|Title:||Ultrasound in postresuscitation care: a narrative review||Authors:||Hsu, Chia-Yu
|Keywords:||cause of arrest; hemodynamic monitoring; postresuscitation care; prognosis; ultrasound; PREDICT FLUID RESPONSIVENESS; INFERIOR VENA-CAVA; CARDIAC-ARREST; CARDIOPULMONARY-RESUSCITATION; MYOCARDIAL DYSFUNCTION; RAPID ULTRASOUND; LIFE-SUPPORT; DIAMETER; EXAM; VELOCITY||Issue Date:||1-Aug-2022||Publisher:||LIPPINCOTT WILLIAMS & WILKINS||Journal Volume:||29||Journal Issue:||4||Start page/Pages:||246||Source:||European journal of emergency medicine : official journal of the European Society for Emergency Medicine||Abstract:||
The efficacy of ultrasound (US) in real-time differential diagnosis and guiding further treatment decisions has been well demonstrated in prearrest conditions and during resuscitation. Evidence is limited regarding the application of US in postresuscitation care. Most of the patients following resuscitation remain comatose, and the requirement for transportation to other examination rooms increases their risk of injury. US can be performed at the bedside with high accessibility and timeliness without radiation. This narrative review provides an overview of current evidence regarding the application of US in identifying the cause of cardiac arrest (CA), hemodynamic monitoring, and prognostication in postresuscitation care. For identifying the cause of CA, cardiac US is mainly used to detect regional wall motion abnormality. However, postarrest myocardial dysfunction would confound the sonographic findings that a combination of electrocardiograms and biomarkers besides the cardiac US could improve the positive predictive value of coronary artery disease. For hemodynamic monitoring, left ventricular outlet tract velocity time integral has the best performance in predicting fluid responsiveness in conjunction with the passive leg raising test. The RUSH protocol assists in determining the subtypes of shock with high sensitivity and specificity in hypovolemic, cardiogenic, or obstructive shock. Evidence regarding the application of US for prognostication is still limited, and further evaluation should be needed.
|Appears in Collections:||醫學院附設醫院 (臺大醫院)|
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