Transoesophageal echocardiography in cardiac arrest: A systematic review

被引:13
|
作者
Hussein, Laila [1 ,2 ]
Rehman, Mohammad Anzal [3 ]
Jelic, Tomislav [4 ]
Berdnikov, Alexei [5 ]
Teran, Felipe [6 ]
Richards, Simon [1 ]
Askin, Nicole [7 ]
Jarman, Robert [8 ]
机构
[1] Teesside Univ, Middlesbrough, Cleveland, England
[2] Sheikh Shakbout Med City, Dept Emergency Med, POB 11001, Abu Dhabi, U Arab Emirates
[3] Zayed Mil Hosp, Dept Emergency Med, Abu Dhabi, U Arab Emirates
[4] Univ Manitoba, Dept Emergency Med, Winnipeg, MB, Canada
[5] Max Rady Coll Med, Winnipeg, MB, Canada
[6] Univ Penn, Sch Med, Ctr Resuscitat Sci, Philadelphia, PA 19104 USA
[7] Univ Manitoba, Winnipeg, MB, Canada
[8] Royal Victoria Infirm, Newcastle Upon Tyne, Tyne & Wear, England
关键词
Cardiac arrest; Resuscitation Echocardiography; Transoesophageal echocardiography; Ultrasound Point-of-care; ultrasound; OF-CARE ULTRASOUND; CARDIOPULMONARY-RESUSCITATION; LIFE-SUPPORT; HEMODYNAMIC INSTABILITY; PULMONARY-EMBOLISM; COMPRESSIONS; GUIDELINES; CONSENSUS; SAFETY; ECHO;
D O I
10.1016/j.resuscitation.2021.08.001
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Aims: To identify, appraise and synthesize all available clinical evidence to evaluate the diagnostic role of transoesophageal echocardiography (TEE) during resuscitation of in-hospital (IHCA) and out-of-hospital cardiac arrest (OHCA) in the identification of reversible causes of cardiac arrest and cardiac contractility. Methods: We conducted a systematic review following PRISMA guidelines. Medline, EMBASE, Web of Science Core Collection, Proquest Disser-tations, Open Grey, CDSR, Cochrane Central, Cochrane Clinical Answers, and the clinicaltrials.gov registry were searched for eligible studies. Stud-ies involving adult patients, with non-traumatic cardiac arrest in whom TEE was used for intra-arrest evaluation, were included. Case studies and case series, animal studies, reviews, guidelines and editorials were excluded. The QUADAS-2 tool was used for quality assessment of all studies. Results: Eleven studies with a total of 358 patients were included. Four studies involved perioperative IHCA, three involved OHCA, and four were mixed population settings. Overall, the risk of bias in the selected studies was either high or unclear due to evidence or lack of information. In all 11 studies, TEE allowed the identification of reversible causes of arrest. We found significant heterogeneity in the criteria used to interpret findings, TEE protocol used, and timing of TEE. Conclusion: Due to heterogeneity of studies, small sample size and inconsistent reference standard, the evidence for TEE in cardiac arrest resus-citation is of low certainty and is aected by a high risk of bias. Further studies are needed to better understand the true diagnostic accuracy of TEE in identifying reversible causes of arrest and cardiac contractility.
引用
收藏
页码:167 / 175
页数:9
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