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Rhythms and prognosis of patients with cardiac arrest, emphasis on pseudo-pulseless electrical activity: another reason to use ultrasound in emergency rooms in Colombia

Authors
  • Devia Jaramillo, German1, 2
  • Navarrete Aldana, Norberto1
  • Rojas Ortiz, Zaira1
  • 1 Universidad del Rosario, Bogotá, Colombia , Bogotá (Colombia)
  • 2 Hospital Universitario Mayor Méderi, Bogotá, Colombia , Bogotá (Colombia)
Type
Published Article
Journal
International Journal of Emergency Medicine
Publisher
Springer Berlin Heidelberg
Publication Date
Dec 04, 2020
Volume
13
Issue
1
Identifiers
DOI: 10.1186/s12245-020-00319-4
Source
Springer Nature
Keywords
License
Green

Abstract

BackgroundThe cardiac arrest is still an emergency with a bad prognosis. The growing adoption of bedside ultrasound allowed to classify PEA in two groups: the true PEA and the pseudo-PEA. pPEA is used to describe a patient who has a supposed PEA in the absence of pulse, with evidence of some cardiac activity on the bedside ultrasound.ObjectiveThis work aims to assess the bedside ultrasound use as a predictor for ROSC and survival at discharge in cardiac arrest patients and compare the pseudo-pulseless electrical activity to other cardiac arrest rhythms, including shockable rhythms.Materials and methodsThis is an observational, historic cohort study carried out in the emergency room of the University Hospital Mayor Méderi. Data were collected from all the adult patients treated for cardiac arrest from June 2018 to 2019. An ultrasound was performed to every cardiac arrest patient.ResultsOf a total of 108 patients, the median of the age was 71 years, 65.8% were male subjects, and the most frequent cause for cardiac arrest was the cardiogenic shock (32.4%). ROSC was observed in 41 cases (37.9%) and survival at discharge was 18 cases (16.7%). VF/VT and pPEA were the two rhythms that showed the highest ROSC and survival at discharge. For the pPEA group, we were able to conclude that the cardiac activity type is related to ROSC.ConclusionThere is a significant difference for ROSC and survival at discharge prognosis among the cardiac arrest rhythms, with better outcomes for VF/VT and pPEA. Among patients with PEA, a routine ultrasound assessment is recommended. The type of cardiac activity recorded during the ultrasound of the cardiac arrest patient might be related to the ROSC and survival at discharge prognosis.

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