Cause: Difference between revisions

Cardiac Arrest Ultra Sound Exam ( CAUSE )

Cardiac arrest is a condition that often occurs in the Emergency Department , Intensive Care Unit and the surgical wards .

The use of ultrasound in resuscitation plays an important role in order to differentiate between the different causes of cardiac arrest, which are not a direct consequence of a primary ventricular arrhythmia. The most common and reversible causes of cardiac arrest include: severe hypovolemia , pneumothorax , cardiac tamponade , and massive pulmonary embolism . Identifying the underlying cause of cardiac arrest is one of the biggest challenges . This is the CAUSE protocol developed .

Flow diagram of the protocol CAUSE

Source image: www.resuscitationjournal.com

Echocardiographic findings

Echocardiography is the only mode with the possibility to in real-time during a cardiac arrest without interfering with the CPR. Moreover, there may be direct when resuscitating a diagnosis and are thus time savings are made between the judgment and appropriate treatment . Below are several clinical findings that differentiate between cardiac tamponade , pneumothorax , pulmonary embolism , and severe hypovolemia secondary to abdominal aortic aneurysm .

Subcostale views Tamponade Hypovolaemia Pneumothorax Pulmonary Embolism

VCI > 20mm < 5mm > 20mm -

Many pericardial pericardium - "Sliding sign"

RV collapsed collapsed dilated -

LV - Flattened Flattened septum septum -

Ultrasound findings in a AP4Ch view . Note: images are mirrored display.

Source: Resuscitation. 2008 Feb ; 76 (2) :198-206 .

#1 pmid=22941889