Impact of Modified Treatment in Echocardiographically Confirmed Pseudo-pulseless Electrical Activity in Out-of-hospital Cardiac Arrest Patients with Constant End-tidal Carbon Dioxide Pressure during Compression Pauses  

Oleh:

Prosen, G ; Krizmaric, M ; Zavrsnik, J

Jenis: Article from Journal - ilmiah internasional
Dalam koleksi: The Journal of International Medical Research vol. 38 no. 04 (Jul. 2010), page 1458-1467.
Topik: cardiopulmonary resuscitation; echocardiography; capnography; pulseless electrical activity; vasopressin

Ketersediaan

Perpustakaan FK Nomor Panggil: J11.K.2010.02 Non-tandon: 1 (dapat dipinjam: 0) Tandon: tidak ada

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Isi artikel

This study evaluated the ability of focused echocardiography (FE) and capnography to differentiate between pulseless electrical activity (PEA) and pseudo-PEA in out-of-hospital cardiac arrest, and the potential survival benefits with modified treatment. In PEA patients with stable end-tidal carbon dioxide pressure (PetCO2) during the compression pause and concomitant FE showing cardiac kinetic activity, the compression pause was prolonged for 15 s and an additional 20 IU vasopressin was administered. If pulselessness persisted, compressions were continued. Fifteen of the 16 patients studied (94%) achieved restoration of spontaneous circulation (ROSC); eight patients (50%) attained a good neurological outcome (Cerebral Performance Category 1 – 2). In an historical PEA group with stable PetCO2 values (n = 48), ROSC was achieved in 26 patients (54%); four patients (8%) attained Cerebral Performance Category 1 – 2. Echocardiographical verification of the pseudo-PEA state enabled additional vasopressor treatment and cessation of chest compressions, and was associated with significantly higher rates of ROSC, survival to discharge and good neurological outcome.

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