Transesophageal Echocardiography During CPR in Patients With Out-of-Hospital Cardiac Arrest

Does transesophageal echocardiography (TEE)–guided cardiopulmonary resuscitation (CPR) to target the left ventricle while avoiding the aortic valve improve clinical outcomes in adults with nontraumatic out-of-hospital cardiac arrest?In this cluster-randomized clinical trial involving 132 adults, TEE guidance yielded no significant differences in return of spontaneous circulation, survival, or neurological outcomes compared with conventional CPR. However, the TEE-guided group demonstrated significantly higher postintervention end-tidal carbon dioxide levels without increased adverse events.In this study, emergency department–based TEE guidance for compression site adjustment did not significantly improve clinical outcomes but appeared to enhance hemodynamic efficacy without increasing harm.

Corresponding Authors: Wen-Chu Chiang, MD, PhD, National Taiwan University Hospital, Yun-Lin Branch, Douliu City, Taiwan, No. 7, Chung-Shan S Rd, Taipei, Taiwan (drchiang.tw@gmail.com); Jen-Tang Sun, MD, MSc, Department of Emergency Medicine, Far Eastern Memorial Hospital, No. 21, Sec. 2, Nan-Ya South Rd, Ban-Qiao Dist., New Taipei City, Taiwan (tangtang05231980@gmail.com).

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