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FACP. Colegio de médicos de Tarragona Nº 4305520 / fgcapriles@gmail.com




Monday, October 10, 2016

USS in cardiac arrest

JC: Is this the REASON to use USS in cardiac arrest?
St. Emlyn´s - By Simon Carley - October 9, 2016
"This month the emergency department point of care ultrasound in out-of-hospital and in-ED cardiac arrest trial from the REASON1 trial is published in the journal Resuscitation. This has been rumoured for some time in the #FOAMed world as patient outcome related evidence for the use of ultrasound in cardiac arrest is not yet definitive.
So, the REASON1 trial is a protocol driven observational trial of the use of point of care ultrasound in the management of cardiac arrest patients in the ED. The aim is stated as looking at the association between cardiac activity on ultrasound and outcome...
What are the main results?
Importantly the main findings of ROSC, admission, and survival to hospital discharge are associated with the finding of cardiac activity on that initial ultrasound. This is arguably unsurprising as a heart which is moving intuitively feels easier to resuscitate than one that is at standstill. Patients with cardiac activity on the initial USS survived to hospital discharge on 3.8% of occasions vs 0.6% where it was absent. For ROSC the difference is even greater – 51% vs 14.3%. So the association appears to be there, and with statistical analysis using a multivariate model, cardiac activity was the single most important factor in survival, although factors such as downtime, rhythm and location of arrest were similarly important..."