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POCUS literature primer: key papers on POCUS in cardiac arrest and shock

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Canadian Journal of Emergency Medicine Aims and scope Submit manuscript

Abstract

Objective

The objective of this study is to identify the top five most influential papers published on the use of point-of-care ultrasound (POCUS) in cardiac arrest and the top five most influential papers on the use of POCUS in shock in adult patients.

Methods

An expert panel of 14 members was recruited from the Canadian Association of Emergency Physicians (CAEP) Emergency Ultrasound Committee and the Canadian Ultrasound Fellowship Collaborative. The members of the panel are ultrasound fellowship trained or equivalent, are engaged in POCUS research, and are leaders in POCUS locally and nationally in Canada. A modified Delphi process was used, consisting of three rounds of sequential surveys and discussion to achieve consensus on the top five most influential papers for the use of POCUS in cardiac arrest and shock.

Results

The panel identified 39 relevant papers on POCUS in cardiac arrest and 42 relevant papers on POCUS in shock. All panel members participated in all three rounds of the modified Delphi process, and we ultimately identified the top five most influential papers on POCUS in cardiac arrest and also on POCUS in shock. Studies include descriptions and analysis of safe POCUS protocols that add value from a diagnostic and prognostic perspective in both populations during resuscitation.

Conclusion

We have developed a reading list of the top five influential papers on the use of POCUS in cardiac arrest and shock to better inform residents, fellows, clinicians, and researchers on integrating and studying POCUS in a more evidence-based manner.

Résumé

Objectif

L’objectif de cette étude est d’identifier les cinq articles les plus influents publiés sur l’utilisation de l’échographie au point de soin (POCUS) dans l’arrêt cardiaque et les cinq articles les plus influents sur l’utilisation de POCUS dans le choc chez les patients adultes.

Méthodes

Un comité d’experts composé de 14 membres a été recruté par le Comité d’échographie d’urgence de l’Association canadienne des médecins d’urgence (ACMU) et le Canadian Ultrasound Fellowship Collaborative. Les membres du comité sont formés en échographie ou l’équivalent, participent à la recherche sur le POCUS et sont des chefs de file du POCUS à l’échelle locale et nationale au Canada. Un processus Delphi modifié a été utilisé, consistant en trois séries de sondages séquentiels et de discussions pour parvenir à un consensus sur les cinq articles les plus influents pour l’utilisation de POCUS dans les arrêts cardiaques et les chocs.

Résultats

Le panel a identifié 39 articles pertinents sur le POCUS en arrêt cardiaque et 42 articles pertinents sur le POCUS en état de choc. Tous les membres du panel ont participé aux trois cycles du processus Delphi modifié, et nous avons finalement identifié les cinq articles les plus influents sur le POCUS en arrêt cardiaque et aussi sur le POCUS en état de choc. Les études comprennent des descriptions et des analyses de protocoles POCUS sûrs qui ajoutent de la valeur d’un point de vue diagnostique et pronostique dans les deux populations pendant la réanimation.

Conclusion

Nous avons dressé une liste de lecture des cinq principaux articles influents sur l’utilisation du POCUS en cas d’arrêt cardiaque et de choc afin de mieux informer les résidents, les boursiers, les cliniciens et les chercheurs sur l’intégration et l’étude du POCUS d’une manière plus factuelle.

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References

  1. Díaz-Gómez JL, Mayo PH, Koenig SJ. Point-of-care ultrasonography. N Engl J Med. 2021;385(17):1593–602.

    Article  PubMed  Google Scholar 

  2. Ultrasound guidelines: emergency, point-of-care and clinical ultrasound guidelines in medicine. Ann Emerg Med. 2017;69:e27–e54.

  3. Lewis D, Rang L, Kim D, Robichaud L, Kwan C, Pham C, et al. Recommendations for the use of point-of-care ultrasound (POCUS) by emergency physicians in Canada. CJEM. 2019;21(6):721–6.

