Transesophageal Echocardiography During CPR in Patients With Out-of-Hospital Cardiac Arrest: The EXECT-CPR Randomized Clinical Trial.
Chu SE, et al. JAMA Intern Med. 2026 Mar 23. doi: 10.1001/jamainternmed.2026.0102.
Editorial: Can Transesophageal Echocardiography–Guided CPR Improve Out-of-Hospital Cardiac Arrest Outcomes?
Methodology: 3/5
Usefulness: 2/5
Question and Methods: This single center RCT of 132 adult patients with non-traumatic out of hospital cardiac arrest compared success rates of sustained ROSC for TEE guided CPR versus conventional CPR.
Findings: There was no significant difference in achievement of sustained ROSC between the TEE group (44%) and conventional CPR (39%) groups. There was a statistically significant improvement in EtCO2 from11-20 minutes after arrival to ED in the TEE group.
Limitations: Limitations include a small sample size, single site, lack of blinding and delay to initiation to TEE guided CPR.
Interpretation: Patients with OHCA may not benefit from initiation of TEE guided CPR on arrival to ED. However, TEE guided CPR does improve EtCO2 early in the initiation process and may be more effective if it can be initiated early in the provision of CPR – such as for arrests witnessed in hospital.
