当前位置： SCI文献检索 > JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY期刊下所有文献 > Diagnostic accuracy of transesophageal echocardiography during cardiopulmonary resuscitation.

Diagnostic accuracy of transesophageal echocardiography during cardiopulmonary resuscitation.

Abstract：

OBJECTIVES:We sought to establish the diagnostic accuracy of transesophageal echocardiography (TEE) during cardiopulmonary resuscitation. BACKGROUND:Because of its bedside diagnostic capabilities, excellent cardiac images and lack of interference with resuscitation efforts, TEE is ideally suited to determine the cause of a circulatory arrest that is not due to severe arrhythmia. However, the diagnostic accuracy of TEE during resuscitation is unknown. METHODS:TEE was performed in patients with prolonged circulatory arrest. The TEE diagnoses were compared with diagnoses from autopsy, surgery and clinical follow-up. RESULTS:Of the 48 study patients (29 male, 19 female, mean age +/- SD 61 +/- 20 years), 28 had an in-hospital cardiac arrest and 20 an out-of-hospital onset of arrest. Forty-four patients eventually died; four survived to discharge. The diagnoses made with TEE were cardiac tamponade (n = 6), myocardial infarction (n = 21), pulmonary embolism (n = 6), ruptured aorta (n = 1), aortic dissection (n = 4), papillary muscle rupture (n = 1), other diagnosis (n = 2) and absence of structural cardiac abnormalities (n = 7). A definite diagnosis from a reference standard was available in 31 patients. The TEE diagnosis was confirmed in 27 of the 31-by postmortem examination (n = 19), operation (n = 2), angiography (n = 2) or clinical course (n = 4). In the other four patients the TEE diagnosis proved incorrect by postmortem examination. The sensitivity, specificity and positive predictive value of TEE were 93%, 50% and 87%, respectively. In 15 patients (31%), major therapeutic decisions were based on TEE findings. CONCLUSIONS:TEE can reliably establish the cause of a circulatory arrest during cardiopulmonary resuscitation.

journal_name

J Am Coll Cardiol

journal_title

Journal of the American College of Cardiology

authors

van der Wouw PA,Koster RW,Delemarre BJ,de Vos R,Lampe-Schoenmaeckers AJ,Lie KI

doi

10.1016/s0735-1097(97)00218-0

subject

Has Abstract

pub_date

1997-09-01 00:00:00

pages

780-3

issue

eissn

0735-1097

issn

1558-3597

pii

S0735-1097(97)00218-0

journal_volume

pub_type

临床试验,杂志文章

在线工具

Diagnostic accuracy of transesophageal echocardiography during cardiopulmonary resuscitation.