title: Assessment of ventricular wall motion with focused echocardiography during cardiac arrest to predict survival.
abstract: OBJECTIVE
  Our primary goal is to investigate the hypothesis that in patients with a detectable ventricular wall motion (VWM) in cardiac ultrasonography (US) during cardiopulmonary resuscitation (CPR), survival rate is significantly more than in patients without VWM in US.
  
  
  METHODS
  In our prospective, single center study, 129 adult cardiac arrest (CA) patients were enrolled. Cardiac US according to Focus Assessed Transthoracic Echo (FATE) protocol was performed before CPR. Presence of VWM was recorded on forms along with demographic data, initial rhythm, CA location, presence of return of spontaneous circulation (ROSC) and time until ROSC was obtained.
  
  
  RESULTS
  129 patients were included. ROSC was obtained in 56/77 (72.7%) patients with VWM and 3/52 (5.8%) patients without VWM which is statistically significant (p > 0.001). Presence of VWM is 95% (95% CI: 0.95-0.99) sensitive and 70% (95% CI: 0.58-0.80) specific for ROSC. 43/77 (55.8%) patients with VWM and 1 (1.9%) of 52 patients without VWM survived to hospital admission which was statistically significant (p < 0.001). Presence of VWM was 100% (95% CI: 0.87-1.00) sensitive and 54% (95% CI: 0.43-0.64) specific for survival to hospital admission.
  
  
  CONCLUSIONS
  No patient without VWM in US survived to hospital discharge. Only 3 had ROSC in emergency department and only 1 survived to hospital admission. This data suggests no patient without VWM before the onset of CPR survived to hospital discharge and this may be an indication to end resuscitative efforts early in these patients.
authors.affiliation: Marmara University, Department of Emergency Medicine, Istanbul, Turkey.
authors.forename: Can
authors.initials: C
authors.lastname: Ozen
authors.affiliation: Marmara University, Department of Emergency Medicine, Istanbul, Turkey.
authors.forename: Emre
authors.initials: E
authors.lastname: Salcin
authors.affiliation: Marmara University, Department of Emergency Medicine, Istanbul, Turkey.
authors.forename: Haldun
authors.initials: H
authors.lastname: Akoglu
authors.affiliation: Marmara University, Department of Emergency Medicine, Istanbul, Turkey.
authors.forename: Ozge
authors.initials: O
authors.lastname: Onur
authors.affiliation: Marmara University, Department of Emergency Medicine, Istanbul, Turkey.
authors.forename: Arzu
authors.initials: A
authors.lastname: Denizbasi
keywords: Cardiopulmonary resuscitation; Echocardiography; Ultrasonography; Ventricular wall motion