Acute cardiac care & resuscitation
Early point-of-care echocardiography as a predictive factor for absence of return of spontaneous circulatory in out-of-hospital cardiac arrests: A multicentre observational study
Authors' conclusion
Early POCUS cardiac standstill during CPR for out-of-hospital cardiac arrest was a reliable predictor of the absence of ROSC.
Study context
- Population
- Patients with OHCA undergoing advanced life support (ALS) with early point-of-care ultrasound (POCUS)analysed
- Participants
- 293 patients
- Exposure
- POCUS cardiac standstill vs visible cardiac motion
- Outcome
- PPV of POCUS cardiac standstill for absence of ROSC
- Follow-up
- Within the first 12 min of ALS initiation
Methodological detailsmulticentre, POCUS performed on average 7.9 ± 2.6 min after ALS initiation
- Multicentre
- POCUS performed on average 7.9 ± 2.6 min after ALS initiation
Main finding
As reported in the abstract
Absence of ROSC
| Group | PPV for absence of return of spontaneous circulation (ROSC) | ROSC achieved |
|---|---|---|
| Cardiac standstill | 84.0% | 16.0% |
| Visible cardiac motions | 48.2% |
PPV for absence of return of spontaneous circulation (ROSC)
Cardiac standstill84.0%
Visible cardiac motionsNot reported in the abstract
ROSC achieved
Cardiac standstill16.0%
Visible cardiac motions48.2%
Observational data: associations, not effects.
Further findings
| Outcome | aOR (95% CI) | |
|---|---|---|
| Predictors of absence of ROSC (multivariable analysis)Cardiac standstill vs Visible cardiac motions · adjusted for variables used in TOR rules | 3.89 (1.86–8.17) | |
| 0.10.31310Adjusted odds ratio (log scale) |
Predictors of absence of ROSC (multivariable analysis)
| Comparison | aOR (95% CI) | |
|---|---|---|
| ETCO2 ≤37 mmHgAdjusted for variables used in TOR rules | 4.27 (2.21–8.25) | |
| 0.10.31310Adjusted odds ratio (log scale) |
- Only POCUS cardiac standstill and end-tidal CO2 (ETCO2) ≤37 mmHg associated with absence of ROSC
Original publication
Early point-of-care echocardiography as a predictive factor for absence of return of spontaneous circulatory in out-of-hospital cardiac arrests: A multicentre observational study. Resuscitation. Published 21 August 2024. doi:10.
Summarised from the published abstract; every number is checked against it