Key result
Multimodal POCUS and TEE detects occult life-threatening abdominal complications following CPR.
Why the study?
Cardiopulmonary resuscitation is associated with iatrogenic thoracic and intra-abdominal complications that can cause post-resuscitation hemodynamic instability.
Case Report (n=2)
Multimodal imaging with POCUS and TEE is crucial for early identification of life-threatening intra-abdominal complications, such as hemoperitoneum and extracardiac tamponade, in patients with unexplained shock following cardiopulmonary resuscitation.
May aid diagnosis in post-CPR shock; hypothesis-generating and requires prospective validation before wider use.
Cardiopulmonary resuscitation (CPR) is associated with iatrogenic complications, including thoracic and intra-abdominal injuries. We present two cases of post-resuscitation hemodynamic instability caused by intra-abdominal hemorrhage. In the first case, hemoperitoneum from splenic injury was rapidly identified using point-of-care ultrasonography (POCUS), prompting emergent surgical intervention. In the second case, a hepatic hematoma resulted in extrinsic compression of the right atrium (RA) and right ventricle (RV), producing extracardiac tamponade physiology confirmed with transesophageal echocardiography (TEE). These cases highlight the importance of early multimodal imaging in patients with unexplained shock following return of spontaneous circulation (ROSC). These complications are relevant to anesthesiologists and intensivists, who are frequently responsible for the perioperative and critical care management of patients following cardiac arrest.
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Smart et al. (2026) conducted a case report in Post-resuscitation hemodynamic instability (n=2). Point-of-care ultrasonography (POCUS) and transesophageal echocardiography (TEE) was evaluated on Identification of occult intra-abdominal hemorrhage and extracardiac tamponade. Multimodal bedside imaging with POCUS and TEE successfully identified life-threatening intra-abdominal complications, including hemoperitoneum and extracardiac tamponade, following CPR.
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