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Mortality in patients with hepatic gas on point‐of‐care ultrasound in cardiac arrest: Does location matter?
Author(s) -
Ramamurti Pradip,
Yamane David,
Desai Sajani,
Boniface Keith,
Drake Aaran
Publication year - 2020
Publication title -
journal of clinical ultrasound
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.272
H-Index - 61
eISSN - 1097-0096
pISSN - 0091-2751
DOI - 10.1002/jcu.22952
Subject(s) - medicine , resuscitation , context (archaeology) , ultrasound , incidence (geometry) , cardiopulmonary resuscitation , retrospective cohort study , emergency department , radiology , surgery , paleontology , physics , biology , optics , psychiatry
Purpose Prior research has suggested an association of hepatic venous gas with mortality in cardiac arrest. As point of care ultrasound (POCUS) is frequently used in the context of resuscitation, we sought to evaluate if the presence of hepatic gas on POCUS had a similar mortality association. Methods A retrospective review was conducted of patients who experienced nontraumatic cardiac arrest. Archived ultrasound images were independently reviewed to determine the presence of gas in the hepatic parenchyma and vasculature. Electronic medical records were then reviewed to collect remaining clinical data. Results From 1 January 2017 through 16 June 2019, 87 patients met inclusion criteria. Among them, 68 (78.2%) patients died. Among those who died, 40 (58.8%) had hepatic gas, while 28 (41.2%) had none. Only a single survivor demonstrated hepatic venous gas (11%). While the difference in mortality with respect to presence of undifferentiated hepatic gas was not significant ( P = .37), there was a significant difference with respect to the presence of venous gas ( P = .004). Conclusion Our study demonstrated that the incidence of postarrest hepatic gas on POCUS was common, and that the presence of hepatic venous gas during cardiac resuscitation was associated with increased mortality, while hepatic parenchymal gas alone was not.