    Article  PubMed  Google Scholar 

  4. Olszynski P, Kim DJ, Chenkin J, Rang L, Members of the CAEP Emergency Ultrasound Committee curriculum working group. The CAEP Emergency Ultrasound Curriculum—objectives and recommendations for implementation in postgraduate training: executive summary. CJEM. 2018;20(5):736–8.

    Article  Google Scholar 

  5. Van Schaik GWW, Van Schaik KD, Murphy MC. Point-of-care ultrasonography (POCUS) in a community emergency department: an analysis of decision making and cost savings associated with POCUS. J Ultrasound Med. 2019;38(8):2133–40.

    Article  PubMed  Google Scholar 

  6. Bayram B, Limon Ö, Limon G, Hancı V. Bibliometric analysis of top 100 most-cited clinical studies on ultrasound in the emergency department. Am J Emerg Med. 2016;34(7):1210–6.

    Article  PubMed  Google Scholar 

  7. Prats MI, Bahner DP, Panchal AR, King AM, Way DP, Lin S, et al. Documenting the growth of ultrasound research in emergency medicine through a bibliometric analysis of accepted academic conference abstracts. J Ultrasound Med. 2018;37(12):2777–84.

    Article  PubMed  Google Scholar 

  8. Kim DJ, Bell C, Jelic T, Sheppard G, Robichaud L, Burwash-Brennan T, et al. Point of care ultrasound literature primer: key papers on focused assessment with sonography in trauma (FAST) and extended FAST. Cureus. 2022;14(10): e30001.

    PubMed  PubMed Central  Google Scholar 

  9. Kim DJ, Bell CR, Jelic T, Thavanathan R, Heslop CL, Myslik F, et al. Point-of-care ultrasound (POCUS) literature primer: key papers on renal and biliary POCUS. Cureus. 2023;15(4): e37294.

    PubMed  PubMed Central  Google Scholar 

  10. Trevelyan EG, Robinson PN. Delphi methodology in health research: how to do it? Eur J Integr Med. 2015;7(4):423–8.

    Article  Google Scholar 

  11. Humphrey-Murto S, Varpio L, Gonsalves C, Wood TJ. Using consensus group methods such as Delphi and Nominal Group in medical education research. Med Teach. 2017;39(1):14–9.

    Article  PubMed  Google Scholar 

  12. Gaspari R, Weekes A, Adhikari S, Noble VE, Nomura JT, Theodoro D, et al. Emergency department point-of-care ultrasound in out-of-hospital and in-ED cardiac arrest. Resuscitation. 2016;109:33–9.

    Article  PubMed  Google Scholar 

  13. Blaivas M, Fox JC. Outcome in cardiac arrest patients found to have cardiac standstill on the bedside emergency department echocardiogram. Acad Emerg Med. 2001;8(6):616–21.

    Article  CAS  PubMed  Google Scholar 

  14. Lalande E, Burwash-Brennan T, Burns K, Atkinson P, Lambert M, Jarman B, et al. Is point-of-care ultrasound a reliable predictor of outcome during atraumatic, non-shockable cardiac arrest? A systematic review and meta-analysis from the SHoC investigators. Resuscitation. 2019;139:159–66.

    Article  PubMed  Google Scholar 

  15. Gaspari R, Weekes A, Adhikari S, Noble V, Nomura JT, Theodoro D, et al. A retrospective study of pulseless electrical activity, bedside ultrasound identifies interventions during resuscitation associated with improved survival to hospital admission. A REASON study. Resuscitation. 2017;120:103–7.

    Article  PubMed  Google Scholar 

  16. Atkinson P, Bowra J, Milne J, Lewis D, Lambert M, Jarman B, et al. International Federation for Emergency Medicine Consensus Statement: Sonography in hypotension and cardiac arrest (SHoC): an international consensus on the use of point of care ultrasound for undifferentiated hypotension and during cardiac arrest. CJEM. 2017;19(6):459–70.

