Highlights
- •TEE allows aortic dissection diagnosis as a cause of cardiac arrest during CPR.
- •Aortic dissection is associated with poor resuscitation outcome.
- •Diagnosis of aortic dissection helps to determine treatment modality.
Abstract
Objectives
Early identification of the causes of cardiac arrest is helpful in determining the
resuscitation measures during cardiopulmonary resuscitation (CPR). We aimed to evaluate
the feasibility of transesophageal echocardiography (TEE) during CPR in diagnosing
aortic dissection and the influence of aortic dissection on resuscitation outcome
in adult patients with prolonged non-traumatic cardiac arrest.
Methods
Adult patients aged >20 years with non-traumatic cardiac arrest who underwent prolonged
CPR (>10 min) and TEE examination during CPR were enrolled. The enrolled patients
were grouped according to the presence of aortic dissection on TEE: the aortic dissection
(AD) group and the non-AD group. Variables related to cardiac arrest event, CPR, and
resuscitation outcome were compared between the two groups.
Results
Forty-five patients (median age, 71 years; 26 men) were enrolled. Ten (22.2%) and
35 (77.8%) patients were included in the AD and non-AD groups, respectively. No patients
in the AD group survived. Aortic dissection on TEE was inversely related to the rate
of return of spontaneous circulation on multivariate analysis (odds ratio, 0.019;
95% confidence interval, 0.001–0.750; p = .035).
Conclusion
TEE is a useful tool for diagnosing aortic dissection as a cause of cardiac arrest
during CPR. Aortic dissection is associated with poor resuscitation outcomes.
Abbreviations:
AD (aortic dissection), CPR (cardiopulmonary resuscitation), ED (emergency department), OR (odds ratio), POC (point-of-care), TEE (transesophageal echocardiography), TTE (transthoracic echocardiography)Keywords
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Article Info
Publication History
Published online: January 16, 2020
Accepted:
January 15,
2020
Received in revised form:
January 13,
2020
Received:
July 3,
2019
Identification
Copyright
© 2020 Elsevier Inc. All rights reserved.
