Impact of Ultrasonography on Chest Compression Fraction and Survival in Patients with Out-of-hospital Cardiac Arrest
Introduction: Whether ultrasonography (US) contributes to delays in chest compressions and hence a negative impact on survival is uncertain. In this study we aimed to investigate the impact of US on chest compression fraction (CCF) and patient survival. Methods: We retrospectively analyzed video rec...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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eScholarship Publishing, University of California
2023-03-01
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| Series: | Western Journal of Emergency Medicine |
| Online Access: | https://escholarship.org/uc/item/5vq7q654 |
| _version_ | 1827977810377965568 |
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| author | Wan-Ching Lien Kah-Meng Chong Chih-Heng Chang Su-Fen Cheng Wei-Tien Chang Matthew Hwei-Ming Ma Wen-Jone Chen |
| author_facet | Wan-Ching Lien Kah-Meng Chong Chih-Heng Chang Su-Fen Cheng Wei-Tien Chang Matthew Hwei-Ming Ma Wen-Jone Chen |
| author_sort | Wan-Ching Lien |
| collection | DOAJ |
| description | Introduction: Whether ultrasonography (US) contributes to delays in chest compressions and hence a negative impact on survival is uncertain. In this study we aimed to investigate the impact of US on chest compression fraction (CCF) and patient survival. Methods: We retrospectively analyzed video recordings of the resuscitation process in a convenience sample of adult patients with non-traumatic, out-of-hospital cardiac arrest. Patients receiving US once or more during resuscitation were categorized as the US group, while the patients who did not receive US were categorized as the non-US group. The primary outcome was CCF, and the secondary outcomes were the rates of return of spontaneous circulation (ROSC), survival to admission and discharge, and survival to discharge with a favorable neurological outcome between the two groups. We also evaluated the individual pause duration and the percentage of prolonged pauses associated with US. Results: A total of 236 patients with 3,386 pauses were included. Of these patients, 190 received US and 284 pauses were related to US. Longer resuscitation duration was observed in the US group (median, 30.3 vs 9.7 minutes, P<.001). The US group had comparable CCF (93.0% vs 94.3%, P=0.29) with the non-US group. Although the non-US group had a better rate of ROSC (36% vs 52%, P=0.04), the rates of survival to admission (36% vs 48%, P=0.13), survival to discharge (11% vs 15%, P=0.37), and survival with favorable neurological outcome (5% vs 9%, P=0.23) did not differ between the two groups. The pause duration of pulse checks with US was longer than pulse checks alone (median, 8 vs 6 seconds, P=0.02). The percentage of prolonged pauses was similar between the two groups (16% vs 14%, P=0.49). Conclusion: When compared to the non-ultrasound group, patients receiving US had comparable chest compression fractions and rates of survival to admission and discharge, and survival to discharge with a favorable neurological outcome. The individual pause was lengthened related to US. However, patients without US had a shorter resuscitation duration and a better rate of ROSC. The trend toward poorer results in the US group was possibly due to confounding variables and nonprobability sampling. It should be better investigated in further randomized studies. |
| first_indexed | 2024-04-09T21:12:16Z |
| format | Article |
| id | doaj.art-a774a96f447643389fcd559843362d10 |
| institution | Directory Open Access Journal |
| issn | 1936-9018 |
| language | English |
| last_indexed | 2024-04-09T21:12:16Z |
| publishDate | 2023-03-01 |
| publisher | eScholarship Publishing, University of California |
| record_format | Article |
| series | Western Journal of Emergency Medicine |
