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Post-resüsitatif Bakımda Yatakbaşı Ultrasonografinin Rolü

Year 2026, Volume: 8 Issue: 1 , 43 - 46 , 31.03.2026
https://izlik.org/JA69SL76YD

Abstract

Amaç: Bu sunum, spontan dolaşımın geri dönüşü (ROSC) sonrası post-resüsitatif bakımda yatakbaşı ultrasonografinin (POCUS) kullanım alanlarını ve önemini vurgulamayı amaçlamaktadır.
Gereç ve Yöntem: Kardiyak arrest sonrası sağkalım, hızlı müdahale ve resüsitasyon sonrası bakımın kalitesine bağlıdır. ROSC sağlansa bile, post-resüsitatif dönemdeki yönetim, hasta sonlanımlarını doğrudan etkiler. Bu bildiri, kardiyak arrest sonrası POCUS kullanımına ilişkin güncel literatür ve uluslararası kılavuzlar taranarak hazırlanmıştır.
Bulgular: POCUS, ROSC sonrası geri döndürülebilir nedenlerin (kardiyak tamponad, pulmoner emboli, pnömotoraks, hipovolemi) saptanmasında yüksek tanısal doğruluk sağlar. Ekokardiyografi ile post-arrest miyokard disfonksiyonu (PAMD) ve bölgesel duvar hareket kusurları (RWMA) değerlendirilebilir; ancak RWMA’nın akut koroner sendrom için spesifik olmadığı unutulmamalıdır. Hemodinamik yönetimde, sıvı yanıtı ve toleransının tahmininde POCUS yol göstericidir; pozitif sıvı dengesi mortalite ile ilişkilidir. USG kılavuzluğunda santral venöz kateterizasyon komplikasyonları %70 oranında azaltır. Akciğer USG, mekanik ventilasyon ayarlarının (PEEP, inspiratuar basınç) optimizasyonuna yardımcı olur. Transkraniyal Doppler, serebral kan akımını değerlendirir; ilk 72 saatte prognostik değeri sınırlıyken, 5-7. günde yüksek akım hızları kötü prognozla ilişkilidir.
Sonuç: POCUS, post-resüsitatif bakımda tanısal ve yönetimsel süreçlerin ayrılmaz bir parçasıdır. Multimodal ve akılcı kullanımı, kardiyak arrest sonrası hasta sonlanımlarını iyileştirme potansiyeline sahiptir.

Ethical Statement

Bu kongre bildirisi için etik kurul onay gerekmemektedir.

Supporting Institution

Bu kongre bildirisi herhangi bir fon desteği almamıştır.

Thanks

Bu bildiri, 12-14 Şubat 2026 tarihleri arasında Konya'da düzenlenen 2. Uluslararası Acil Akademik Tıp Kongresi'nde sunulmuştur.

