Prognostic accuracy of point-of-care ultrasound in patients with pulseless electrical activity: a systematic review and meta-analysis.

IF 3 2区医学 Q1 EMERGENCY MEDICINE

Scandinavian Journal of Trauma Resuscitation & Emergency Medicine Pub Date : 2025-02-10 DOI:10.1186/s13049-025-01327-0

Shang-Jun Zhang Jian, Tzu-Heng Cheng, Chieh-Ching Yen

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引用次数: 0

Abstract

Background: The prognosis for pulseless electrical activity (PEA) is typically poor; however, patients with cardiac activity observed on point-of-care ultrasound (POCUS) tend to have better outcomes compared to those without. This systematic review and meta-analysis were conducted to assess the prognostic accuracy of cardiac activity detected by POCUS in predicting resuscitation outcomes in patients experiencing PEA.

Methods: A comprehensive literature search was conducted in PubMed, Embase, and the Cochrane Central Register of Controlled Trials to identify relevant studies. The pooled sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio, and the area under the summary receiver operating characteristic curve (SROC) were calculated using the bivariate model.

Results: Eighteen studies comprising 1202 patients were included in the meta-analysis. Cardiac activity observed on POCUS demonstrated a pooled sensitivity of 0.86 (95% CI 0.67-0.95) and specificity of 0.64 (95% CI 0.51-0.75) for predicting return of spontaneous circulation, a pooled sensitivity of 0.89 (95% CI 0.80-0.94) and specificity of 0.73 (95% CI 0.63-0.81) for survival to admission (SHA), and a pooled sensitivity of 0.79 (95% CI 0.58-0.91) and specificity of 0.58 (95% CI 0.47-0.68) for survival to discharge. The highest area under the SROC, 0.89 (95% CI 0.86-0.92), was observed for SHA.

Conclusions: Our study suggests that POCUS may serve as a vital component of a multimodal approach for early termination of resuscitation.

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无脉性电活动患者的即时超声预测准确性：一项系统回顾和荟萃分析。

背景：无脉性电活动（PEA）的预后通常较差；然而，通过即时超声（POCUS）观察到心脏活动的患者往往比没有心脏活动的患者有更好的结果。本系统综述和荟萃分析旨在评估POCUS检测心脏活动预测PEA患者复苏结果的预后准确性。方法：在PubMed、Embase和Cochrane Central Register of Controlled Trials中进行全面的文献检索，以确定相关研究。采用双变量模型计算合并敏感性、特异性、阳性似然比（PLR）、阴性似然比（NLR）、诊断优势比和总受试者工作特征曲线下面积（SROC）。结果：18项研究包括1202例患者被纳入meta分析。POCUS观察到的心脏活动显示，预测自发循环恢复的总敏感性为0.86 （95% CI 0.67-0.95）和特异性为0.64 (95% CI 0.51-0.75)，预测生存至入院（SHA）的总敏感性为0.89 （95% CI 0.80-0.94）和特异性为0.73 (95% CI 0.63-0.81)，预测生存至出院的总敏感性为0.79 （95% CI 0.58-0.91）和特异性为0.58 （95% CI 0.47-0.68）。SHA的SROC下面积最大，为0.89 （95% CI 0.86-0.92）。结论：我们的研究表明，POCUS可能是早期终止复苏的多模式方法的重要组成部分。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Scandinavian Journal of Trauma Resuscitation & Emergency Medicine EMERGENCY MEDICINE-

CiteScore

6.10

自引率

6.10%

发文量

审稿时长

6-12 weeks

期刊介绍： The primary topics of interest in Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine (SJTREM) are the pre-hospital and early in-hospital diagnostic and therapeutic aspects of emergency medicine, trauma, and resuscitation. Contributions focusing on dispatch, major incidents, etiology, pathophysiology, rehabilitation, epidemiology, prevention, education, training, implementation, work environment, as well as ethical and socio-economic aspects may also be assessed for publication.