| spelling | doaj.art-a774a96f447643389fcd559843362d102023-03-28T15:41:41ZengeScholarship Publishing, University of CaliforniaWestern Journal of Emergency Medicine1936-90182023-03-0124210.5811/westjem.2023.1.58796wjem-24-322Impact of Ultrasonography on Chest Compression Fraction and Survival in Patients with Out-of-hospital Cardiac ArrestWan-Ching Lien0Kah-Meng Chong1Chih-Heng Chang2Su-Fen Cheng3Wei-Tien ChangMatthew Hwei-Ming MaWen-Jone Chen4National Taiwan University Hospital, Department of Emergency Medicine, Taipei City, Taiwan, Republic of ChinaNational Taiwan University Hospital, Department of Emergency Medicine, Taipei City, Taiwan, Republic of ChinaNational Taiwan University Hospital, Department of Emergency Medicine, Taipei City, Taiwan, Republic of ChinaNational Taiwan University Hospital, Department of Emergency Medicine, Taipei City, Taiwan, Republic of ChinaNational Taiwan University Hospital, Department of Emergency Medicine, Taipei City, Taiwan, Republic of ChinaIntroduction: Whether ultrasonography (US) contributes to delays in chest compressions and hence a negative impact on survival is uncertain. In this study we aimed to investigate the impact of US on chest compression fraction (CCF) and patient survival. Methods: We retrospectively analyzed video recordings of the resuscitation process in a convenience sample of adult patients with non-traumatic, out-of-hospital cardiac arrest. Patients receiving US once or more during resuscitation were categorized as the US group, while the patients who did not receive US were categorized as the non-US group. The primary outcome was CCF, and the secondary outcomes were the rates of return of spontaneous circulation (ROSC), survival to admission and discharge, and survival to discharge with a favorable neurological outcome between the two groups. We also evaluated the individual pause duration and the percentage of prolonged pauses associated with US. Results: A total of 236 patients with 3,386 pauses were included. Of these patients, 190 received US and 284 pauses were related to US. Longer resuscitation duration was observed in the US group (median, 30.3 vs 9.7 minutes, P<.001). The US group had comparable CCF (93.0% vs 94.3%, P=0.29) with the non-US group. Although the non-US group had a better rate of ROSC (36% vs 52%, P=0.04), the rates of survival to admission (36% vs 48%, P=0.13), survival to discharge (11% vs 15%, P=0.37), and survival with favorable neurological outcome (5% vs 9%, P=0.23) did not differ between the two groups. The pause duration of pulse checks with US was longer than pulse checks alone (median, 8 vs 6 seconds, P=0.02). The percentage of prolonged pauses was similar between the two groups (16% vs 14%, P=0.49). Conclusion: When compared to the non-ultrasound group, patients receiving US had comparable chest compression fractions and rates of survival to admission and discharge, and survival to discharge with a favorable neurological outcome. The individual pause was lengthened related to US. However, patients without US had a shorter resuscitation duration and a better rate of ROSC. The trend toward poorer results in the US group was possibly due to confounding variables and nonprobability sampling. It should be better investigated in further randomized studies.https://escholarship.org/uc/item/5vq7q654 |
| spellingShingle | Wan-Ching Lien Kah-Meng Chong Chih-Heng Chang Su-Fen Cheng Wei-Tien Chang Matthew Hwei-Ming Ma Wen-Jone Chen Impact of Ultrasonography on Chest Compression Fraction and Survival in Patients with Out-of-hospital Cardiac Arrest Western Journal of Emergency Medicine |
| title | Impact of Ultrasonography on Chest Compression Fraction and Survival in Patients with Out-of-hospital Cardiac Arrest |
| title_full | Impact of Ultrasonography on Chest Compression Fraction and Survival in Patients with Out-of-hospital Cardiac Arrest |
| title_fullStr | Impact of Ultrasonography on Chest Compression Fraction and Survival in Patients with Out-of-hospital Cardiac Arrest |
| title_full_unstemmed | Impact of Ultrasonography on Chest Compression Fraction and Survival in Patients with Out-of-hospital Cardiac Arrest |
| title_short | Impact of Ultrasonography on Chest Compression Fraction and Survival in Patients with Out-of-hospital Cardiac Arrest |
| title_sort | impact of ultrasonography on chest compression fraction and survival in patients with out of hospital cardiac arrest |
| url | https://escholarship.org/uc/item/5vq7q654 |
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