Division of Cardiology, University of Washington, Seattle, WA, USA.
Department of Internal Medicine, University of Washington, Seattle, WA, USA.
Resuscitation. 2023 Oct;191:109916. doi: 10.1016/j.resuscitation.2023.109916. Epub 2023 Jul 26.
Causes for sudden circulatory arrest (SCA) can vary widely making early treatment and triage decisions challenging. Additionally, cardiopulmonary resuscitation (CPR), while a life-saving link in the chain of survival, can be associated with traumatic injuries. Computed tomography (CT) can identify many causes of SCA as well as its sequelae. However, the diagnostic and therapeutic impact of CT in survivors of SCA has not been reviewed to date. This general review outlines the rationale and potential applications of focused head, chest, and abdomen/pelvis CT as well as comprehensive head-to-pelvis CT imaging after SCA. CT has a diagnostic yield approaching 30% to identify causes of SCA while the addition of ECG-gated chest CT provides further information about coronary anatomy and cardiac function. Risks of CT include radiation exposure, contrast-induced kidney injury, and incidental findings. This review's findings suggest that routine head-to-pelvis CT can yield clinically actional findings with the potential to improve clinical outcome after SCA that merits further investigation.
心搏骤停(SCA)的原因多种多样,这使得早期的治疗和分诊决策具有挑战性。此外,心肺复苏(CPR)虽然是生存链中的救生环节,但也可能与创伤性损伤有关。计算机断层扫描(CT)可以识别 SCA 的许多原因及其后果。然而,迄今为止,尚未对 SCA 幸存者的 CT 在诊断和治疗方面的影响进行审查。本综述概述了在 SCA 后进行针对性头部、胸部和腹部/骨盆 CT 以及全面头部到骨盆 CT 成像的基本原理和潜在应用。CT 的诊断率接近 30%,可确定 SCA 的原因,而附加 ECG 门控胸部 CT 可提供有关冠状动脉解剖结构和心脏功能的更多信息。CT 的风险包括辐射暴露、造影剂诱导的肾损伤和偶然发现。本综述的研究结果表明,常规的头部到骨盆 CT 可以提供具有临床意义的发现,有可能改善 SCA 后的临床结果,值得进一步研究。