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Contrast agent pooling on CT- an indicator for imminent cardiac arrest: Study
![Contrast agent pooling on CT- an indicator for imminent cardiac arrest: Study Contrast agent pooling on CT- an indicator for imminent cardiac arrest: Study](https://medicaldialogues.in/h-upload/2022/05/17/750x450_176538-contrast-agent-pooling.webp)
Taiwan: Contrast agent pooling on CT-known as the CAP sign-can be considered as an alarm for imminent cardiac arrest and poor prognosis, says a recent study in the journal BMC Emergency Medicine. In simpler words, patients with positive CAP sign are more likely to encounter imminent cardiac arrest; in contrast, less likely to survive.
Some case reports have reported the sign of contrast agent pooling (C.A.P.) in the dependent part of the venous system, which happened in the patients prior to sudden cardiac arrest. Until now, there is not enough solid evidence to address the importance of the sign. Shyh-Shyong Sim, Department of Emergency Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan, and colleagues, therefore, aimed to assess the accuracy of the C.A.P. sign in predicting imminent cardiac arrest and the association of the C.A.P. sign with patient's survival in a retrospective cohort study.
The study included all patients who visited the emergency department who received a contrast computed tomography (CT) scan and then experienced cardiac arrest at the emergency department (from January 1, 2016, to December 31, 2018). The researchers evaluated the occurrence of the C.A.P. sign on the chest or abdominal CT scan, those with ECMO were excluded. With a positive CAP sign, whether in-hospital cardiac arrest happens within an hour was the primary outcome, the CAP sign was calculated. The secondary outcome is survival to discharge.
The findings of the study were as follows:
· In the study, 128 patients were included. 8.6% (N = 11) patients had positive C.A.P. sign and 91.4% (N = 117) patients did not.
· The accuracy of C.A.P. sign in predicting cardiac arrest within 1 h was 85.94%.
· The C.A.P. sign had a positive association with IHCA within 1 h after the CT scan (adjusted odds ratio 7.35).
· The relative risk (RR) of survival to discharge was 0.90 with a positive C.A.P. sign.
"From our findings, the C.A.P. sign could be addressed as an imaging feature of circulatory failure, it could be used to predict imminent cardiac arrest," the authors wrote. "And, should be considered a warning sign for clinical physicians to provide in-time interventions for critically ill patients."
Reference:
Lee, YH., Chen, J., Chen, PA. et al. Contrast Agent Pooling (C.A.P.) sign and imminent cardiac arrest: a retrospective study. BMC Emerg Med 22, 77 (2022). https://doi.org/10.1186/s12873-022-00634-4
MSc. Biotechnology
Medha Baranwal joined Medical Dialogues as an Editor in 2018 for Speciality Medical Dialogues. She covers several medical specialties including Cardiac Sciences, Dentistry, Diabetes and Endo, Diagnostics, ENT, Gastroenterology, Neurosciences, and Radiology. She has completed her Bachelors in Biomedical Sciences from DU and then pursued Masters in Biotechnology from Amity University. She has a working experience of 5 years in the field of medical research writing, scientific writing, content writing, and content management. She can be contacted at  editorial@medicaldialogues.in. Contact no. 011-43720751
Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: editorial@medicaldialogues.in. Contact no. 011-43720751