Evidence map›Paper›PMID 41484784›Full record

Trial reportCritical care (London, England)2026

Prehospital transesophageal echocardiography versus conventional advanced life support in out-of-hospital cardiac arrest (PHTEE-OHCA) - a randomized controlled pilot study.

Stephan Katzenschlager, Nikolai Kaltschmidt, Maximilian Dietrich, Mascha Fiedler-Kalenka, Sascha Klemm, Othmar Kofler, Stefan Mohr, Christoph Eisner, Christopher Neuhaus, Christoph Simon and 3 more

Abstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Critical care (London, England), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

13 authors.

Stephan KatzenschlagerMedical Faculty Heidelberg, Department of Anesthesiology, Heidelberg University, Im Neuenheimer Feld 420, Heidelberg, 69120, Germany. stephan.katzenschlager@med.uni-heidelberg.de.
Nikolai KaltschmidtMedical Faculty Heidelberg, Department of Anesthesiology, Heidelberg University, Im Neuenheimer Feld 420, Heidelberg, 69120, Germany.
Maximilian DietrichMedical Faculty Heidelberg, Department of Anesthesiology, Heidelberg University, Im Neuenheimer Feld 420, Heidelberg, 69120, Germany.
Mascha Fiedler-KalenkaMedical Faculty Heidelberg, Department of Anesthesiology, Heidelberg University, Im Neuenheimer Feld 420, Heidelberg, 69120, Germany.
Sascha KlemmMedical Faculty Heidelberg, Department of Anesthesiology, Heidelberg University, Im Neuenheimer Feld 420, Heidelberg, 69120, Germany.
Othmar KoflerMedical Faculty Heidelberg, Department of Anesthesiology, Heidelberg University, Im Neuenheimer Feld 420, Heidelberg, 69120, Germany.
Stefan MohrMedical Faculty Heidelberg, Department of Anesthesiology, Heidelberg University, Im Neuenheimer Feld 420, Heidelberg, 69120, Germany.
Christoph EisnerMedical Faculty Heidelberg, Department of Anesthesiology, Heidelberg University, Im Neuenheimer Feld 420, Heidelberg, 69120, Germany.
Christopher NeuhausMedical Faculty Heidelberg, Department of Anesthesiology, Heidelberg University, Im Neuenheimer Feld 420, Heidelberg, 69120, Germany.
Christoph SimonMedical Faculty Heidelberg, Department of Anesthesiology, Heidelberg University, Im Neuenheimer Feld 420, Heidelberg, 69120, Germany.
Markus A WeigandMedical Faculty Heidelberg, Department of Anesthesiology, Heidelberg University, Im Neuenheimer Feld 420, Heidelberg, 69120, Germany.
Frank WeilbacherMedical Faculty Heidelberg, Department of Anesthesiology, Heidelberg University, Im Neuenheimer Feld 420, Heidelberg, 69120, Germany.
Erik PoppMedical Faculty Heidelberg, Department of Anesthesiology, Heidelberg University, Im Neuenheimer Feld 420, Heidelberg, 69120, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundTransesophageal echocardiography during out-of-hospital cardiac arrest can be performed during ongoing chest compressions and may improve resuscitation quality, but its prehospital use has not been systematically evaluated. To assess the feasibility, diagnostic yield, and impact of prehospital TEE on resuscitation metrics and advanced life support (ALS) interventions during OHCA.

methodsWe conducted a randomized controlled trial in a physician-staffed two-tiered emergency medical service (EMS). Adults with ongoing non-traumatic OHCA were randomized 1:1 to standard ALS or ALS plus TEE. The primary endpoints were hands-off time and chest compression fraction (CCF) from EMS arrival to return of spontaneous circulation (ROSC) or resuscitation termination. Secondary endpoints included ROSC at hospital admission, survival to hospital discharge, neurological status at hospital discharge, and TEE findings. Analyses followed the intention-to-treat principle.

resultsOf 249 screened patients, 35 were randomized and 32 analyzed (TEE n = 15; control n = 17). Median hands-off time was 4 s in both groups. Mean CCF was higher in the TEE group (96.2%) than the control group (91.6%), with a mean difference of 4.6% (95% confidence interval 2.5-6.7; p < 0.001). Sustained ROSC occurred in 40% (TEE) versus 71% (control; p = 0.083). The control group had an eCPR rate of 41%, compared to 20% in the TEE group. Using TEE, an incorrect area of maximal compression or inadequate depth was identified in 23% and 14%, respectively.

conclusionPrehospital TEE during OHCA was feasible without negatively interfering with CPR metrics, and provided clinically relevant diagnostic information and procedural guidance, warranting further evaluation in larger trials.

trial registrationGerman Clinical Trials Register DRKS00028695 registered on 28 April 2022.

Indexed as

Advanced Cardiac Life SupportEchocardiography, TransesophagealOut-of-Hospital Cardiac ArrestAgedCardiopulmonary ResuscitationEmergency Medical ServicesFemaleHumansMaleMiddle AgedPilot ProjectsAdvanced life supportEmergency medical service, extracorporeal cardiopulmonary resuscitationOut-of-hospital cardiac arrestTransesophageal echocardiography

Identifiers

PMID41484784
PMCPMC12849066

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.