    Article  PubMed  Google Scholar 

  17. Jones AE, Tayal VS, Sullivan DM, Kline JA. Randomized, controlled trial of immediate versus delayed goal-directed ultrasound to identify the cause of nontraumatic hypotension in emergency department patients. Crit Care Med. 2004;32(8):1703–8.

    Article  PubMed  Google Scholar 

  18. Atkinson PR, Milne J, Diegelmann L, Lamprecht H, Stander M, Lussier D, et al. Does point-of-care ultrasonography improve clinical outcomes in emergency department patients with undifferentiated hypotension? An international randomized controlled trial from the SHoC-ED investigators. Ann Emerg Med. 2018;72(4):478–89.

    Article  PubMed  Google Scholar 

  19. Shokoohi H, Boniface KS, Pourmand A, Liu YT, Davison DL, Hawkins KD, et al. Bedside ultrasound reduces diagnostic uncertainty and guides resuscitation in patients with undifferentiated hypotension. Crit Care Med. 2015;43(12):2562–9.

    Article  PubMed  Google Scholar 

  20. Stickles SP, Carpenter CR, Gekle R, Kraus CK, Scoville C, Theodoro D, et al. The diagnostic accuracy of a point-of-care ultrasound protocol for shock etiology: a systematic review and meta-analysis. CJEM. 2019;21(3):406–17.

    Article  PubMed  Google Scholar 

  21. Perera P, Mailhot T, Riley D, Mandavia D. The RUSH exam: rapid ultrasound in SHock in the evaluation of the critically lll. Emerg Med Clin N Am. 2010;28(1):29–56, vii.

  22. Weingart S. Original RUSH article. In: EMCrit Project. 2008. https://emcrit.org/rush-exam/original-rush-article/. Accessed 15 July 2023.

  23. Huis In ’t Veld MA, Allison MG, Bostick DS, Fisher KR, Goloubeva OG, Witting MD, et al. Ultrasound use during cardiopulmonary resuscitation is associated with delays in chest compressions. Resuscitation. 2017;119:95–8.

  24. Clattenburg EJ, Wroe P, Brown S, Gardner K, Losonczy L, Singh A, et al. Point-of-care ultrasound use in patients with cardiac arrest is associated prolonged cardiopulmonary resuscitation pauses: a prospective cohort study. Resuscitation. 2018;122:65–8.

    Article  PubMed  Google Scholar 

  25. Berg RA, Sanders AB, Kern KB, Hilwig RW, Heidenreich JW, Porter ME, et al. Adverse hemodynamic effects of interrupting chest compressions for rescue breathing during cardiopulmonary resuscitation for ventricular fibrillation cardiac arrest. Circulation. 2001;104(20):2465–70.

    Article  CAS  PubMed  Google Scholar 

  26. Cheskes S, Schmicker RH, Christenson J, Salcido DD, Rea T, Powell J, et al. Perishock pause: an independent predictor of survival from out-of-hospital shockable cardiac arrest. Circulation. 2011;124(1):58–66.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Merchant RM, Topjian AA, Panchal AR, Cheng A, Aziz K, Berg KM, et al. Part 1: executive summary: 2020 American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation. 2020;142(16_suppl_2):S337–S357.

  28. Teran F, Dean AJ, Centeno C, Panebianco NL, Zeidan AJ, Chan W, et al. Evaluation of out-of-hospital cardiac arrest using transesophageal echocardiography in the emergency department. Resuscitation. 2019;137:140–7.

    Article  PubMed  Google Scholar 

  29. Inaba K, Chouliaras K, Zakaluzny S, Swadron S, Mailhot T, Seif D, et al. FAST ultrasound examination as a predictor of outcomes after resuscitative thoracotomy: a prospective evaluation. Ann Surg. 2015;262(3):512–8 (discussion 516–518).

