Der ÖGUM-Förderpreis 2010 wurde den Herren Dr. Peter Michael Zechner (Jahrg. 1984,
MU Graz) und Dr. Gernot Aichinger (Jahrg. 1982, LKH Villach) für ihre gemeinsame Arbeit
über "The presence or absence of cardiac movement identifi ed on prehospital echocardiography
predicts outcome in cardiac arrest patients" zuerkannt. Die Preisverleihung und ein
Kurzreferat über ihre Arbeit fanden im Rahmen der Generalversammlung auf dem DLT in
Mainz statt. Die ÖGUM hat mit diesem Preis wieder junge Wissenschaftler geehrt, die
sich mit innovativen Ideen von Ultraschallanwendungen auseinandergesetzt haben. Beide
Preisträger befinden sich noch in der Turnusausbildung zum Arzt für Allgemeinmedizin.
Einen Abriss ihrer prämierten Arbeit fi nden Sie unten. Beiden Preisträgern einen
herzlichen Glückwunsch und viele weitere (Ultraschall-) Erfolge in Ihrem Beruf !
The presence or absence of cardiac movement identifi ed on prehospital echocardiography
predicts outcome in cardiac arrest patients, Zechner PM, Aichinger G, Prause G, Sacherer
F, Wildner G, Anderson C, Pocivalnik M, Fox JC.
Introduction: The prognostic value of emergency echocardiography (EE) in the management
of cardiac arrest patients has only been studied in the in-hospital setting. These
studies mainly included patients who underwent CPR by emergency medicine technicians
at the scene who arrived to the emergency department (ED) in cardiac arrest. In most
European countries patients suff ering from cardiac arrest are normally treated by
physician-staff ed EMS teams on-scene. Transportation to the ED while undergoing CPR
is uncommon. The aim of our study was to evaluate the feasibility and accuracy of
prehospital on-scene EE as a predictor of outcome in cardiac arrest patients.
Dr. G. Aichinger und Dr. P.-M. Zechner
Methods: Our research was a prospective observational study of nonconsecutive, non-trauma,
adult cardiac arrest patients who were treated by physician-staff ed urban EMS teams
on-scene. Participating emergency physicians (EP) received a four-hour course in focused
echocardiography including video demonstrations, hands-on training and an introduction
into an ultrasound algorithm conform with recent ALS guidelines. After obtaining initial
stabilization procedures such as defi brillation, endotracheal intubation and vascular
access, an EE was performed during a rhythm and pulse check using a 4-2 MHz microconvex
transducer. A single subxiphoid, four-chamber view was required for study enrollment.
We defi ned sonographic evidence of cardiac kinetic activity as any detected motion
of the myocardium, ranging from visible ventricular fi brillation to coordinated ventricular
contractions. CPR had to be continued for at least 15 minutes after the initial echocardiography
in accordance.
Results: 42 patients were enrolled into the study. Feasibility was 100 %. Of the 42
study patients, fi ve (11.9 %) survived to hospital admission. Of the 32 patients
who had cardiac standstill on initial EE, only one (3.1 %) survived to hospital admission,
whereas 4 out of 10 (40 %) patients with cardiac movement on initial EE survived to
hospital admission (p = 0.008). Neither asystole on inital ECG nor peak capnography
values, age, bystander CPR or downtime were signifi cant predictors for survival in
our study. Only cardiac movement was associated with survival and cardiac standstill
at any time during CPR resulted in a positive predictive value of 97.1 % for death
at the scene.
Conclusion: Our results support the idea of focused echocardiography as a valid predictor
of outcome in CPR patients and demonstrate its feasibilty in the prehospital setting.
