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Sep 25, 2017

Resuscitation 2017

Cardiac movement identified on Focused Cardiac Ultrasound and Resuscitation outcome in Non-traumatic out-of-hospital cardiac arrest.

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Kanjana KOYDUL

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Abstract

Cardiac movement identified on Focused Cardiac Ultrasound and Resuscitation outcome in Non-traumatic out-of-hospital cardiac arrest. BACKGROUND: Focused Cardiac Ultrasound (FCU) has been reported its usage to identify the correctable cause of cardiac arrest but there are few studies on its application to predicting the resuscitation outcomes. The aim of the study is to determine the association between cardiac wall movement identified on FCU and non-traumatic OHCA survival rates. METHODS: A prospective obsrevational study was conducted. All adults non-traumatic OHCA patients who were resuscitated by emergency department staffs andNarenthorn EMS Rajavithi hospital from February - October 2016 were enrolled in this study.Cardiac wall and/or valve movement data were recorded using 2D ultrasound on ED arrivals and 5 repetitive scans during the 2-min pause in each CPR cycles. Any changes of cardiac motions from absence to presence of movement will be recorded and analyzed with ROSC, survival to hospital admission and to hospital discharge or 30th day after arrest events. RESULTS: 63 non-traumatic OHCA patients were enrolled in the study. The average age is55.51±19.17 years with predominantly male (73%). Majority cause of arrest is presumed cardiac etiology (65.1%) with 63.48% were witnessed. Bystander response rate was 7.1%.Patients’ clinical and demographic data were similar to previous literature except for lower bystander CPR rate. The present of cardiac wall or valve movement in FCU on emergency departments arrival has shown the statistically significant relationship to the ROSC and survival to hospital admission (p-value <0.001, OR 77.33, 95%CI 9.14 to 654.41 and p value<0.001, OR 8.29, 95%CI 2.33 to 29.44 respectively). The transition from absence to presence cardiac wall motion after receiving resuscitation were correlated with ROSC and survival to hospital admission (p-value <0.001). Sensitivity and Specificity of FCU cardiac wall movement to ROSC and survival to hospital admission are 76.32% and 96.67% respectively with 84.13%accuracy. CONCLUSIONS: Presence cardiac wall/valve movement on focused cardiac ultrasound was associated with ROSC and survival to hospital admission. Focused cardiac ultrasound may have its benefits on resuscitation outcome prognostication.

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© Copyright 2019 Morressier GmbH.
All rights reserved.