    Article  PubMed  Google Scholar 

  30. Hu K, Gupta N, Teran F, Saul T, Nelson BP, Andrus P. Variability in interpretation of cardiac standstill among physician sonographers. Ann Emerg Med. 2018;71(2):193–8.

    Article  PubMed  Google Scholar 

  31. Atkinson PR, Beckett N, French J, Banerjee A, Fraser J, Lewis D. Does point-of-care ultrasound use impact resuscitation length, rates of intervention, and clinical outcomes during cardiac arrest? A study from the Sonography in Hypotension and Cardiac Arrest in the Emergency Department (SHoC-ED) investigators. Cureus. 2019;11(4): e4456.

    PubMed  PubMed Central  Google Scholar 

  32. Gottlieb M, Alerhand S. Managing cardiac arrest using ultrasound. Ann Emerg Med. 2023;81(5):532–42.

    Article  PubMed  Google Scholar 

  33. Volpicelli G, Lamorte A, Tullio M, Cardinale L, Giraudo M, Stefanone V, et al. Point-of-care multiorgan ultrasonography for the evaluation of undifferentiated hypotension in the emergency department. Intensive Care Med. 2013;39(7):1290–8.

    Article  CAS  PubMed  Google Scholar 

  34. Peach M, Milne J, Diegelmann L, Lamprecht H, Stander M, Lussier D, et al. Does point-of-care ultrasonography improve diagnostic accuracy in emergency department patients with undifferentiated hypotension? An international randomized controlled trial from the SHOC-ED investigators. CJEM. 2023;25(1):48–56.

    Article  CAS  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Emergency Medicine, Vancouver General Hospital, University of British Columbia, Vancouver, BC, Canada

    Daniel J. Kim

  2. Department of Emergency Medicine, Dalhousie Medicine New Brunswick, Saint John, NB, Canada

    Paul Atkinson & David Lewis

  3. Discipline of Emergency Medicine, Memorial University of Newfoundland, St. John’s, NF, Canada

    Gillian Sheppard

  4. Division of Emergency Medicine, Department of Medicine, University of Toronto, Toronto, ON, Canada

    Jordan Chenkin & Claire L. Heslop

  5. Department of Emergency Medicine, Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON, Canada

    Rajiv Thavanathan

  6. Department of Emergency Medicine, University of Calgary, Calgary, AB, Canada

    Colin R. Bell

  7. Department of Emergency Medicine, University of Manitoba, Winnipeg, MB, Canada

    Tomislav Jelic

  8. Department of Emergency Medicine, Université Laval, Quebec City, QC, Canada

    Elizabeth Lalande

  9. Division of Emergency Medicine, Department of Medicine, McMaster University, Hamilton, ON, Canada

    Ian M. Buchanan

  10. Department of Family and Emergency Medicine, Université de Montréal, Montreal, QC, Canada

    Talia Burwash-Brennan

  11. Division of Emergency Medicine, Department of Medicine, Western University, London, ON, Canada

    Frank Myslik

  12. Department of Emergency Medicine, University of Saskatchewan, Saskatoon, SK, Canada

    Paul Olszynski

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  1. Daniel J. Kim
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Corresponding author

Correspondence to Daniel J. Kim.

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Conflict of interest

PA, GS, JC, RT, DL, EL, CH, TB, FM, and PO do not report any conflicts of interest. DJK provides consultant services to Fujifilm Sonosite. CRB has received honoraria from Fujifilm Sonosite. TJ provides consultant services to Butterfly Network. IMB provides educational advisory board services to Pfizer Inc.

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Kim, D.J., Atkinson, P., Sheppard, G. et al. POCUS literature primer: key papers on POCUS in cardiac arrest and shock. Can J Emerg Med 26, 15–22 (2024). https://doi.org/10.1007/s43678-023-00611-1

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  • DOI: https://doi.org/10.1007/s43678-023-00611-1

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