Benefits of cardiac sonography performed by a non-expert sonographer in patients with non-traumatic cardiopulmonary arrest
Benefits of cardiac sonography performed by a non-expert sonographer in patients with non-traumatic cardiopulmonary arrest
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DOI：
10.1016/j.resuscitation.2016.02.025
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发表时间：
2016-05-01
期刊：
影响因子：
6.5
通讯作者：
Yildirim, Cuma
中科院分区：
文献类型：
--
作者：
Zengin, Suat;Yavuz, Erdal;Yildirim, Cuma
本研究的目的是评价由经过培训的非专业超声医师进行的快速心脏超声评估，并将其整合到高级心脏生命支持（ACLS）中。本研究在两个日历年（2013年和2014年）期间在急诊科（艾德）接受心肺复苏（CPR）的179例患者（104例男性和75例女性）中进行了前瞻性研究。两名接受过紧急心脏超声检查培训的高级医生通过心尖、剑突下或胸骨旁窗口进行心脏超声检查。同时进行超声评价和脉冲控制。结果：63.7%（114例）的心肺骤停事件发生在院外。在初始评估期间，只有13名患者有股动脉搏动，而166名患者没有股动脉搏动。初步监测显示，53例患者心律正常，18例患者室颤，108例患者无心律。超声首次评估检测到26例患者的有效心率和14例患者的室颤，而139例患者未观察到有效心率。此外，超声显示心包填塞7例，右心室扩大4例。全球运动功能减退被检测到在四名患者和低血容量被观察到在另外四名patients.Conclusion：使用实时超声与实时股动脉脉搏检查复苏过程中，可以帮助促进区分豌豆型逮捕，确定逮捕的原因，推断一个合适的治疗，并优化医疗管理决策CPR终止。(C)2016爱思唯尔爱尔兰有限公司版权所有。
The purpose of this study was to evaluate a rapid cardiac ultrasound assessment performed by trained non-expert sonographers integrated into the advanced cardiac life support (ACLS).Material and methods: This study was prospectively performed in 179 patients (104 males and 75 females) who underwent cardiopulmonary resuscitation (CPR) in an emergency department (ED) during two calendar years (2013 and 2014). Two senior doctors, who had received emergency cardiac ultrasonography training, performed cardiac ultrasound through the apical, subxiphoid, or parasternal windows. Ultrasound evaluation and pulse controls were performed simultaneously. SPSS 18.0 was used for statistical analysis.Results: A total of 63.7% (114) of the cardiopulmonary arrest incidents occurred out of the hospital. Only 13 patients had a femoral pulse during the initial evaluation, while 166 showed no femoral pulse. Initial monitoring showed a regular rhythm in 53 patients, ventricular fibrillation in 18 patients, and no rhythms in 108 patients. The first evaluation with ultrasound detected an effective heart rate in 26 patients and ventricular fibrillation in 14 patients, while no effective heart rate was observed in 139 patients. In addition, ultrasound revealed pericardial tamponade in seven patients and right ventricular enlargement in four cases. Global hypokinesia was detected in four patients and hypovolemia was observed in another four patients.Conclusion: The use of real-time ultrasonography during resuscitation with real-time femoral pulse check can help facilitate the distinguishing of pea-type arrest, ascertain the cause of the arrest, infer a suitable treatment, and optimize medical management decisions regarding CPR termination. (C) 2016 Elsevier Ireland Ltd. All rights reserved.