EFSUMB EUROPEAN FEDERATION OF SOCIETIES FOR ULTRASOUND IN MEDICINE AND BIOLOGY ‘Building a European Ultrasound Community’ Young Investigator’s Award WFUMB 2011 VIENNA AUSTRIA 28 August 2011 13.50 – 15.45 10 minutes each for presentation plus 3 minutes discussion The Presence or Absence of Cardiac Movement Identified on Prehospital Echocardiography Predicts Outcome in Cardiac Arrest Patients 1
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P.M. Zechner , G. Aichinger , G. Prause , G. Wildner , J.C. Fox ; 1
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LKH Graz West; Graz/AT, LKH Villach; Villach/AT, Medical University of Graz; Graz/AT, University of California/Irvine; Irivne/US
ABSTRACT Purpose: To determine the ability of prehospital emergency echocardiography to predict survival in cardiac arrest patients at the scene. Material & Methods: All participating emergency physicians (n = 24) received a 4-h course in focused echocardiography including 1 h of theoretical basics, 1 h of video demonstrations and 2 h of hands-on training. After obtaining standard procedures such as defibrillation, intubation and vascular access, a focused ultrasound was performed during the pulse check according to the FEEL algorithm described by Breitkreutz et al. Patients were divided into movement and no-movement groups. Sonographic evidence of movement was defined as any motion of the myocardium, ranging from visible ventricular fibrillation to coordinated ventricular contractions. CPR had to be continued for at least 15 min after the initial echocardiography according to recent AHA guidelines and no decisions were made based on the results of ultrasound. Results: We enrolled 40 patients in the study. Thirty patients had no movement on echocardiography. One patient of the no movement group (3%) versus four patients of the movement group (40%) survived until hospital admission (p < 0.05). Cardiac standstill on echocardiogram resulted in a positive predictive value of 96.7% for death at the scene with a negative predictive value of 40%. Conclusion: The absence of cardiac movement on prehospital ultrasound may help predict adverse outcome in cardiac arrest patients. Larger studies are needed before any conclusions about ending resuscitative efforts prematurely can be made.