Abstract
Point-of-care ultrasounds (US) are used during cardiopulmonary resuscitation (CPR) and after return of spontaneous circulation (ROSC). Carotid ultrasounds are a potential non-invasive monitoring tool for chest compressions, but their general value and feasibility during CPR are not fully determined. In this prospective observational study, we performed carotid US during conventional- and extracorporeal CPR and after ROSC with at least one transverse and coronal image, corresponding loops with and without color doppler, and pulsed-wave doppler loops. The feasibility of carotid US during (peri-)arrest and type and frequency of diagnostic findings were examined. We recruited 16 patients and recorded utilizable US images in 14 cases (88%; complete imaging protocols in 11 patients [69%]). In three of all patients (19%) and in 60% (3/5) of cases during CPR plus a full imaging protocol, we observed: (i) in one patient a collapse of the common carotid artery linked to hypovolemia, and (ii) in two patients a biphasic flow during CPR linked to prolonged low-flow time prior to admission and adverse outcome. Carotid artery morphology and carotid blood flow characteristics may serve as therapeutic target and prognostic parameters. However, future studies with larger sample sizes are needed.
Highlights
High quality of chest compressions are of utmost importance for favorable outcomes after cardiac arrest (CA) [2,3]
return of spontaneous circulation (ROSC) was achieved in 44%, and survival to hospital discharge could be achieved in 19% (Table 1)
There were no significant differences in peak systolic velocity (PSV) or enddiastolic velocity (EDV)
Summary
Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. High quality of chest compressions are of utmost importance for favorable outcomes after CA [2,3]. Chest compressions (CC) are highly susceptible to confounders such as tiring of providers; continuously monitoring CC quality is vital [4]. Carotid ultrasound (US) is currently seen as a potential non-invasive monitoring tool for CC efficacy [5,6]. It facilitates the detection of a pulse during rhythm checks [7,8]. The main objective of this study was to investigate the general feasibility of carotid US during CPR measures, as well as its potential as a novel therapeutic target
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