Does Point-of-care Ultrasound Improve Survival when Used During Cardiac Arrest? A Systematic Review and Meta-analysis

Abstract

Aim of the review: This review aimed to evaluate the impact of Point-of-care Ultrasound during cardio- pulmonary resuscitation for adult non-traumatic CA on clinical outcomes and survival. Data sources: This review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The PubMed and Embase databases were searched on 14 November 2022. The eligibility criteria were studies including: adults with non-traumatic cardiac arrest and Point-of-care Ultrasound utilisation, a control group, and an analysis of short- and long-term outcomes and neurological outcomes. The risk of bias and certainty of evidence were assessed using the Grading of Recommendations Assessment, Development and Evaluation form. Data are reported as risk of ratios for each outcome. Results: From the two databases, 7658 studies were identified, of which 3 met the predefined eligibility criteria. The main findings showed no difference in rate of return of spontaneous circulation (RR 0.83, 95% CI 0.24–1.66, p=0.60) (very low certainty of evidence) and a significant decrease in rate of survival to hospital discharge (RR 0.44, 95% CI 0.22–0.88, p=0.02) (very low quality of evidence). No study reported data regarding neurological status at hospital discharge, 30-day survival rate, or neurological outcome. Conclusion: The impact of Point-of-care Ultrasound during cardiopulmonary resuscitation on clinical outcomes during cardiac arrest is hampered by the very low certainty of evidence, heterogeneity, and high risk of bias. Studies have shown no difference in return of spontaneous circulation but a significant decrease in survival to hospital discharge when Point-of-care Ultrasound was performed.