Best Pocus Ultrasound Cardiac arrest, a sudden cessation of heart activity, has alarmingly high mortality rates in both in-hospital and out-of-hospital settings. Point-of-care ultrasound (POCUS) has emerged as a potential diagnostic and prognostic tool during cardiac arrest management, providing real-time insights into cardiac activity. This systematic review assesses the role of POCUS in predicting clinical outcomes such as return of spontaneous circulation (ROSC), survival to hospital admission (SHA), and survival to hospital discharge (SHD). Researchers comprehensively searched electronic databases, including PubMed, Medline, and Embase, identifying 3984 studies, and included 22 after applying rigorous selection criteria.
The Study Highlights
The study highlights significant variability in the definition of cardiac activity across studies, impacting the reliability of pooled data. While POCUS showed potential for predicting outcomes like ROSC, SHA, and SHD, its heterogeneity limited statistical analysis, preventing meta-analyses. The quality of the included studies was assessed using the QUADAS-2 tool, ensuring methodological robustness. The results underscored the susceptibility of POCUS to bias, especially the “self-fulfilling prophecy” phenomenon, and its association with prolonged CPR times, which can negatively influence patient survival.
Clinicians can use POCUS to gather valuable data during cardiac arrest, offering insights into the presence or absence of cardiac activity and guiding decision-making. However, relying solely on POCUS for predicting outcomes may not be sufficient. It is essential to complement its findings with clinical judgment, which considers the broader clinical context, and incorporate additional diagnostic tools to ensure a more accurate and comprehensive assessment of the patient’s condition.. The study concludes that while POCUS is a useful adjunct, it should not solely determine the decision to terminate resuscitation efforts. The findings call for standardized definitions and training protocols to enhance its utility in cardiac arrest management.
