The Relationship between Echocardiography Findings with Prognosis and Response to the Treatment during Cardiopulmonary Resuscitation in Patients with Cardiac-Pulmonary Arrest Referred to the Emergency Department

Abstract

Background and objective: Ultrasound can increase to diagnose the reversible causes of cardiac arrest. This study aimed to determine the relationship between Echo findings during CPR with prognosis and response to treatment in patients with cardiac-pulmonary arrest referred to the Emergency Department (ED).

Materials and Methods: This descriptive cross-sectional study was performed in all the patients referred to the ED. Patients were included in the study if needed for cardiopulmonary resuscitation on the basis of inclusion and exclusion criteria. Echo were implanted at resuscitation intervals (0 min), 15 min and 30 min after resuscitation. Demographic data including age, sex, heart rhythm of the patient, need for shock and life situation 24 hours after resuscitation in case of positive response to resuscitation were recorded in the checklist.

Results: The male to female ratio was 1.56. The age mean of the total population was 56.40 years. The ratio of cardiopulmonary arrest cases outside to inside was 3.25, the rate of successful CPR was 30.9%, and the ratio of life to death after 24 hours of successful CPR was 1.6. 72.1% of patients had asystole at the onset of resuscitation, 63.2% of patients had no mechanical activity at the onset of resuscitation. The success rate of CPR in cardiopulmonary arrest cases in-hospital was 50% and 25% in outside (P=0.058). The success rate in patients who did not asystole initiate resuscitation was 73.7% and in patients who did asystole initiate resuscitation was 14.3% (P <0.001). Survival rates at 24 hours after CPR were 47.4% in patients with no asystole and 8.2% in patients with asystole at onset of resuscitation (P= 0.001). The success of CPR in patients who had cardiac mechanical activity at the onset of resuscitation was 3.48 times greater than that of the group that did not have cardiac mechanical activity. The survival rate at 24 hours after CPR in the group that had cardiac mechanical activity at the start of resuscitation was 3.57 times higher than that of the group that had no cardiac mechanical activity at the start of resuscitation.

Conclusion: In sum, it can be concluded that the presence of mechanical activity in echocardiography during cardio-pulmonary resuscitation in patients with cardiac arrest is associated with better success rate and awareness; therefore, echocardiography can be used as a suitable tool during cardiopulmonary resuscitation.