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The Ultrasound Journal

Table 2 Prognostic test performance of POCUS findings stratified according to cardiac activity definition, initial cardiac rhythm and level of POCUS training

From: The role of point-of-care ultrasound (POCUS) imaging in clinical outcomes during cardiac arrest: a systematic review

PICO

Subgroup

Outcomes

Author (year)

Sensitivity (95% CI)

Specificity (95% CI)

Does presence of cardiac activity on pre-hospital POCUS predict clinical outcomes during cardiac arrest

Initial cardiac arrest rhythm

PEA

SHA

Aichinger (2012)

1.00 (0.25–1.00)

0.70 (0.35–0.93)

Breitkreutz (2010)

0.95 (0.77–1.00)

0.41 (0.24–0.61)

Asystole

SHA

Aichinger (2012)

0.50 (0.13–0.99)

1.00 (0.81–1.00)

Breitkreutz (2010)

0.69 (0.39–0.91)

0.83 (0.62–0.95)

VF/VT

SHA

Aichinger (2012)

1.00 (0.15–1.00)

0.67 (0.30–0.93)

Definition of cardiac activity

Unspecified cardiac activity

SHA

Breitkreutz (2010)

0.86 (0.70–0.94)

0.60 (0.47–0.725)

Any movement of the myocardium

SHA

Aichinger (2012)

0.80 (0.31–0.97)

0.84 (0.68–0.93)

Does presence of cardiac activity on in-hospital (ICU & ED) POCUS predict clinical outcomes of cardiac arrest patients

Initial cardiac arrest rhythm

PEA

ROSC

Chardoli (2012)

1.00 (0.81–1.00)

0.33 (0.18–0.52)

 

Kim (2016)

1.00 (0.54–1.00)

0.50 (0.01–0.99)

 

Salen (2005)

1.00 (0.63–1.00)

0.88 (0.70–0.98)

 

Tomruk (2012)

0.43 (0.26–0.61)

0.76 (0.56–0.90)

 

SHA

Cureton (2012)

0.80 (0.28–0.99)

0.80 (0.69–0.89)

 

Cebicci (2014)

0.93 (0.82–0.99)

0.93 (0.78–0.99)

 

Blaivas (2001)

1.00 (0.74–1.00)

0.77 (0.56 – 0.91)

 

Chua (2017)

0.67 (0.22–0.96)

0.88 (0.68–0.97)

 

Salen (2001)

0.89 (0.52–1.00)

0.50 (0.35–0.65)

Asystole

ROSC

Kim (2016)

0.0 (0.0–0.16)

1.00 (0.81–1.00)

 

Salen (2005)

0.0

1.00 (0.90–1.00)

 

Tomruk (2012)

0.11 (0.03–0.26)

0.97 (0.87–1.00)

 

SHA

Cebicci (2014)

1.00 (0.15–1.00)

1.00 (0.98–1.00)

 

Blaivas (2001)

0.0

1.00 (0.94–1.00)

 

Chua (2017)

0.67 (0.30–0.93)

0.85 (0.72–0.94)

 

Salen (2001)

0.0 (0.0–0.98)

0.91 (0.77–0.98)

VF/VT

ROSC

Kim (2016)

1.00 (0.03–100)

0.0

 

Tomruk (2012)

0.0 (0.0–0.60)

1.00 (0.40–1.00)

 

SHA

Cebbici (2014)

0.94 (0.79–0.99)

0.62 (0.32–0.86)

 

Blaivas (2001)

1.00 (0.63–1.00)

0.88 (0.76–0.95)

 

Salen (2001)

1.00 (0.29–1.00)

0.50 (0.16–0.84)

Definition of cardiac activity

Unspecified cardiac activity

ROSC

Lien (2018)

0.62 (0.50–0.73)

0.98 (0.95–100)

 

Bolvardi (2016)

0.73 (0.60–0.84)

0.92 (0.85–0.96)

 

SHA

Breitkreutz (2010)

0.86 (0.70–0.94)

0.60 (0.47–0.73)

 

Cebbici (2014)

0.94 (0.86–0.97)

0.98 (0.95–0.99)

 

Chua (2017)

0.72 (0.48–0.88)

0.84 (0.75–0.91)

 

SHD

Lien (2018)

0.48 (0.28–0.69)

0.77 (0.69–0.83)

Any movement of the myocardium

ROSC

Gaspari (2016)

0.64 (0.57–0.70)

0.78 (0.74–0.81)

  

Thandar (2023)

0.52 (0.33–0.71)

0.95 (0.86–0.98)

 

SHA

Aichinger (2012)

0.80 (0.31–0.97)

0.84 (0.68–0.93)

  

Blaivas (2001)

0.98 (0.71–1.00)

0.91 (0.85–0.95)

  

Gaspari (2016)

0.67 (0.58–0.75)

0.73 (0.69–0.76)

  

Thandar (2023)

0.31 (0.13–0.57)

0.84 (0.77–0.89)

 

SHD

Gaspari (2016)

0.77 (0.48–0.92)

0.68 (0.64–0.71)

