Acute cardiac care & resuscitation
Transesophageal Echocardiography During Cardiopulmonary Resuscitation (CPR) in Patients With Out-of-Hospital Cardiac Arrest: The EXECT-CPR Randomized Clinical Trial
Primary result · Sustained return of spontaneous circulation (≥20 minutes)Result — go to the resultCluster-adjusted odds ratio 1.21 95% CI 0.64–2.29Authors' conclusion
In this randomized clinical trial among adults transported to the emergency department with ongoing CPR for nontraumatic out-of-hospital cardiac arrest, TEE-guided CPR with an adjusted compression site after arrival did not significantly improve clinical outcomes compared with conventional CPR, although it produced potential hemodynamic benefits without increasing adverse events. Given that the trial was underpowered due to optimistic effect size assumptions, these neutral findings should be interpreted with caution.
Study context
- Population
- Adults who consecutively presented to the emergency department with nontraumatic out-of-hospital cardiac arrestunderwent randomization
- Participants
- 132 adults
- Comparison
- Transesophageal echocardiography (TEE)-guided CPR vs conventional CPR
- TEE-guided groupn = 66
- Conventional groupn = 66
- Primary endpoint
- Sustained return of spontaneous circulation (≥20 minutes)
Methodological details1 tertiary medical center in Taiwan, complete blinding not feasible
- 1 tertiary medical center in Taiwan
- Complete blinding not feasible
Primary result
As reported in the abstract
Cluster-adjusted odds ratio
1.21
95% CI 0.64–2.29
Events by treatment group
Secondary outcomes
- Secondary outcomes did not significantly differ
- Higher intra-CPR end-tidal carbon dioxide levels in the TEE-guided group during the 11th to 20th minutes after arrival
Original publication
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