References

  • Latsios G, Sanidas E, Velliou M, Nikitas G, Bounas P, Parisis C, et al. Cardiac arrest: Pre-hospital strategies to facilitate successful resuscitation and improve recovery rates. World J Cardiol. 2025;17:100782. DOI: 10.4330/wjc.v17.i1.100782.
  • Wong A, Vignon P, Robba C. How I use ultrasound in cardiac arrest. Intensive Care Med. 2023;49(12):1531-4. DOI: 10.1007/s00134-023-07249-8.
  • Long B, Adrian RJ, Gottlieb M. Emergency medicine updates: Point-of-care ultrasound in cardiac arrest. Am J Emerg Med. 2026;99:176-87. DOI: 10.1016/j.ajem.2025.09.021.
  • Ávila-Reyes D, Acevedo-Cardona AO, Gómez-González JF, Echeverry-Piedrahita DR, Aguirre-Flórez M, Giraldo-Diaconeasa A. Point-of-care ultrasound in cardiorespiratory arrest (POCUS-CA): narrative review article. Ultrasound J. 2021;13(1):46. DOI: 10.1186/s13089-021-00249-5.
  • Savastano S, Baldi E, Schnaubelt S, Auricchio A. Post resuscitation ST-segment elevation: When a few minutes make the difference between a class I and a class III indication for immediate coronary angiography. Resuscitation. 2023;192:109971. DOI: 10.1016/j.resuscitation.2023.109971.
  • Rao SV, O’Donoghue ML, Ruel M, Rab T, Tamis-Holland JE, Alexander JH, et al. 2025 ACC/AHA/ACEP/NAEMSP/SCAI Guideline for the Management of Patients With Acute Coronary Syndromes: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. 2025;151(13):e771-862. DOI: 10.1161/CIR.0000000000001309.
  • Mauriello A, Marrazzo G, Del Vecchio GE, Ascrizzi A, Roma AS, Correra A, et al. Echocardiography in Cardiac Arrest: Incremental Diagnostic and Prognostic Role during Resuscitation Care. Diagnostics. 2024;14(18):2107. DOI: 10.3390/diagnostics14182107.
  • Nolan JP, Sandroni C, Böttiger BW, Cariou A, Cronberg T, Friberg H, et al. European Resuscitation Council and European Society of Intensive Care Medicine Guidelines 2021: Post-resuscitation care. Resuscitation. 2021;161:220-69. DOI: 10.1016/j.resuscitation.2021.02.012.
  • Elfwén L, Hildebrand K, Schierbeck S, Sundqvist M, Ringh M, Claesson A, et al. Focused cardiac ultrasound after return of spontaneous circulation in cardiac-arrest patients. Resuscitation. 2019;142:16-22. DOI: 10.1016/j.resuscitation.2019.06.282.
  • Gaspari R, Weekes A, Adhikari S, Noble VE, Nomura JT, Theodoro D, et al. Emergency department point-of-care ultrasound in out-of-hospital and in-ED cardiac arrest. Resuscitation. 2016;109:33-9. DOI: 10.1016/j.resuscitation.2016.09.018.
  • Imazio M, De Ferrari GM. Cardiac tamponade: an educational review. Eur Heart J Acute Cardiovasc Care. 2021;10(1):102-9. DOI: 10.1177/2048872620939341.
  • Gonzalez MS, Basnight MA, Appleton CP. Experimental pericardial effusion: relation of abnormal respiratory variation in mitral flow velocity to hemodynamics and diastolic right heart collapse. J Am Coll Cardiol. 1991;17(1):239-48. DOI: 10.1016/0735-1097(91)90735-s.
  • Pérez C, Diaz-Caicedo D, Almanza Hernández DF, Moreno-Araque L, Yepes AF, Carrizosa Gonzalez JA. Critical Care Ultrasound in Shock: A Comprehensive Review of Ultrasound Protocol for Hemodynamic Assessment in the Intensive Care Unit. J Clin Med. 2024;13(18):5344. DOI: 10.3390/jcm13185344.
  • Comess KA, DeRook FA, Russell ML, Tognazzi-Evans TA, Beach KW. The incidence of pulmonary embolism in unexplained sudden cardiac arrest with pulseless electrical activity. Am J Med. 2000;109(5):351-6. DOI: 10.1016/s0002-9343(00)00506-0.
  • Beshara M, Bittner EA, Goffi A, Berra L, Chang MG. Nuts and bolts of lung ultrasound: utility, scanning techniques, protocols, and findings in common pathologies. Crit Care. 2024;28(1):328. DOI: 10.1186/s13054-024-05102-y.
  • Seif D, Perera P, Mailhot T, Riley D, Mandavia D. Bedside ultrasound in resuscitation and the rapid ultrasound in shock protocol. Crit Care Res Pract. 2012;2012:503254. DOI: 10.1155/2012/503254.
  • Fletcher DJ, Boller M. Fluid Therapy During Cardiopulmonary Resuscitation. Front Vet Sci. 2021;7:625361. DOI: 10.3389/fvets.2020.625361.
  • Didier J, Murris J, Schopper H, Guérin E, Flajoliet N, Amiot M, et al. Fluid balance after cardiac arrest: Any impact on outcome? Insights from the MIMIC IV database. Resusc Plus. 2025;25:101037. DOI: 10.1016/j.resplu.2025.101037.
  • Renaudier M, Lascarrou JB, Chelly J, Lesieur O, Bourenne J, Jaubert P, et al. Fluid balance and outcome in cardiac arrest patients admitted to intensive care unit. Crit Care. 2025;29(1):152. DOI: 10.1186/s13054-025-05391-x.
  • Tsotsolis N, Tsirgogianni K, Kioumis I, Pitsiou G, Baka S, Papaiwannou A, et al. Pneumothorax as a complication of central venous catheter insertion. Ann Transl Med. 2015;3(3):40. DOI: 10.3978/j.issn.2305-5839.2015.02.11.
  • Lopes NLG, Amaral VH, Minozzi MS, Guazzelli Pitta Madureira P, Zagne Braz L, da Hora Passos R. Lung ultrasound in the management of mechanical ventilation in pediatric critical care: a narrative review. Front Pediatr. 2025;13:1630918. DOI: 10.3389/fped.2025.1630918.
  • Bianchini A, Pintus L, Vitale G, Mazzotta E, Felicani C, Zangheri E, et al. Lung Ultrasound in Mechanical Ventilation: A Purposive Review. Diagnostics. 2025;15(7):870. DOI: 10.3390/diagnostics15070870.
  • Lau VI, Arntfield RT. Point-of-care transcranial Doppler by intensivists. Crit Ultrasound J. 2017;9(1):21. DOI: 10.1186/s13089-017-0077-9.
  • Meunier J, Engrand N, Saulnier P, Deye N, Landais M, Cariou A, et al. Transcranial Doppler goal-directed therapy after cardiac arrest (GOODYEAR): a feasibility study. Resusc Plus. 2025;25:101001. DOI: 10.1016/j.resplu.2025.101001.
  • Reichenbach A, Alteheld L, Henriksen J, Nakstad ER, Andersen GØ, Sunde K, et al. Transcranial Doppler during the first week after cardiac arrest and association with 6-month outcomes. Front Neurol. 2023;14:1222401. DOI: 10.3389/fneur.2023.1222401.
  • Sayed MS, Radi AMAE, Mohamed MF, Eltaher AF. Predicting the neurological outcome in survivors of cardiopulmonary resuscitation by transcranial Doppler measurement values. Egypt J Crit Care Med. 2025;12:11. DOI: 10.1007/s44349-025-00023-3.

