Intra-arrest transoesophageal echocardiographic findings and resuscitation outcomes

Background/Aim: The relationship between echocardiographic findings of intra-arrest TEE and resuscitation outcomes was not clearly identified. We assessed echocardiographic findings observed in intra-arrest TEE and its relationship with resuscitation outcomes. Methods: This retrospective observational study analysed adult patients with non-traumatic out-of-hospital cardiac arrest who underwent TEE during cardiopulmonary resuscitation in the emergency department. Patients were grouped according to the presence of specific TEE findings with cardiac arrest. Resuscitation outcomes were compared between groups. Results: The study enrolled 158 patients (108 males, median age: 72.5 years), 40 (25.3%) patients (TEE positive group) had specific TEE findings including possible causes of cardiac arrest in 31 (19.6%) and the sequela of cardiac arrest in 9 (5.7%) while 118 (74.7%) patients (TEE negative group) had no specific TEE findings. In the TEE positive group, TEE identified possible causes of cardiac arrest including aortic dissection in 19 (47.5%), pulmonary embolism in 8 (20.0%), cardiac tamponade in 4 (10.0%), and the sequela of cardiac arrest including intracardiac thrombi in 9 (22.5%) patients. No patients in the TEE positive group and 7 patients (5.9%) in the TEE negative group survived to hospital discharge. Return of spontaneous circulation rates were 27.5% and 39.8% in the TEE positive and TEE negative groups, respectively (p = 0.16). Conclusion: Intra-arrest TEE identifies specific findings related to causes of cardiac arrest. Presence of specific findings is associated with poor resuscitation outcomes.