Can serial focussed echocardiographic evaluation in life support (FEEL) predict resuscitation outcome or termination of resuscitation (TOR)? A pilot study

초록

Aim of the study: This study aimed to evaluate the correlation between serial echocardiography findings and return of spontaneous circulation (ROSC) in patients with out-of-hospital cardiac arrest (OHCA) and to examine whether echocardiographic cardiac standstill duration can be used to predict ROSC. Methods: This was a prospective observational study of non-consecutive non-trauma adult patients with OHCA. Echocardiography was performed every 2 min during a pulse check for < 10 s throughout the resuscitation effort managed according to advanced life support treatment guidelines. Echocardiography findings were recorded as video clips. Results: Forty-eight patients were enrolled in the study. Serial echocardiographic cardiac standstill duration in the ROSC and no ROSC groups were 2.86 +/- 2.07 min versus 20.30 +/- 8.42 min, respectively (p < 0.001). Cardiac standstill duration >= 10 min predicted non-ROSC with a sensitivity of 90.0%, specificity of 100%, positive predictive value of 100%, and negative predictive value of 93.3%. A receiver operating characteristic curve was generated to determine the accuracy of serial echocardiographic cardiac standstill duration for predicting no ROSC. The area under the curve was 0.991 (p < 0.000). Conclusions: In all patients with serial echocardiographic cardiac standstill >= 10 min, no patients had ROSC. These results displayed compelling test performance and discrimination ability for subjects with and without ROSC. Our study is suggestive, and it warrants further study. (C) 2016 Elsevier Ireland Ltd. All rights reserved.

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