Abstract 259: First in Man Study of Ultrasound to Measure Blood Flow During Cardiopulmonary Resuscitation
INTRODUCTION: Use of hemodynamic measures to improve cardiopulmonary resuscitation (CPR) technique during attempted resuscitation is recommended when available. Hemodynamic-guided resuscitation (HGR) achieves better outcomes than resuscitation guided by depth of chest compression in animal models of cardiac arrest. Traditionally HGR requires an invasive procedure that is not feasible during resuscitation. Ultrasound is widely available but to date has not been used for HGR in patients with cardiac arrest
OBJECTIVE: We sought to determine the feasibility of using US to measure blood flow during cardiopulmonary resuscitation.
METHODS: Included were adults receiving manual compressions for attempted resuscitation of cardiac arrest. Excluded were pregnant patients, prisoners or those with potential neck injury or obvious traumatic etiology of arrest. Images were acquired using a commercially available portable US machine (CX30, Philips Healthcare Inc., Andover, MA). Color flow clips and spectral Doppler waveform images were sought from the common carotid artery. Trained physicians not involved in the clinical care of the subject acquired all images. Feasibility was defined as the proportion of eligible subjects upon whom US recording was acquired. This study was conducted with waiver of consent under minimal risk.
RESULTS: Nineteen subjects had imaging attempted during cardiac arrest. Three subjects had imaging performed but not saved due to technical factors, and one resuscitation was terminated prior to enrollment. Usable images were acquired on 15 (79% of attempted) subjects. Mean scan time was 7 minutes 46 seconds ± 6 minutes. Blood flow was verified in all 15 subjects, and blood velocity measurements were obtained in 12 (80%). Mean peak systolic velocity was 71 cm/s ±20, and mean end-diastolic velocity was 19cm/s ±12.
CONCLUSIONS: Ultrasound measurement of blood flow during CPR is feasible, safe and efficacious. Additional work is required to assess whether US-based HGR improves outcomes in patients with cardiac arrest.
Author Disclosures: A. Adedipe: None. D. Fly: None. S. Schwitz: None. H. Duric: Employment; Significant; Philips Healthcare. D. Jorgenson: Employment; Significant; Philips Healthcare. M. Sayre: None. G. Nichol: Employment; Modest; University of Washington. Research Grant; Modest; NHLBI, FDA, Cardiac Science Corp, Heartsine Technologies Inc, Philips Healthcare Inc., Physio -Control Inc, ZOLL Inc., Velomedix Inc.
- © 2014 by American Heart Association, Inc.