Unlabelled: Introduction The International Federation for Emergency Medicine (IFEM) Ultrasound Special Interest Group (USIG) was tasked with development of a hierarchical consensus approach to the use of point of care ultrasound (PoCUS) in patients with hypotension and cardiac arrest.
Methods: The IFEM USIG invited 24 recognized international leaders in PoCUS from emergency medicine and critical care to form an expert panel to develop the sonography in hypotension and cardiac arrest (SHoC) protocol. The panel was provided with reported disease incidence, along with a list of recommended PoCUS views from previously published protocols and guidelines. Using a modified Delphi methodology the panel was tasked with integrating the disease incidence, their clinical experience and their knowledge of the medical literature to evaluate what role each view should play in the proposed SHoC protocol.
Results: Consensus on the SHoC protocols for hypotension and cardiac arrest was reached after three rounds of the modified Delphi process. The final SHoC protocol and operator checklist received over 80% consensus approval. The IFEM-approved final protocol, recommend Core, Supplementary, and Additional PoCUS views. SHoC-hypotension core views consist of cardiac, lung, and inferior vena vaca (IVC) views, with supplementary cardiac views, and additional views when clinically indicated. Subxiphoid or parasternal cardiac views, minimizing pauses in chest compressions, are recommended as core views for SHoC-cardiac arrest; supplementary views are lung and IVC, with additional views when clinically indicated. Both protocols recommend use of the "4 F" approach: fluid, form, function, filling.
Conclusion: An international consensus on sonography in hypotension and cardiac arrest is presented. Future prospective validation is required.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1017/cem.2016.394 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Attenuated cardiac autonomic function in patients with long-COVID with impaired orthostatic hemodynamics.
Clin Auton Res
January 2025
Department of Cardiac Sciences, Libin Cardiovascular Institute, University of Calgary, GAC70 HRIC Building, 3280 Hospital Dr NW, Calgary, AB, T2N 4Z6, Canada.
Purpose: Long-coronavirus disease (long-COVID) is associated with initial orthostatic hypotension and postural orthostatic tachycardia syndrome. Whether altered autonomic tone underlies these abnormalities is unknown. We compared autonomic function between patients with long-COVID and healthy controls, and within patients with long-COVID with different orthostatic hemodynamic phenotypes.
View Article and Find Full Text PDFLarge-bore aspiration thrombectomy for the treatment of pulmonary embolism in octogenarians.
CVIR Endovasc
January 2025
Department of Radiology and Imaging Sciences, Indiana University School of Medicine, 550 University Blvd, Room 0641, Indianapolis, IN, 46202, USA.
Purpose: To evaluate outcomes in patients aged ≥ 80 years following large-bore aspiration thrombectomy (LBAT) for the treatment of pulmonary embolism (PE).
Materials And Methods: All patients ≥ 80 years of age with PE treated via LBAT at a single center were analyzed from September 2019 - August 2024. This included the octogenarian subgroup from a recently published retrospective analysis assessing all PE patients treated with LBAT at our center between September 2019 and January 2023.
The impact of pediatric post-cardiac arrest care on survival: A multicenter review from the AHA get with the Guidelines®-resuscitation post-cardiac arrest care registry.
Resuscitation
September 2024
Department of Anesthesiology & Critical Care, Perelman School of Medicine at the University of Pennsylvania, Children's Hospital of Philadelphia 3401 Civic Center Blvd., Philadelphia, PA 19104, USA.
Aim: Adherence to post-cardiac arrest care (PCAC) recommendations is associated with improved outcomes for adults. We aimed to describe the survival impact of meeting American Heart Association (AHA) PCAC guidelines in children after cardiac arrest.
Methods: We conducted a retrospective study using Get With The Guidelines® Resuscitation's (GWTG®-R) registry to describe the PCAC of patients ≤ 18 years old who suffered an in-hospital or out-of-hospital cardiac arrest (IHCA or OHCA).
Peri-Intubation Cardiac Arrest in a Patient With Hypertensive Cardiac Tamponade.
Cureus
December 2024
Emergency Medicine, Barts Health NHS Trust, London, GBR.
Cardiac tamponade is widely known to be associated with life-threatening hypotension and rarely with hypertension. We present the case of a 53-year-old woman with hypertension and echocardiographic features of tamponade who had a cardiac arrest on intubation. The paradoxical hypertension is thought to be due to tachycardia and increased peripheral vascular resistance resulting from the compensatory sympathetic surge following impaired cardiac filling caused by the effusion.
View Article and Find Full Text PDFCardiotoxic Effects Following CAR-T Cell Therapy: A Literature Review.
Curr Oncol Rep
January 2025
Department of Radiology, Albert Einstein College of Medicine and the Montefiore Medical Center, 111 East 210Th Street, Bronx, NY, 10461, USA.
Purpose Of Review: This paper reviewed the current literature on incidence, clinical manifestations, and risk factors of Chimeric Antigen Receptor T-cell (CAR-T) cardiotoxicity.
Recent Findings: CAR-T therapy has emerged as a groundbreaking treatment for hematological malignancies since FDA approval in 2017. CAR-T therapy is however associated with a few side effects, among which cardiotoxicity is of significant concern.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!