopher Payette; Anahita Rahimi-Saber; Jennifer Rabjohns; Andrew D Sparks; Keith Boniface; Aaran Drake Journal: West J Emerg Med Date: 2020-10-20