The Role of Point-of-care Ultrasound in Post-resuscitation Care

Year 2026, Volume: 8 Issue: 1 , 43 - 46 , 31.03.2026
https://izlik.org/JA69SL76YD

Abstract

Objective: This presentation aims to highlight the utility and importance of point-of-care ultrasound (POCUS) in post-resuscitation care following the return of spontaneous circulation (ROSC).
Material and Method: Survival after cardiac arrest depends on rapid intervention and the quality of post-resuscitation care. Even after achieving ROSC, management during the post-resuscitation period directly influences patient outcomes. This conference proceeding was prepared by scanning the current literature and international guidelines on the use of POCUS after cardiac arrest.
Results: POCUS provides high diagnostic accuracy in identifying reversible causes after ROSC, including cardiac tamponade, pulmonary embolism, pneumothorax, and hypovolemia. Echocardiography allows assessment of post-arrest myocardial dysfunction (PAMD) and regional wall motion abnormalities (RWMA); however, RWMA is not specific for acute coronary syndrome. In hemodynamic management, POCUS helps predict fluid responsiveness and tolerance; positive fluid balance is associated with increased mortality. Ultrasound guidance reduces central venous catheterization complications by up to 70%. Lung ultrasound aids in optimizing mechanical ventilation settings (PEEP, inspiratory pressure). Transcranial Doppler evaluates cerebral blood flow; while its prognostic value is limited in the first 72 hours, high flow velocities on days 5-7 correlate with poor outcomes.
Conclusion: POCUS is an integral part of diagnostic and management processes in post-resuscitation care. Its multimodal and rational use has the potential to improve patient outcomes after cardiac arrest.

