Point-of-care ultrasound (POCUS) is a widely used tool in critical care areas, allowing for the performance of accurate diagnoses and thus enhancing the decision-making process. Every major organ or system can be safely evaluated with POCUS. In that respect, the utility of POCUS in cardiac arrest is gaining interest. In this article, we will review the actual role of ultrasound in cardiac arrest and the main POCUS protocols focused to this scenario as well as discuss the potential role of POCUS in monitoring the efficacy of the chest compressions.
La diagnostica ecografica (point-of-care ultrasound, POCUS) è uno strumento ampiamente utilizzato nelle aree di terapia intensiva e rianimazione, dove consente di ottenere diagnosi accurate e di migliorare il processo decisionale. Ogni grande organo o sistema puo’ essere tranquillamente esaminato con POCUS. In questo ambito, l’utilità del POCUS nei casi di arresto cardiaco sta riscuotendo un interesse crescente. In questo articolo passeremo in rassegna l’effettivo ruolo degli ultrasuoni nei casi di arresto cardico ed i principali protocolli POCUS mirati a questo scenario. Trattaremo inoltre il potenziale ruolo del POCUS nel monitoraggio dell’efficacia delle compressioni toraciche.
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Soar J, Nolan JP, Böttiger BW, Perkins GD, Lott C, Carli P et al (2015) European resuscitation council guidelines for resuscitation 2015: section 3. Adult Advanced life support. Resuscitation 95:100–147
Link MS, Berkow LC, Kudenchuk PJ, Halperin HR, Hess EP, Moitra VK et al (2015) Part 7: adult advanced cardiovascular life support: 2015 American heart association guidelines update for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation 132(18 Suppl 2):S444–S464
Breitkreutz R, Price S, Steiger HV, Seeger FH, Ilper H, Ackermann H et al (2010) Focused echocardiographic evaluation in life support and peri-resuscitation of emergency patients: a prospective trial. Resuscitation 81(11):1527–1533
Gaspari R, Weekes A, Adhikari S, Noble VE, Nomura JT, Theodoro D et al (2016) Emergency department point-of-care ultrasound in out-of-hospital and in-ED cardiac arrest. Resuscitation 109:33–39
Chardoli M, Heidari F, Rabiee H, Sharif-Alhoseini M, Shokoohi H, Rahimi-Movaghar V (2012) Echocardiography integrated ACLS protocol versus conventional cardiopulmonary resuscitation in patients with pulseless electrical activity cardiac arrest. Chin J Traumatol 15(5):284–287
Amaya SC, Langsam A (1999) Ultrasound detection of ventricular fibrillation disguised as asystole. Ann Emerg Med 33(3):344–346
Querellou E, Meyran D, Petitjean F, Le Dreff P, Maurin O (2009) Ventricular fibrillation diagnosed with trans-thoracic echocardiography. Resuscitation 80(10):1211–1213
Seif D, Perera P, Mailhot T, Riley D, Mandavia D (2012) Bedside ultrasound in resuscitation and the rapid ultrasound in shock protocol. Crit Care Res Pract 2012:503254
Blanco P, Miralles Aguiar F, Blaivas M (2015) Rapid ultrasound in shock (RUSH) velocity-time integral: a proposal to expand the RUSH protocol. J Ultrasound Med 34:1691–1700
Hernandez C, Shuler K, Hannan H, Sonyika C, Likourezos A, Marshall J (2008) C.A.U.S.E.: cardiac arrest ultra-sound exam—a better approach to managing patients in primary non-arrhythmogenic cardiac arrest. Resuscitation 76(2):198–206
Breitkreutz R, Walcher F, Seeger FH (2007) Focused echocardiographic evaluation in resuscitation management: concept of an advanced life support-conformed algorithm. Crit Care Med 35(5 Suppl):S150–S161
Testa A, Cibinel GA, Portale G, Forte P, Giannuzzi R, Pignataro G, Silveri NG (2010) The proposal of an integrated ultrasonographic approach into the ALS algorithm for cardiac arrest: the PEA protocol. Eur Rev Med Pharmacol Sci 14(2):77–88
Lichtenstein D (2014) How can the use of lung ultrasound in cardiac arrest make ultrasound a holistic discipline? The example of the SESAME-protocol. Med Ultrason 16(3):252–255
Lichtenstein D, Malbrain ML (2015) Critical care ultrasound in cardiac arrest. Technological requirements for performing the SESAME-protocol—a holistic approach. Anaesthesiol Intensive Ther 47(5):471–481
Labovitz AJ, Noble VE, Bierig M, Goldstein SA, Jones R, Kort S et al (2010) Focused cardiac ultrasound in the emergent setting: a consensus statement of the American Society of Echocardiography and American College of Emergency Physicians. J Am Soc Echocardiogr 23(12):1225–1230
Querellou E, Leyral J, Brun C, Lévy D, Bessereau J, Meyran D, Le Dreff P (2009) In and out-of-hospital cardiac arrest and echography: a review. Ann Fr Anesth Reanim 28(9):769–778
Blanco P, Volpicelli G (2016) Common pitfalls in point-of-care ultrasound: a practical guide for emergency and critical care physicians. Crit Ultrasound J 8(1):15
Blaivas M (2008) Transesophageal echocardiography during cardiopulmonary arrest in the emergency department. Resuscitation 78(2):135–140
Blyth L, Atkinson P, Gadd K, Lang E (2012) Bedside focused echocardiography as predictor of survival in cardiac arrest patients: a systematic review. Acad Emerg Med 19(10):1119–1126
Flato UA, Paiva EF, Carballo MT, Buehler AM, Marco R, Timerman A (2015) Echocardiography for prognostication during the resuscitation of intensive care unit patients with non-shockable rhythm cardiac arrest. Resuscitation 92:1–6
Hwang SO, Zhao PG, Choi HJ, Park KH, Cha KC, Park SM, Kim SC, Kim H, Lee KH (2009) Compression of the left ventricular outflow tract during cardiopulmonary resuscitation. Acad Emerg Med 16(10):928–933
Shin J, Rhee JE, Kim K (2007) Is the inter-nipple line the correct hand position for effective chest compression in adult cardiopulmonary resuscitation? Resuscitation 75(2):305–310
Higano ST, Oh JK, Ewy GA, Seward JB (1990) The mechanism of blood flow during closed chest cardiac massage in humans: transesophageal echocardiographic observations. Mayo Clin Proc 65(11):1432–1440
Kühn C, Juchems R, Frese W (1991) Evidence for the ‘cardiac pump theory’ in cardiopulmonary resuscitation in man by transesophageal echocardiography. Resuscitation 22(3):275–282
Liu P, Gao Y, Fu X, Lu J, Zhou Y, Wei X et al (2002) Pump models assessed by transesophageal echocardiography during cardiopulmonary resuscitation. Chin Med J (Engl) 115(3):359–363
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Blanco, P., Martínez Buendía, C. Point-of-care ultrasound in cardiopulmonary resuscitation: a concise review. J Ultrasound 20, 193–198 (2017). https://doi.org/10.1007/s40477-017-0256-3
- Cardiac arrest
- Cardiopulmonary resuscitation