A Multicenter, Prospective Study Comparing Subxiphoid and Parasternal Views During Brief Echocardiography: Effect on...

Area of Science:

• Emergency Medicine
• Cardiology
• Medical Imaging

Background:

• Echocardiography (echo) during cardiac arrest may prolong chest compression interruptions.
• The choice of sonographic approach may influence the efficiency and quality of echo during resuscitation.

Purpose of the Study:

• To compare the subxiphoid (SX) and parasternal long (PSL) views for echocardiography during simulated cardiac arrest.
• To assess the impact of view approach on time to image completion, image quality, and cardiac anatomy visualization.

Main Methods:

• A multicenter, randomized controlled trial in 29 emergency departments.
• Experienced clinicians performed both SX and PSL views in a simulated cardiac arrest scenario.
• Time to image acquisition and image quality were recorded and analyzed.

Main Results:

• Overall time to image acquisition was 9.0 seconds.
• Parasternal long (PSL) view acquisition was faster (8.8s) than subxiphoid (SX) view (9.3s).
• PSL views demonstrated significantly better image quality (3.86 vs. 3.54) and superior visualization of cardiac anatomy.

Conclusions:

• Echocardiography can be performed in under 10 seconds in over 50% of patients with either technique.
• The PSL view offers improved image quality and better identification of cardiac landmarks compared to the SX view.
• These findings support the use of PSL view for echocardiography during Advanced Cardiac Life Support.