  

Thandar (2023)

0.50 (0.06–0.94)

0.83 (0.73–0.90)

  

Zengin (2016)

0.40 (0.10–0.80)

0.77 (0.67–0.84)

Any atrial, valvular or ventricular Movement

ROSC

Chardoli (2012)

1.00 (0.81–1.00)

0.33 (0.18–0.52)

  

Hayhurst (2010)

0.92 (0.59–0.99)

0.76 (0.60–0.87)

  

Kim (2016)

0.25 (0.11–0.45)

0.95 (0.75–1.00)

  

Salen (2005)

0.94 (0.49–1.00)

0.94 (0.85–0.98)

  

Masoumi (2021)

0.61 (0.44–0.75)

0.82 (0.74–0.88)

  

Ozen (2016)

0.95 (0.85–0.98)

0.70 (0.58–0.80)

  

Tomruk (2012)

0.26 (0.17–0.37)

0.89 (0.80–0.95)

 

SHA

Hayhurst (2010)

0.80 (0.31–0.97)

0.64 (0.50–0.77)

  

Masoumi (2021)

0.75 (0.52–0.89)

0.79 (0.71–0.85)

  

Ozen (2016)

0.98 (0.86–1.00)

0.60 (0.49–0.70)

 

SHD

Tayal (2003)

1.00 (0.59–1.00)

0.62 (0.32–0.86)

  

Masoumi (2021)

0.85 (0.42–0.99)

0.74 (0.66–0.81)

Organized cardiac activity

ROSC

Atkinson (2019)

0.34 (0.21–0.49)

0.96 (0.91–0.99)

  

Flato (2015)

0.53 (0.35–0.70)

0.38 (0.13–0.68)

 

SHA

Atkinson (2019)

0.39 (0.20–0.62)

0.91 (0.86–0.95)

  

Cureton (2012)

0.86 (0.42–0.98)

0.91 (0.85–0.95)

 

SHD

Atkinson (2019)

0.67 (0.09–0.99)

0.89 (0.84–0.93)

  

Flato (2015)

1.00 (0.54–1.00)

0.51 (0.35–0.67)

Does level of POCUS training influence the ability to predict clinical outcomes of cardiac arrest

Inexperienced

ROSC

Lien (2018)

0.62 (0.50–0.73)

0.98 (0.95–100)

   

Thandar (2023)

0.52 (0.33–0.71)

0.95 (0.86–0.98)

   

Tomruk (2012)

0.26 (0.17–0.37)

0.89 (0.80–0.95)

  

SHA

Aichinger (2012)

0.80 (0.31–0.97)

0.84 (0.68–0.93)

   

Blaivas (2001)

0.98 (0.71–1.00)

0.91 (0.85–0.95)

   

Chua (2012)

0.72 (0.48–0.88)

0.84 (0.75–0.91)

   

Salen (2001)

0.85 (0.55–0.96)

0.67 (0.56–0.76)

   

Thandar (2023)

0.31 (0.13–0.57)

0.84 (0.77–0.89)

  

SHD

Lien (2018)

0.48 (0.28–0.69)

0.77 (0.69–0.83)

   

Thandar (2023)

0.50 (0.06–0.94)

0.83 (0.73–0.90)

   

Zengin (2016)

0.40 (0.10–0.80)

0.77 (0.67–0.84)

   

Tayal (2003)

1.00 (0.59–1.00)

0.62 (0.32–0.86)

 

Experienced

ROSC

Atkinson (2019)

0.34 (0.21–0.49)

0.96 (0.91–0.99)

   

Masoumi (2021)

0.61 (0.44–0.75)

0.82 (0.74–0.88)

   

Hayhurst (2010)

0.92 (0.59–0.99)

0.76 (0.60–0.87)

   

Kim (2016)

0.25 (0.11–0.45)

0.95 (0.75–1.00)

   

Ozen (2016)

0.95 (0.85–0.98)

0.70 (0.58–0.80)

   

Gaspari (2016)

0.64 (0.57–0.70)

0.78 (0.74–0.81)

  

SHA

Atkinson (2019)

0.39 (0.20–0.62)

0.91 (0.86–0.95)

   

Cureton (2012)

0.86 (0.42–0.98)

0.91 (0.85–0.95)

   

Masoumi (2021)

0.75 (0.52–0.89)

0.79 (0.71–0.85)

   

Gaspari (2016)

0.67 (0.58–0.75)

0.73 (0.69–0.76)

   

Hayhurst (2010)

0.80 (0.31–0.97)

0.64 (0.50–0.77)

   

Cebbici (2014)

0.94 (0.86–0.97)

0.98 (0.95–0.99)

  

SHD

Atkinson (2019)

0.67 (0.09–0.99)

0.89 (0.84–0.93)

   

Masoumi (2021)

0.85 (0.42–0.99)

0.74 (0.66–0.81)

   

Gaspari (2016)

0.77 (0.48–0.92)

0.68 (0.64–0.71)

   

Flato (2015)

1.00 (0.54–1.00)

0.51 (0.35–0.67)

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