[In and out-of-hospital cardiac arrest and echography: a review]

Area of Science:

• Emergency Medicine
• Cardiology
• Critical Care

Background:

• Cardiac arrest (CA) presents a frequent emergency with poor outcomes for patients in asystole or pulseless electrical activity.
• Identifying the etiology of non-shockable cardiac arrest is crucial for effective treatment and improved survival rates.

Purpose of the Study:

• To evaluate the utility of echocardiography in identifying the causes of cardiac arrest.
• To propose an algorithm for cardiac arrest care incorporating echocardiography for identifying reversible causes.

Main Methods:

• A systematic literature search was conducted across multiple databases, selecting clinical trial studies.
• Editorials, case reports, and animal studies were excluded from the analysis.
• Echocardiography findings were analyzed to detect various physiopathological and semiological statuses indicative of CA etiology.

Main Results:

• Echocardiography can reveal specific signs within minutes of arrest, such as increased right ventricle volume, suggesting pulmonary embolism or infarction.
• Ventricular collapse detected by echocardiography is pathological and can indicate pericardic effusion, pneumothorax, or shock.
• The study proposes a cardiac arrest algorithm integrating transthoracic echocardiography to identify curable causes.

Conclusions:

• Echocardiography is a valuable tool for detecting the etiology of cardiac arrest, particularly in non-shockable rhythms.
• The proposed algorithm aligns with international resuscitation guidelines (ILCOR, ERC, AHA).
• Further clinical studies are necessary to determine the impact of echocardiography on patient morbidity and mortality during advanced cardiac life support (ACLS).