picture of pulseless electrical activity

Some reports show survival rates of up to 40% with ventricular fibrillation rhythms in opposition to 2.4% with non-shockable rhythms, such as pulseless electrical activity (PEA). Regarding the cardiac arrest rhythm, shockable rhythms have been reported to have a better survival prognosis in comparison to non-shockable rhythms. The type of cardiac activity recorded during the ultrasound of the cardiac arrest patient might be related to the ROSC and survival at discharge prognosis.ĭespite recent progress on cardiopulmonary resuscitation, cardiac arrest is still an emergency with a bad prognosis, with reports of low survival at discharge rates ranging from 8.3% to 10%. Among patients with PEA, a routine ultrasound assessment is recommended. There is a significant difference for ROSC and survival at discharge prognosis among the cardiac arrest rhythms, with better outcomes for VF/VT and pPEA.

For the pPEA group, we were able to conclude that the cardiac activity type is related to ROSC. VF/VT and pPEA were the two rhythms that showed the highest ROSC and survival at discharge. ROSC was observed in 41 cases (37.9%) and survival at discharge was 18 cases (16.7%). Of a total of 108 patients, the median of the age was 71 years, 65.8% were male subjects, and the most frequent cause for cardiac arrest was the cardiogenic shock (32.4%). An ultrasound was performed to every cardiac arrest patient. Data were collected from all the adult patients treated for cardiac arrest from June 2018 to 2019. This is an observational, historic cohort study carried out in the emergency room of the University Hospital Mayor Méderi.

This work aims to assess the bedside ultrasound use as a predictor for ROSC and survival at discharge in cardiac arrest patients and compare the pseudo-pulseless electrical activity to other cardiac arrest rhythms, including shockable rhythms. pPEA is used to describe a patient who has a supposed PEA in the absence of pulse, with evidence of some cardiac activity on the bedside ultrasound. The growing adoption of bedside ultrasound allowed to classify PEA in two groups: the true PEA and the pseudo-PEA. The cardiac arrest is still an emergency with a bad prognosis.

Picture of pulseless electrical activity