References

  • Latsios G, Sanidas E, Velliou M, Nikitas G, Bounas P, Parisis C, et al. Cardiac arrest: Pre-hospital strategies to facilitate successful resuscitation and improve recovery rates. World J Cardiol. 2025;17:100782. DOI: 10.4330/wjc.v17.i1.100782.
  • Wong A, Vignon P, Robba C. How I use ultrasound in cardiac arrest. Intensive Care Med. 2023;49(12):1531-4. DOI: 10.1007/s00134-023-07249-8.
  • Long B, Adrian RJ, Gottlieb M. Emergency medicine updates: Point-of-care ultrasound in cardiac arrest. Am J Emerg Med. 2026;99:176-87. DOI: 10.1016/j.ajem.2025.09.021.
  • Ávila-Reyes D, Acevedo-Cardona AO, Gómez-González JF, Echeverry-Piedrahita DR, Aguirre-Flórez M, Giraldo-Diaconeasa A. Point-of-care ultrasound in cardiorespiratory arrest (POCUS-CA): narrative review article. Ultrasound J. 2021;13(1):46. DOI: 10.1186/s13089-021-00249-5.
  • Savastano S, Baldi E, Schnaubelt S, Auricchio A. Post resuscitation ST-segment elevation: When a few minutes make the difference between a class I and a class III indication for immediate coronary angiography. Resuscitation. 2023;192:109971. DOI: 10.1016/j.resuscitation.2023.109971.
  • Rao SV, O’Donoghue ML, Ruel M, Rab T, Tamis-Holland JE, Alexander JH, et al. 2025 ACC/AHA/ACEP/NAEMSP/SCAI Guideline for the Management of Patients With Acute Coronary Syndromes: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. 2025;151(13):e771-862. DOI: 10.1161/CIR.0000000000001309.
  • Mauriello A, Marrazzo G, Del Vecchio GE, Ascrizzi A, Roma AS, Correra A, et al. Echocardiography in Cardiac Arrest: Incremental Diagnostic and Prognostic Role during Resuscitation Care. Diagnostics. 2024;14(18):2107. DOI: 10.3390/diagnostics14182107.
  • Nolan JP, Sandroni C, Böttiger BW, Cariou A, Cronberg T, Friberg H, et al. European Resuscitation Council and European Society of Intensive Care Medicine Guidelines 2021: Post-resuscitation care. Resuscitation. 2021;161:220-69. DOI: 10.1016/j.resuscitation.2021.02.012.
  • Elfwén L, Hildebrand K, Schierbeck S, Sundqvist M, Ringh M, Claesson A, et al. Focused cardiac ultrasound after return of spontaneous circulation in cardiac-arrest patients. Resuscitation. 2019;142:16-22. DOI: 10.1016/j.resuscitation.2019.06.282.
  • Gaspari R, Weekes A, Adhikari S, Noble VE, Nomura JT, Theodoro D, et al. Emergency department point-of-care ultrasound in out-of-hospital and in-ED cardiac arrest. Resuscitation. 2016;109:33-9. DOI: 10.1016/j.resuscitation.2016.09.018.
  • Imazio M, De Ferrari GM. Cardiac tamponade: an educational review. Eur Heart J Acute Cardiovasc Care. 2021;10(1):102-9. DOI: 10.1177/2048872620939341.
  • Gonzalez MS, Basnight MA, Appleton CP. Experimental pericardial effusion: relation of abnormal respiratory variation in mitral flow velocity to hemodynamics and diastolic right heart collapse. J Am Coll Cardiol. 1991;17(1):239-48. DOI: 10.1016/0735-1097(91)90735-s.
  • Pérez C, Diaz-Caicedo D, Almanza Hernández DF, Moreno-Araque L, Yepes AF, Carrizosa Gonzalez JA. Critical Care Ultrasound in Shock: A Comprehensive Review of Ultrasound Protocol for Hemodynamic Assessment in the Intensive Care Unit. J Clin Med. 2024;13(18):5344. DOI: 10.3390/jcm13185344.
  • Comess KA, DeRook FA, Russell ML, Tognazzi-Evans TA, Beach KW. The incidence of pulmonary embolism in unexplained sudden cardiac arrest with pulseless electrical activity. Am J Med. 2000;109(5):351-6. DOI: 10.1016/s0002-9343(00)00506-0.
