Efficacy of emergency ultrasonography during cardiopul- monary resuscitation for detecting cardiac tamponade: A trial for improving outcomes of cardiac arrest

Results: Of the 119 patients, 103 patients (64 men [62.1%] and 39 women [37.9%]; mean age, 69.9 ± 15 years) were examined with ultrasonography at admission by an emergency physician, and cardiac tamponade was diagnosed in 8 of these patients. At autopsy, cardiac tamponade was diagnosed in 14 patients, and 11 of them were from aortic dissection and 3 from cardiac rupture due to acute myocardial infarction. The sensitivity, specificity, positive predictive value, negative predictive value, and overall accuracy of ultrasonography were 57.1% (95% confidence interval [CI], 39.0–63.0), 98.9% (95%CI, 96.0–99.8), 88.9% (95%CI, 60.6–98.0), 93.5% (95%CI, 90.8–94.4), and 93.1%(95%CI, 88.2–94.7), respectively. Conclusions: OHCA due to cardiac tamponade was missed by ultrasonography during CPR in approximately 50% of patients. Therefore, a standardized resuscitation protocol with superior performance of ultrasonography is needed to improve outcomes in patients with OHCA. Further reading