Department of Emergency Medicine, Dongguk University College of Medicine, Dongguk University Ilsan Hospital, Goyang, Republic of Korea.
Department of Emergency Medicine, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea.
Am J Emerg Med. 2021 Jan;39:92-95. doi: 10.1016/j.ajem.2020.01.026. Epub 2020 Jan 16.
Early identification of the causes of cardiac arrest is helpful in determining the resuscitation measures during cardiopulmonary resuscitation (CPR). We aimed to evaluate the feasibility of transesophageal echocardiography (TEE) during CPR in diagnosing aortic dissection and the influence of aortic dissection on resuscitation outcome in adult patients with prolonged non-traumatic cardiac arrest.
Adult patients aged >20 years with non-traumatic cardiac arrest who underwent prolonged CPR (>10 min) and TEE examination during CPR were enrolled. The enrolled patients were grouped according to the presence of aortic dissection on TEE: the aortic dissection (AD) group and the non-AD group. Variables related to cardiac arrest event, CPR, and resuscitation outcome were compared between the two groups.
Forty-five patients (median age, 71 years; 26 men) were enrolled. Ten (22.2%) and 35 (77.8%) patients were included in the AD and non-AD groups, respectively. No patients in the AD group survived. Aortic dissection on TEE was inversely related to the rate of return of spontaneous circulation on multivariate analysis (odds ratio, 0.019; 95% confidence interval, 0.001-0.750; p = .035).
TEE is a useful tool for diagnosing aortic dissection as a cause of cardiac arrest during CPR. Aortic dissection is associated with poor resuscitation outcomes.
及早识别心搏骤停的病因有助于确定心肺复苏（CPR）期间的复苏措施。我们旨在评估经食管超声心动图（TEE）在诊断主动脉夹层（AD）中的可行性，并评估 AD 对成人非创伤性心搏骤停时间延长患者复苏结局的影响。
纳入行长时间（>10 min）CPR 并于 CPR 期间行 TEE 检查的年龄>20 岁的非创伤性心搏骤停成年患者。根据 TEE 上是否存在 AD 将纳入患者分为 AD 组和非 AD 组。比较两组与心搏骤停事件、CPR 和复苏结局相关的变量。
共纳入 45 例患者（中位年龄 71 岁，26 例男性）。10 例（22.2%）和 35 例（77.8%）患者分别纳入 AD 组和非 AD 组。AD 组无一例患者存活。TEE 上存在 AD 与自主循环恢复率呈负相关（多变量分析，比值比，0.019；95%置信区间，0.001-0.750；p=0.035）。
TEE 是诊断 CPR 中心搏骤停病因中 AD 的有用工具。AD 与复苏结局不良相关。
