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Krammel M, Hamp T, Hafner C, Magnet I, Poppe M, Marhofer P. Feasibility of resuscitative transesophageal echocardiography at out-of-hospital emergency scenes of cardiac arrest. Sci Rep 2023; 13:20085. [PMID: 37973909 PMCID: PMC10654663 DOI: 10.1038/s41598-023-46684-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 11/03/2023] [Indexed: 11/19/2023] Open
Abstract
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.
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Affiliation(s)
- Mario Krammel
- Emergency Medical Service Vienna, Radetzkystrasse 1, 1030, Vienna, Austria
- PULS Austrian Cardiac Arrest Awareness Association, Lichtentaler Gasse 4/1/R03, 1090, Vienna, Austria
| | - Thomas Hamp
- Emergency Medical Service Vienna, Radetzkystrasse 1, 1030, Vienna, Austria.
- Department of Anesthesia, Intensive Care Medicine and Pain Medicine, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.
| | - Christina Hafner
- Department of Anesthesia, Intensive Care Medicine and Pain Medicine, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Ingrid Magnet
- Department of Emergency Medicine, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Michael Poppe
- Department of Emergency Medicine, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Peter Marhofer
- Department of Anesthesia, Intensive Care Medicine and Pain Medicine, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
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Platz E, Morrow DA, Verbrugge FH, Vranckx P, Cullen L. Acute cardiovascular care in the emergency department and beyond: a call for interdisciplinary collaboration in clinical research. EUROPEAN HEART JOURNAL. ACUTE CARDIOVASCULAR CARE 2023; 12:77-79. [PMID: 36585901 DOI: 10.1093/ehjacc/zuac170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Accepted: 12/28/2022] [Indexed: 01/01/2023]
Affiliation(s)
- Elke Platz
- Cardiovascular Division, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA
| | - David A Morrow
- Cardiovascular Division, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA
| | - Frederik H Verbrugge
- Centre for Cardiovascular Diseases, University Hospital Brussels, Jette, Belgium & Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Pascal Vranckx
- Department of Cardiology and Critical Care medicine, Jessa Ziekenhuis Hasselt & Faculty of Medicine and Life Sciences, University of Hasselt, Hasselt, Belgium
| | - Louise Cullen
- Emergency and Trauma Centre, Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia
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