Enhancing Cardiopulmonary Resuscitation: A Hemodynamic Approach Using Doppler Ultrasound and Echocardiography

Abstract

Background: Effective cardiopulmonary resuscitation (CPR) is critical for survival after cardiac arrest. Traditional methods of assessing CPR effectiveness, such as pulse palpation, have limitations. This study investigated the utility of Doppler ultrasound and echocardiography for real-time hemodynamic assessment during CPR. Objectives: The objectives of this research were to evaluate the effectiveness of CPR using Doppler ultrasound and echocardiography and to correlate these findings with patient demographics, presenting symptoms, medical history, and resuscitation outcomes. Methods: This one-year descriptive study enrolled 100 adult patients requiring CPR in the emergency department of Be'sat Nahaja Hospital. Data collected included patient demographics, presenting complaints, medical history, vital signs, and hemodynamic parameters [peak systolic velocity (PSV), pulse peak point, and ejection fraction (EF)] obtained via Doppler ultrasound and echocardiography during CPR. Statistical analysis, including repeated measures two-way ANOVA, was performed to assess the relationship between these variables and resuscitation outcomes [return of spontaneous circulation (ROSC) and survival to hospital admission]. Results: The mean age of patients was 63.46 years, with 68% being male and 70% experiencing out-of-hospital cardiac arrests. Return of spontaneous circulation was achieved in 22% of cases, and survival to hospital admission was 17%. Hemodynamic parameters, including PSV, pulse peak point, and EF, varied significantly across CPR phases. Successful cases showed higher values during active cardiac massage (e.g., mean PSV of 75.3 cm/s in successful cases vs. 11.8 cm/s in unsuccessful cases). A four-phase classification of cardiac activity was proposed based on these parameters, ranging from "No Effective Cardiac Activity" (PSV/pulse peak point/EF ≤ 10 cm/s) to "Effective Cardiac Activity" (> 40 cm/s). Conclusions: Doppler ultrasound and echocardiography provide valuable real-time hemodynamic assessment during CPR, offering objective measures of cardiac function and blood flow that correlate with resuscitation outcomes. These technologies can aid in the evaluation of CPR effectiveness.