Emergency Medical Service Vienna, Radetzkystrasse 1, 1030, Vienna, Austria.
PULS Austrian Cardiac Arrest Awareness Association, Lichtentaler Gasse 4/1/R03, 1090, Vienna, Austria.
Sci Rep. 2023 Nov 16;13(1):20085. doi: 10.1038/s41598-023-46684-x.
Guidelines recommend the use of ultrasound in cardiac arrest. Transthoracic echocardiography, has issues with image quality and by increasing hands-off times during resuscitation. We assessed the feasibility of transesophageal echocardiography (TEE), which does not have both problems, at out-of-hospital cardiac arrest (OHCA) emergency scenes. Included were 10 adults with non-traumatic OHCA in Vienna, Austria. An expert in emergency ultrasound was dispatched to the scenes in addition to the resuscitation team. Feasibility was defined as the ability to collect specific items of information by TEE within 10 min. Descriptive statistics were compiled and hands-off times were compared to a historical control group. TEE examinations were feasible in 9 of 10 cases and prompted changes in clinical management in 2 cases (cardiac tamponade: n = 1; right ventricular dilatation: n = 1). Their mean time requirement was 5.1 ± 1.7 (2.8-8.0) min, and image quality was invariably rated as excellent or good during both compressions and pauses. No TEE-related complications, or interferences with activities of advanced life support were observed. The hands-off times during resuscitation were comparable to a historical control group not involving ultrasound (P = 0.24). Given these feasibility results, we expect that TEE can be used routinely at OHCA emergency scenes.
指南建议在心脏骤停时使用超声。经胸超声心动图在图像质量方面存在问题，并且在复苏期间增加了脱手时间。我们评估了经食管超声心动图（TEE）在院外心脏骤停（OHCA）急救现场的可行性，TEE 没有这两个问题。该研究纳入了奥地利维也纳的 10 名非创伤性 OHCA 成人患者。除了复苏团队外，还派遣了一名急救超声专家到现场。可行性定义为在 10 分钟内通过 TEE 收集特定信息项目的能力。收集了描述性统计数据，并比较了脱手时间与历史对照组。在 10 例中，TEE 检查在 9 例中可行，并在 2 例中促使临床管理发生变化（心脏压塞：n=1；右心室扩张：n=1）。其平均时间需求为 5.1±1.7（2.8-8.0）分钟，在按压和暂停期间，图像质量始终被评为优秀或良好。未观察到与 TEE 相关的并发症或与高级生命支持活动的干扰。与不涉及超声的历史对照组相比，复苏期间的脱手时间相当（P=0.24）。鉴于这些可行性结果，我们预计 TEE 可以在 OHCA 急救现场常规使用。
