Femoral artery Doppler ultrasound is more accurate than manual palpation for pulse detection in cardiac arrest

作     者：Cohen, Allison L. Li, Timmy Becker, Lance B. Owens, Casey Singh, Neha Gold, Allen Nelson, Mathew J. Jafari, Daniel Haddad, Ghania Nello, Alexander, V Rolston, Daniel M. 

作者机构：Donald & Barbara Zucker Sch Med Hofstra Northwell Dept Emergency Med Hempstead NY USA Northwell Hlth North Shore Univ Hosp Dept Emergency Med Manhasset NY USA Northwell Hlth Feinstein Inst Med Res Manhasset NY USA Alleghany Hlth Network St Vincent Hosp Dept Emergency Med Erie NY USA 

出 版 物：《RESUSCITATION》 (复苏)

年 卷 期：2022年第173卷第0期

页      面：156-165页

核心收录：

学科分类：1002[医学-临床医学] 10[医学] 

基　　金：ZOLL Foundation 

主　　题：Cardiac arrest Cardiopulmonary resuscitation Doppler ultrasound Pulse detection 

摘      要：Objectives: Our primary objective was to assess the accuracy of Doppler ultrasound versus manual palpation in detecting any pulse with an arterial line waveform in cardiac arrest. Secondarily, we sought to determine whether peak systolic velocity (PSV) on Doppler ultrasound could detect a pulse with a systolic blood pressure (SBP) = 60 mmHg. Methods: We conducted a prospective, cross-sectional, diagnostic accuracy study on a convenience sample of adult, Emergency Department (ED) cardiac arrest patients. All patients had a femoral arterial line. During a pulse check, manual pulse detection, PSV and Doppler ultrasound clips, and SBP were recorded. A receiver operator characteristic curve analysis was performed to determine the optimal cut-off of PSV associated with a SBP = 60 mmHg. Accuracy of manual palpation and Doppler ultrasound for detection of any pulse and SBP = 60 mmHg were compared with McNemar s test. Results: 54 patients and 213 pulse checks were analysed. Doppler ultrasound demonstrated higher accuracy than manual palpation (95.3% vs. 54.0%;p = 60 mmHg was 20 cm/s (area under the curve = 0.975). To detect SBP = 60 mmHg, accuracy of a PSV = 20 cm/s was higher than manual palpation (91.4% vs. 66.2%;p = 20 cm/s, Doppler ultrasound was also more accurate for detecting a SBP = 60 mmHg.