• J. Int. Med. Res. · Jul 2010

    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.

    • G Prosen, M Križmarić, J Završnik, and S Grmec.
    • Centre for Emergency Medicine Maribor, University of Maribor, Maribor, Slovenia. gregorprosen@gmail.com
    • J. Int. Med. Res. 2010 Jul 1;38(4):1458-67.

    AbstractThis study evaluated the ability of focused echocardiography (FE) and capnography to differentiate between pulseless electrical activity (PEA) and pseudo-PEA in out-of-hospital cardiac arrest, and the potential survival benefits with modified treatment. In PEA patients with stable end-tidal carbon dioxide pressure (P(et)CO(2)) during the compression pause and concomitant FE showing cardiac kinetic activity, the compression pause was prolonged for 15 s and an additional 20 IU vasopressin was administered. If pulselessness persisted, compressions were continued. Fifteen of the 16 patients studied (94%) achieved restoration of spontaneous circulation (ROSC); eight patients (50%) attained a good neurological outcome (Cerebral Performance Category 1 - 2). In an historical PEA group with stable P(et)CO(2) values (n = 48), ROSC was achieved in 26 patients (54%); four patients (8%) attained Cerebral Performance Category 1 - 2. Echocardiographical verification of the pseudo-PEA state enabled additional vasopressor treatment and cessation of chest compressions, and was associated with significantly higher rates of ROSC, survival to discharge and good neurological outcome.

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