Can serial focussed echocardiographic evaluation in life support (FEEL) predict resuscitation outcome or termination of resuscitation (TOR)? A pilot study
Can serial focussed echocardiographic evaluation in life support (FEEL) predict resuscitation outcome or termination of resuscitation (TOR)? A pilot study
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DOI：
10.1016/j.resuscitation.2016.01.013
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发表时间：
2016-04-01
期刊：
影响因子：
6.5
通讯作者：
Cho, Young Soon
中科院分区：
文献类型：
--
作者：
Kim, Han Bit;Suh, Jun Young;Cho, Young Soon
研究目的：本研究旨在评估院外心脏骤停（OHCA）患者连续超声心动图表现与自发循环恢复（ROSC）的相关性，并探讨超声心动图心脏静止时间是否可用于预测ROSC。方法：这是一项前瞻性观察研究，研究对象是非连续的非创伤性成年OHCA患者。根据高级生命支持治疗指南，在复苏过程中每隔2分钟进行一次脉搏检查，持续时间小于10秒。超声心动图结果记录为视频片段。结果：48例患者入组研究。连续超声心动图显示，ROSC组和无ROSC组心脏静止时间分别为2.86 +/- 2.07 min和20.30 +/- 8.42 min （p < 0.001）。心脏静止时间>= 10 min预测非rosc的敏感性为90.0%，特异性为100%，阳性预测值为100%，阴性预测值为93.3%。生成接受者工作特征曲线，以确定连续超声心动图心脏静止时间预测无ROSC的准确性。曲线下面积为0.991 （p < 0.000）。结论：在所有连续超声心动图心脏停止>= 10 min的患者中，没有患者发生ROSC。这些结果显示了具有和不具有ROSC的受试者令人信服的测试表现和辨别能力。我们的研究具有启发性，值得进一步研究。2016爱思唯尔爱尔兰有限公司版权所有。
Aim of the study: This study aimed to evaluate the correlation between serial echocardiography findings and return of spontaneous circulation (ROSC) in patients with out-of-hospital cardiac arrest (OHCA) and to examine whether echocardiographic cardiac standstill duration can be used to predict ROSC.Methods: This was a prospective observational study of non-consecutive non-trauma adult patients with OHCA. Echocardiography was performed every 2 min during a pulse check for < 10 s throughout the resuscitation effort managed according to advanced life support treatment guidelines. Echocardiography findings were recorded as video clips.Results: Forty-eight patients were enrolled in the study. Serial echocardiographic cardiac standstill duration in the ROSC and no ROSC groups were 2.86 +/- 2.07 min versus 20.30 +/- 8.42 min, respectively (p < 0.001). Cardiac standstill duration >= 10 min predicted non-ROSC with a sensitivity of 90.0%, specificity of 100%, positive predictive value of 100%, and negative predictive value of 93.3%. A receiver operating characteristic curve was generated to determine the accuracy of serial echocardiographic cardiac standstill duration for predicting no ROSC. The area under the curve was 0.991 (p < 0.000).Conclusions: In all patients with serial echocardiographic cardiac standstill >= 10 min, no patients had ROSC. These results displayed compelling test performance and discrimination ability for subjects with and without ROSC. Our study is suggestive, and it warrants further study. (C) 2016 Elsevier Ireland Ltd. All rights reserved.