Table 1 Main characteristics of the included studies
Author, year, country | Study design | Population (N) | Arrest setting | Study scene | Age (mean, SD) | PEA Sample size | Window | Sonographer | Training | Sonographic timing | Definition of cardiac activity | Make, model, transducer (MHz) | Outcome | |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Aichinger, [20] Austria | Prospective cohort | Medical (42) | OHCA | Pre-hospital | 70.3 ± 2.4 | 11 | Subxiphoid | EP | 2-h course in focused echocardiography | During a rhythm and pulse check | Any movement of myocardium | SonoSite 180(4–2-MHz) Microconvex | SHA | |
Beckett, [26] Canada | Retrospective cohort | Medical (180) | OHCA | ED | 65.3 ± 15.0 | 45 | Subxiphoid, parasternal long axis, or apical four chambers | EP | Not specified | During pulse and rhythm checks and necessary resuscitative procedures | Sustained coordinated contractility of the left ventricle, with visible valve movement | Machine not specified, curvilinear ±  phased array | ROSC, SHA, SHD | |
Blaivas, [32] USA | Prospective cohort | Medical (169) | OHCA | ED | Adult (not specified) | 38 | Subxiphoid; if unable to obtain, use parasternal views | EP or resident | Credentialed | The duration of the pulse check | Myocardial contraction | Aloka 2000(2.5) phased arrayand curvilinear | SHA | |
Breitkreutz, [21] Germany | Prospective cohort | Medical (99) Traumatic (1) Shock (130) | OHCA | Pre-hospital | 65 ± 19 | 51 | Subcostal, parasternal or apical | EP | Credentialed | During an ALS conformed interruption of CPR | Coordinated cardiac activity | Modified Tringa (3.5–5) Sonosite iLook15 (4–2) curvilinear | SHA | |
Cebicci, [18] Turkey | Retrospective cohort | Medical (392) Traumatic (18) | OHCA or ED | ED | 63.2 ± 20.7 | 75 | Not specified | EP | Certified with good experience | Not specified | Not specified | CHISON 8500, 3,5 MHz curvilinear transducer | SHA | |
Chardoli, [3], Iran | Prospective cohort | Mixed (50) | OHCA | ED | 58.0 ± 6.1 | 50 | Subxiphoid | EP | Attended a teaching course to performing echocardiography | Just in the first NFI | Mechanical ventricular activities | Not specified | ROSC | |
Chua, [23] Singapore | Prospective cohort | Mixed (100) | OHCA | ED | 68.3 ± 18.0 | 30 | Various | EP (senior resident or above) | Passed training course (lecture, simulation, live patients, multiple choice test) | During pulse checks | Not specified | SonoSite Edge II (Fujifilm SonoSite, Inc., Bothell, WA) and Terason (Teratech Corporation, Burlington, MA) ultrasound scanners | SHA | |
Cureton, [28] USA | Retrospective cohort | Trauma (318) | OHCA | ED | Adult (not specified) | 71 | Subxiphoid | EP, Trauma surgeon, resident | Not specified | Not specified | Organized cardiac contractility, non-fibrillating movement | SonoSite MicroMaxx ultrasound scanner (SonoSite, Bothell, WA), 5-MHz curvilinear probe | SHA, SHD | |
Flato, [4] Brazil | Prospective cohort | Mixed (135) | ICU | In-hospital | 59.8 ± 18.1 | 32 | Subxiphoid, apical four chambers or parasternal long and short axis | Professional personnel | Had a 60-min lecture on ALS-conformed-TTE | During the intervals for rhythm check | Intrinsic movement of the myocardium coordinated with cardiac valve movement | SonoSite M Turbo,SonoSite FujiFilm Inc., Bothell, Washington, USA and a 3-MHz sector transducer | ROSC, SHD | |
Gaspari, [27] USA & Canada | Prospective cohort | Medical (793) | OHCA or ED | ED | 64.2 ± 17.4 | 414 | Subxiphoid or parasternal long axis | EP | Credentialed | During pauses in resuscitation | Any movement of myocardium | Not specified | ROSC | |
Israr, [25] USA | Retrospective cohort | Trauma (277) | OHCA | ED | 43.1 ± 17.5 | 79 | Not specified | Trauma surgeon | Not specified | Not specified | Presence of cardiac wall motion | Not specified | SHA, SHD | |
Jaramillo, [33] Colombia | Retrospective cohort | Medical (108) | OHCA or ED | ED | 68.4 ± 13.3 | 56 | Parasternal long axis, apical four- or five chamber view, or subxiphoid | Specialized medical staff from ED | Not specified | Not specified | Predominant ventricular and valvular activity | SonoSite M-Turbo | ROSC, SHA, SHD | |
Kim, [24] Korea | Prospective cohort | Medical (48) | OHCA or ED | ED | 63.9 ± 14.5 | 8 | Subcostal or parasternal | EP or resident | ≧3 years experience | During pulse checks | Any ventricular, valvular or atrial motion | GE LOGIQS6(3.5) phased array | ROSC | |
Masoumi, [34] Iran | Prospective cohort | Medical (151) | OHCA or ED | ED | 65.3 ± 11.7 | 62 | Subxiphoid | EP | more than 6 years’ experience in emergency echocardiography | During pulse check and rhythm determination | Any visible atrial, valvular, or ventricular movement | Philips Affiniti 70 with a curved probe (2–6 MHz) | ROSC, SHD | |
Salen, [30] USA | Prospective cohort | Medical (102) | ED | ED | Adult (not specified) | 55 | Subxiphoid; the apical view as an adjunct in obese patients | EP or resident | 4 h course | During the pulse check pause of the ALS | Myocardial contraction | Pie Medical200 (3.5), GERT3200 (3.5) curvilinear | SHA | |
Salen, [31] USA | Prospective cohort | Medical (70) | OHCA or ED | Pre-hospital and ED | Adult (not specified) | 34 | Subxiphoid or parasternal | EP | Not specified | Examinations during the pulse check | Any ventricular, valvular or atrial motion | Machine not specified (3.5-MHz) sector or curvilinear | ROSC, SHA, SHD | |
Schuster, [29] USA | Retrospective and prospective cohort | Trauma (28) | OHCA or ED | ED | Adult and pediatric 8–87 (48.6 ± 20.1) | 28 | Subxiphoid or parasternal | EP, surgeon, or resident under direct supervision | Complete ultrasound training | Not specified | Organized non-fibrillating cardiac activity | Philips Envisor, phased and/ or 5-MHz curvilinear probe | ROSC, SHA, SHD | |
Tomruk, [19] Turkey | Prospective cohort | Mixed (149) | OHCA or ED | ED | 61.6 ± 17.9 | 64 | Subxiphoid | EP | Theoretical and hands-on training in cardiac ultrasonography | During the initial assessment | Any detected motion within the heart, including atrial, valvular and/or ventricular motion | Chison 600M with a 7 MHz curvilinear transducer (Chison Medical Imaging, Wuxi City, China) | ROSC | |