Clinical application of point-of-care ultrasound during cardiopulmonary resuscitation: a systematic review and meta-analysis.

BACKGROUND: Point-of-care ultrasound (PoCUS) is now more commonly being utilized in cardiopulmonary resuscitation to offer immediate evaluation of cardiac motion and to direct management. However, the evidence is still heterogeneous. Therefore, the purpose of this systematic literature review and meta-analysis is to assess the clinical utility of PoCUS in terms of its effects on resuscitation outcomes. METHODS: A systematic review and meta-analysis were performed by searching MEDLINE, EMBASE, Cochrane Central, Web of Science, and Scopus databases. Studies on adult patients with in-hospital cardiac arrest or out-of-hospital cardiac arrest (OHCA) were included following predefined Population, Intervention, Comparison, Outcomes, and Study Design (PICOS) criteria. Two reviewers independently screened, extracted data, and appraised quality using Risk of Bias 2 (RoB 2) tool for randomized trials and the Risk of Bias in Non-randomized Studies of Interventions (ROBINS-I) tools. Subgroup and sensitivity analyses were performed to assess robustness and the presence of publication bias was evaluated. RESULTS: Pooled results of all included studies involving patient populations showed that PoCUS during cardiopulmonary resuscitation (CPR) increased the rate of the return of spontaneous circulation (ROSC) (43% vs. 28%). Survival to hospital discharge was also greater in the PoCUS group (19 % vs. 12 %). Subgroup and sensitivity analyses confirmed the robustness of the results, and no significant publication bias was found. CONCLUSIONS: This systematic review and meta-analysis indicates that performing PoCUS during CPR is associated with better clinical outcomes, including increased ROSC and survival to hospital discharge, further highlighting the potential advantages of PoCUS to assist in cardiac arrest management as well as making clinical decisions.