Timing of focused cardiac ultrasound during advanced life support - A prospective clinical study

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Timing of focused cardiac ultrasound during advanced life support - A prospective clinical study. / Aagaard, Rasmus; Løfgren, Bo; Grøfte, Thorbjørn; Sloth, Erik; Nielsen, Roni R; Frederiksen, Christian A; Granfeldt, Asger; Bøtker, Morten T.

I: Resuscitation, Bind 124, 03.2018, s. 126-131.

Publikation: Bidrag til tidsskrift/Konferencebidrag i tidsskrift /Bidrag til avisTidsskriftartikelForskningpeer review

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@article{02db194f0b724817b603ad2bd6a9427b,
title = "Timing of focused cardiac ultrasound during advanced life support - A prospective clinical study",
abstract = "INTRODUCTION: Focused cardiac ultrasound can potentially identify reversible causes of cardiac arrest during advanced life support (ALS), but data on the timing of image acquisition are lacking. This study aimed to compare the quality of images obtained during rhythm analysis, bag-mask ventilations, and chest compressions.METHODS: Adult patients in cardiac arrest were prospectively included during 23 months at a Danish community hospital. Physicians who had completed basic ultrasound training performed subcostal focused cardiac ultrasound during rhythm analysis, bag-mask ventilations, and chest compressions. Image quality was categorised as either useful for interpretation or not. Two echocardiography experts rated images useful for interpretation if all the following characteristics could be determined: 1) right ventricle larger than left ventricle, 2) pericardial fluid, and 3) collapsing ventricles.RESULTS: Images were obtained from 60 of 114 patients undergoing ALS. A higher proportion of the images obtained during rhythm analysis and bag-mask ventilations were useful for interpretation when compared with chest compressions (rhythm analysis vs chest compressions: OR 2.2 (95{\%}CI 1.3-3.8), P = 0.005; bag mask ventilations vs chest compressions: OR 2.0 (95{\%}CI 1.1-3.7), P = 0.03). There was no difference between images obtained during rhythm analysis and bag-mask ventilations (OR 1.1 (95{\%}CI 0.6-2.0), P = 0.74).CONCLUSION: The quality of focused cardiac ultrasound images obtained during rhythm analysis and bag-mask ventilations was superior to that of images obtained during chest compressions. There was no difference in the quality of images obtained during rhythm analysis and bag-mask ventilations. Bag-mask ventilations may constitute an overlooked opportunity for image acquisition during ALS.",
keywords = "Focused cardiac ultrasound, Image quality, In-hospital cardiac arrest",
author = "Rasmus Aagaard and Bo L{\o}fgren and Thorbj{\o}rn Gr{\o}fte and Erik Sloth and Nielsen, {Roni R} and Frederiksen, {Christian A} and Asger Granfeldt and B{\o}tker, {Morten T}",
note = "Copyright {\circledC} 2017. Published by Elsevier B.V.",
year = "2018",
month = "3",
doi = "10.1016/j.resuscitation.2017.12.012",
language = "English",
volume = "124",
pages = "126--131",
journal = "Resuscitation",
issn = "0300-9572",
publisher = "Elsevier Ireland Ltd.",

}

RIS

TY - JOUR

T1 - Timing of focused cardiac ultrasound during advanced life support - A prospective clinical study

AU - Aagaard, Rasmus

AU - Løfgren, Bo

AU - Grøfte, Thorbjørn

AU - Sloth, Erik

AU - Nielsen, Roni R

AU - Frederiksen, Christian A

AU - Granfeldt, Asger

AU - Bøtker, Morten T

N1 - Copyright © 2017. Published by Elsevier B.V.

PY - 2018/3

Y1 - 2018/3

N2 - INTRODUCTION: Focused cardiac ultrasound can potentially identify reversible causes of cardiac arrest during advanced life support (ALS), but data on the timing of image acquisition are lacking. This study aimed to compare the quality of images obtained during rhythm analysis, bag-mask ventilations, and chest compressions.METHODS: Adult patients in cardiac arrest were prospectively included during 23 months at a Danish community hospital. Physicians who had completed basic ultrasound training performed subcostal focused cardiac ultrasound during rhythm analysis, bag-mask ventilations, and chest compressions. Image quality was categorised as either useful for interpretation or not. Two echocardiography experts rated images useful for interpretation if all the following characteristics could be determined: 1) right ventricle larger than left ventricle, 2) pericardial fluid, and 3) collapsing ventricles.RESULTS: Images were obtained from 60 of 114 patients undergoing ALS. A higher proportion of the images obtained during rhythm analysis and bag-mask ventilations were useful for interpretation when compared with chest compressions (rhythm analysis vs chest compressions: OR 2.2 (95%CI 1.3-3.8), P = 0.005; bag mask ventilations vs chest compressions: OR 2.0 (95%CI 1.1-3.7), P = 0.03). There was no difference between images obtained during rhythm analysis and bag-mask ventilations (OR 1.1 (95%CI 0.6-2.0), P = 0.74).CONCLUSION: The quality of focused cardiac ultrasound images obtained during rhythm analysis and bag-mask ventilations was superior to that of images obtained during chest compressions. There was no difference in the quality of images obtained during rhythm analysis and bag-mask ventilations. Bag-mask ventilations may constitute an overlooked opportunity for image acquisition during ALS.

AB - INTRODUCTION: Focused cardiac ultrasound can potentially identify reversible causes of cardiac arrest during advanced life support (ALS), but data on the timing of image acquisition are lacking. This study aimed to compare the quality of images obtained during rhythm analysis, bag-mask ventilations, and chest compressions.METHODS: Adult patients in cardiac arrest were prospectively included during 23 months at a Danish community hospital. Physicians who had completed basic ultrasound training performed subcostal focused cardiac ultrasound during rhythm analysis, bag-mask ventilations, and chest compressions. Image quality was categorised as either useful for interpretation or not. Two echocardiography experts rated images useful for interpretation if all the following characteristics could be determined: 1) right ventricle larger than left ventricle, 2) pericardial fluid, and 3) collapsing ventricles.RESULTS: Images were obtained from 60 of 114 patients undergoing ALS. A higher proportion of the images obtained during rhythm analysis and bag-mask ventilations were useful for interpretation when compared with chest compressions (rhythm analysis vs chest compressions: OR 2.2 (95%CI 1.3-3.8), P = 0.005; bag mask ventilations vs chest compressions: OR 2.0 (95%CI 1.1-3.7), P = 0.03). There was no difference between images obtained during rhythm analysis and bag-mask ventilations (OR 1.1 (95%CI 0.6-2.0), P = 0.74).CONCLUSION: The quality of focused cardiac ultrasound images obtained during rhythm analysis and bag-mask ventilations was superior to that of images obtained during chest compressions. There was no difference in the quality of images obtained during rhythm analysis and bag-mask ventilations. Bag-mask ventilations may constitute an overlooked opportunity for image acquisition during ALS.

KW - Focused cardiac ultrasound

KW - Image quality

KW - In-hospital cardiac arrest

U2 - 10.1016/j.resuscitation.2017.12.012

DO - 10.1016/j.resuscitation.2017.12.012

M3 - Journal article

C2 - 29246742

VL - 124

SP - 126

EP - 131

JO - Resuscitation

JF - Resuscitation

SN - 0300-9572

ER -