PDF(Pubmed)
Abstract：
UNASSIGNED: Intra-arrest transthoracic echocardiography (TTE) and transesophageal echocardiography (TEE) have been introduced in adult patients with cardiac arrest (CA). Whether the diagnostic performance of TTE or TEE is superior during resuscitation is unclear. We conducted a systematic review following PRISMA guidelines.
UNASSIGNED: We searched databases from PubMed, Embase, and Google Scholar and evaluated articles with intra-arrest TTE and TEE in adult patients with non-traumatic CA. Two authors independently screened and selected articles for inclusion; they then dual-extracted study characteristics and target conditions (pericardial effusion, aortic dissection, pulmonary embolism, myocardial infarction, hypovolemia, left ventricular dysfunction, and sonographic cardiac activity). We performed quality assessment using the Quality Assessment of Diagnostic Accuracy Studies Version 2 criteria.
UNASSIGNED: A total of 27 studies were included: 14 studies with 2,145 patients assessed TTE; and 16 with 556 patients assessed TEE. A high risk of bias or applicability concerns in at least one domain was present in 20 studies (74%). Both TTE and TEE found positive findings in nearly one-half of the patients. The etiology of CA was identified in 13% (271/2,145), and intervention was performed in 38% (102/271) of patients in the TTE group. In patients who received TEE, the etiology was identified in 43% (239/556), and intervention was performed in 28% (68/239). In the TEE group, a higher incidence regarding the etiology of CA was observed, particularly for those with aortic dissection. However, the outcome of those with aortic dissection in the TEE group was poor.
UNASSIGNED: While TEE could identify more causes of CA than TTE, sonographic cardiac activity was reported much more in the TTE group. The impact of TTE and TEE on the return of spontaneous circulation and further survival was still inconclusive in the current dataset.
UNASSIGNED: We searched databases from PubMed, Embase, and Google Scholar and evaluated articles with intra-arrest TTE and TEE in adult patients with non-traumatic CA. Two authors independently screened and selected articles for inclusion; they then dual-extracted study characteristics and target conditions (pericardial effusion, aortic dissection, pulmonary embolism, myocardial infarction, hypovolemia, left ventricular dysfunction, and sonographic cardiac activity). We performed quality assessment using the Quality Assessment of Diagnostic Accuracy Studies Version 2 criteria.
UNASSIGNED: A total of 27 studies were included: 14 studies with 2,145 patients assessed TTE; and 16 with 556 patients assessed TEE. A high risk of bias or applicability concerns in at least one domain was present in 20 studies (74%). Both TTE and TEE found positive findings in nearly one-half of the patients. The etiology of CA was identified in 13% (271/2,145), and intervention was performed in 38% (102/271) of patients in the TTE group. In patients who received TEE, the etiology was identified in 43% (239/556), and intervention was performed in 28% (68/239). In the TEE group, a higher incidence regarding the etiology of CA was observed, particularly for those with aortic dissection. However, the outcome of those with aortic dissection in the TEE group was poor.
UNASSIGNED: While TEE could identify more causes of CA than TTE, sonographic cardiac activity was reported much more in the TTE group. The impact of TTE and TEE on the return of spontaneous circulation and further survival was still inconclusive in the current dataset.
摘要：
■在患有心脏骤停（CA）的成年患者中引入了骤停经胸超声心动图（TTE）和经食道超声心动图（TEE）。在复苏期间，TTE或TEE的诊断性能是否优越尚不清楚。我们遵循PRISMA指南进行了系统审查。
■我们从PubMed搜索了数据库，Embase,和GoogleScholar，并评估了非创伤性CA成年患者中TTE和TEE的停搏内文章。两位作者独立筛选并选择纳入的文章；然后他们双重提取研究特征和目标条件（心包积液，主动脉夹层,肺栓塞,心肌梗塞,血容量不足,左心功能不全,和超声检查心脏活动）。我们使用诊断准确性研究质量评估第2版标准进行质量评估。
■共纳入27项研究：14项研究对2,145名患者进行了TTE评估；16项研究对556名患者进行了TEE评估。在20项研究中（74％）存在至少一个领域的高偏倚或适用性风险。TTE和TEE都在近一半的患者中发现了阳性结果。在13%(271/2,145)中确定了CA的病因，TTE组中38%(102/271)的患者进行了干预.在接受TEE的患者中，病因在43%(239/556)中被确定，进行干预的比例为28%(68/239)。在TEE组,观察到CA的病因发生率较高，尤其是主动脉夹层。然而,TEE组主动脉夹层患者的结局较差.
■虽然TEE比TTE可以识别更多的CA原因，据报道，TTE组的超声心脏活动更多。在当前数据集中，TTE和TEE对自发循环恢复和进一步生存的影响仍不确定。
■我们从PubMed搜索了数据库，Embase,和GoogleScholar，并评估了非创伤性CA成年患者中TTE和TEE的停搏内文章。两位作者独立筛选并选择纳入的文章；然后他们双重提取研究特征和目标条件（心包积液，主动脉夹层,肺栓塞,心肌梗塞,血容量不足,左心功能不全,和超声检查心脏活动）。我们使用诊断准确性研究质量评估第2版标准进行质量评估。
■共纳入27项研究：14项研究对2,145名患者进行了TTE评估；16项研究对556名患者进行了TEE评估。在20项研究中（74％）存在至少一个领域的高偏倚或适用性风险。TTE和TEE都在近一半的患者中发现了阳性结果。在13%(271/2,145)中确定了CA的病因，TTE组中38%(102/271)的患者进行了干预.在接受TEE的患者中，病因在43%(239/556)中被确定，进行干预的比例为28%(68/239)。在TEE组,观察到CA的病因发生率较高，尤其是主动脉夹层。然而,TEE组主动脉夹层患者的结局较差.
■虽然TEE比TTE可以识别更多的CA原因，据报道，TTE组的超声心脏活动更多。在当前数据集中，TTE和TEE对自发循环恢复和进一步生存的影响仍不确定。
