Accuracy of point-of-care focused echocardiography in predicting outcome of resuscitation in cardiac arrest patients: A systematic review and meta-analysis.
Resuscitation · 2017-03-02 · Meta-analysis
Abstract
OBJECTIVE: We aim to summarize current evidence on the value of point-of-care (POC) focused echocardiography in the assessment of short-term survival in patients with cardiac arrest. METHODS: PubMed and EMBASE were searched from inception to July 2016 for eligible studies that evaluated the utility of POC echocardiography in patients with cardiac arrest. Modified QUADAS was used to appraise the quality of included studies. A random-effect bivariate model and a hierarchical summary receiving operating curve were used to summarize the performance characteristics of focused echocardiography. RESULTS: Initial search identified 961 citations of which 15 were included in our final analysis. A total of 1695 patients had POC echocardiography performed during resuscitation. Ultrasonography was mainly utilized to detect spontaneous cardiac movement (SCM) and identify reversible causes of cardiac arrest. Subcostal, apical and parasternal views were used to identify cardiac tamponade, pulmonary embolism, and pleural view for tension pneumothorax. Results of meta-analysis showed that SCM detected by focused echocardiography had a pooled sensitivity (0.95, 95%CI: 0.72-0.99) and specificity (0.80, 95%CI: 0.63-0.91) in predicting return of spontaneous circulation (ROSC) during cardiac arrest, with a positive likelihood ratio of 4.8 (95% CI: 2.5-9.4) and a negative likelihood ratio of 0.06 (95%CI: 0.01-0.39). CONCLUSION: POC focused echocardiography can be used to identify reversible causes and predict short-term outcome in patients with cardiac arrest. In patients with a low pretest probability for ROSC, absence of SCM on echocardiography can predict a low likelihood of survival and guide the decision of resuscitation termination.
Abstract © the authors or publisher, via PubMed. Reuse and removal
Tags
Mortality & survival · Point-of-care ultrasound
Related articles
- Clinical application of point-of-care ultrasound during cardiopulmonary resuscitation: a systematic review and meta-analysis. (Quant Imaging Med Surg, 2026)
- Does Cardiac Standstill on Early Focused Transthoracic Echocardiography Predict Absence of Return of Spontaneous Circulation in Cardiac Arrest? A Systematic Review and Meta-Analysis. (J Emerg Med, 2026)
- Prognostic accuracy of point-of-care ultrasound in patients with pulseless electrical activity: a systematic review and meta-analysis. (Scand J Trauma Resusc Emerg Med, 2025)
- Focused echocardiography, end-tidal carbon dioxide, arterial blood pressure or near-infrared spectroscopy monitoring during paediatric cardiopulmonary resuscitation: A scoping review. (Resusc Plus, 2021)
- Early point-of-care echocardiography as a predictive factor for absence of return of spontaneous circulatory in out-of-hospital cardiac arrests: A multicentre observational study. (Resuscitation, 2024)
- Impact of modified treatment in echocardiographically confirmed pseudo-pulseless electrical activity in out-of-hospital cardiac arrest patients with constant end-tidal carbon dioxide pressure during compression pauses. (J Int Med Res, 2010)