  • Beshara M, Bittner EA, Goffi A, Berra L, Chang MG. Nuts and bolts of lung ultrasound: utility, scanning techniques, protocols, and findings in common pathologies. Crit Care. 2024;28(1):328. DOI: 10.1186/s13054-024-05102-y.
  • Seif D, Perera P, Mailhot T, Riley D, Mandavia D. Bedside ultrasound in resuscitation and the rapid ultrasound in shock protocol. Crit Care Res Pract. 2012;2012:503254. DOI: 10.1155/2012/503254.
  • Fletcher DJ, Boller M. Fluid Therapy During Cardiopulmonary Resuscitation. Front Vet Sci. 2021;7:625361. DOI: 10.3389/fvets.2020.625361.
  • Didier J, Murris J, Schopper H, Guérin E, Flajoliet N, Amiot M, et al. Fluid balance after cardiac arrest: Any impact on outcome? Insights from the MIMIC IV database. Resusc Plus. 2025;25:101037. DOI: 10.1016/j.resplu.2025.101037.
  • Renaudier M, Lascarrou JB, Chelly J, Lesieur O, Bourenne J, Jaubert P, et al. Fluid balance and outcome in cardiac arrest patients admitted to intensive care unit. Crit Care. 2025;29(1):152. DOI: 10.1186/s13054-025-05391-x.
  • Tsotsolis N, Tsirgogianni K, Kioumis I, Pitsiou G, Baka S, Papaiwannou A, et al. Pneumothorax as a complication of central venous catheter insertion. Ann Transl Med. 2015;3(3):40. DOI: 10.3978/j.issn.2305-5839.2015.02.11.
  • Lopes NLG, Amaral VH, Minozzi MS, Guazzelli Pitta Madureira P, Zagne Braz L, da Hora Passos R. Lung ultrasound in the management of mechanical ventilation in pediatric critical care: a narrative review. Front Pediatr. 2025;13:1630918. DOI: 10.3389/fped.2025.1630918.
  • Bianchini A, Pintus L, Vitale G, Mazzotta E, Felicani C, Zangheri E, et al. Lung Ultrasound in Mechanical Ventilation: A Purposive Review. Diagnostics. 2025;15(7):870. DOI: 10.3390/diagnostics15070870.
  • Lau VI, Arntfield RT. Point-of-care transcranial Doppler by intensivists. Crit Ultrasound J. 2017;9(1):21. DOI: 10.1186/s13089-017-0077-9.
  • Meunier J, Engrand N, Saulnier P, Deye N, Landais M, Cariou A, et al. Transcranial Doppler goal-directed therapy after cardiac arrest (GOODYEAR): a feasibility study. Resusc Plus. 2025;25:101001. DOI: 10.1016/j.resplu.2025.101001.
  • Reichenbach A, Alteheld L, Henriksen J, Nakstad ER, Andersen GØ, Sunde K, et al. Transcranial Doppler during the first week after cardiac arrest and association with 6-month outcomes. Front Neurol. 2023;14:1222401. DOI: 10.3389/fneur.2023.1222401.
  • Sayed MS, Radi AMAE, Mohamed MF, Eltaher AF. Predicting the neurological outcome in survivors of cardiopulmonary resuscitation by transcranial Doppler measurement values. Egypt J Crit Care Med. 2025;12:11. DOI: 10.1007/s44349-025-00023-3.
There are 26 citations in total.

Details

Primary Language Turkish
Subjects Emergency Medicine, Radiology and Organ Imaging
Journal Section Other
Authors

Ömer Jaradat 0000-0002-6177-710X

Submission Date February 20, 2026
Acceptance Date February 26, 2026
Publication Date March 31, 2026
IZ https://izlik.org/JA69SL76YD
Published in Issue Year 2026 Volume: 8 Issue: 1

Cite

Vancouver 1.Ömer Jaradat. Post-resüsitatif Bakımda Yatakbaşı Ultrasonografinin Rolü. Phnx Med J. [Internet]. 2026 Mar. 1;8(1):43-6. Available from: https://izlik.org/JA69SL76YD

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