Author/Editor		Prosen, Gregor; Križmarić, Miljenko; Završnik, Jernej; Grmec, Štefek
Title		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
Type		članek
Source		J Int Med Res
Vol. and No.		Letnik 38, št. 4
Publication year		2010
Volume		str. 1458-67
Language		eng
Abstract		This 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 (PetCO2) 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 PetCO2 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.
Descriptors		CARDIOPULMONARY RESUSCITATION ECHOCARDIOGRAPHY CAPNOGRAPHY CARBON DIOXIDE HEART ARREST VASOPRESSINS TREATMENT OUTCOME