Ehsan Bolvardi; Roohie Farzaneh
Abstract
Introduction: Echocardiography or cardiac imaging is proposed as a gold standard method for identifying high risk patients for cardiac arrest. In this systematic review, we studied the prognostic value of cardiac sonography in patients with cardiac arrest. Methods: PubMed was searched for the relevant ...
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Introduction: Echocardiography or cardiac imaging is proposed as a gold standard method for identifying high risk patients for cardiac arrest. In this systematic review, we studied the prognostic value of cardiac sonography in patients with cardiac arrest. Methods: PubMed was searched for the relevant articles. Case reports were not included. Inclusion criteria were all the studies applied transthorasic echocardiography in patients with cardiac arrest arrived at emergency department that studied the efficacy of this modality on patients survived to emergency discharge and returned to spontaneous circulation.Result: Overall, 870 articles were obtained through initial search and only nine articles were included after the evaluation of the title, abstract, and the full text. Echocardiography has high sensitivity and specificity in predicting the return of spontaneous circulation.Conclusion: Cardiac sonography is a fairly effective (not definitive) modality in predicting death in patients with lack of cardiac activity during resuscitation. Echocardiography should not be the sole basis for the decision to cease resuscitative efforts.
Jafar Malmir; Ehsan Bolvardi; Monavar Afzal Aghaee
Abstract
The severe sepsis and septic shock are as common and lethal that emergency physicians routinely confront. Actually, more than two thirds of sepsis patients present initially to the ED. Only a few laboratory tests for markers of sepsis are currently available. The serum lactate level can help in determining ...
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The severe sepsis and septic shock are as common and lethal that emergency physicians routinely confront. Actually, more than two thirds of sepsis patients present initially to the ED. Only a few laboratory tests for markers of sepsis are currently available. The serum lactate level can help in determining prognosis and to risk-stratify patients with severe sepsis. This independent review of the literature includes 83 studies published in all electronic-based database such as Elsevier, PubMed, and SID during the last 18 years (40–320 patients in each). Data gathered from English language articles and books published between 1995 and 2013. The serum lactate concentrations measured in almost all patients with severe sepsis raised at admission and were higher in patients who had the worst outcomes such as higher Apache-II and SOFA score. Serum lactate was associated with mortality independent of clinically apparent organ dysfunction and shock in patients with severe sepsis admitted to the emergency department and intensive care unit. This review focuses on the association between initial and serial serum lactate level and mortality in patients presenting to the emergency department with severe sepsis.