Authors: Asaad S. Shujaa , Rasha Buhumaid , Nora Fahad Alabdulkareem , Muzn Saud Alharbi , Norah A. Bin Sulaiman , Lina Talal Alotabi

Abstract

Point-of-care ultrasound (POCUS) has emerged as a transformative diagnostic tool in cardiac arrest management, particularly for non-trauma cases, offering clinicians real-time, dynamic imaging to guide resuscitation efforts. As with any relatively new area of study, previous research on POCUS is limited, and there is a lot of heterogeneity in studies’ methods, outcomes, and practice contexts. This systematic review and meta-analysis aimed to evaluate the effectiveness of POCUS in both identifying the cause of non-traumatic cardiac arrest and improving patient outcomes during treatment. A comprehensive search of multiple databases from January 2010 to
December 2023 identified studies meeting rigorous inclusion criteria, focusing on adult patients and assessing outcomes such as return of spontaneous circulation, survival rates, and diagnostic accuracy. To support the high quality of the analysis, the quality assessment of diagnostic accuracy studies-2 tool and the Cochrane risk of bias tool were employed. Pooled analysis was undertaken using RevMan with relative risks for mortality, while the clinical setting formed the basis of the subgroup analysis. The research presented suggested that POCUS can help identify treatable causes of cardiac arrest, such as tamponade, pulmonary embolism, and hypovolemic shock, which can positively impact the chances of successful resuscitation and guide treatment during cardiopulmonary
resuscitation. Nevertheless, unlike routine diagnostics, POCUS has high diagnostic precision and therapeutic application, but still has several drawbacks: operator-dependency and unpredictable protocols. This review further emphasized the relevance of POCUS in enhancing the outcome of cardiac arrest about which prescribes a need for more national protocols with a view to enhancing its implementation.

Keywords: Point-of-care ultrasound, non-trauma cardiac arrest, diagnostic accuracy systematic review, meta-analysis.