The predictive value of bedside ultrasound to restore spontaneous circulation in patients with pulseless electrical activity: A systematic review and meta-analysis

The prognosis of pulseless electrical activity is dismal. However, it is still challengable to decide when to terminate or continue resuscitation efforts. The aim of this study was to determine whether the use of bedside ultrasound (US) could predict the restoration of spontaneous circulation (ROSC)...

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Bibliographic Details
Published in:PloS one 2018-01, Vol.13 (1), p.e0191636-e0191636
Main Authors: Wu, Chunshuang, Zheng, Zhongjun, Jiang, Libing, Gao, Yuzhi, Xu, Jiefeng, Jin, Xiaohong, Chen, Qijiang, Zhang, Mao
Format: Article
Language:English
Subjects:
Analysis
Biology and Life Sciences
Blood Circulation
Cardiac arrest
Cardiac patients
Cardiopulmonary resuscitation
Care and treatment
Confidence intervals
CPR
Emergency medical care
Emergency services
Evaluation
Health aspects
Heart
Heart diseases
Humans
Identification methods
Medical prognosis
Medicine and Health Sciences
Meta-analysis
Patients
People and Places
Physical Sciences
Physicians
Point-of-Care Systems
Prognosis
Quality assessment
Research and Analysis Methods
Restoration
Resuscitation
Statistical analysis
Studies
Systematic review
Ultrasonography
Ultrasound
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Summary:The prognosis of pulseless electrical activity is dismal. However, it is still challengable to decide when to terminate or continue resuscitation efforts. The aim of this study was to determine whether the use of bedside ultrasound (US) could predict the restoration of spontaneous circulation (ROSC) in patients with pulseless electrical activity (PEA) through the identification of cardiac activity. This was a systematic review and meta-analysis of studies that used US to predict ROSC. A search of electronic databases (Cochrane Central, MEDLINE, EMBASE) was conducted up to June 2017, and the assessment of study quality was performed with the Newcastle-Ottawa Scale. Statistical analysis was performed with Review Manager 5.3 and Stata 12. Eleven studies that enrolled a total of 777 PEA patients were included. A total of 230 patients experienced ROSC. Of these, 188 had sonographically identified cardiac activity (pseudo-PEA). A meta-analysis showed that PEA patients with cardiac activity on US were more likely to obtain ROSC compared to those with cardiac standstill: risk ratio (RR) = 4.35 (95% confidence interval [CI], 2.20-8.63; p
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0191636