The correct answer is D
The Resus Room covered this systematic review last week.
Results about prognostication using ultrasound in PEA-arrest were included from 10 papers. Half of which (5) reported ROSC as the primary outcome. A combined 188 patients had no cardiac motion on ultrasound of which 26 (13,8 percent) still achieved ROSC or survival to hospital admission or 24-h survival.
Indeed it seems quite a lot of patients (13,8 percent) still achieved ROSC or better. However, the vast majority of these cases (20 out of 26) came from one paper.
This brings up the issue of definition of cardiac motion (if only the valves are moving, is that a moving heart?) and even ROSC which may vary between physicians (and papers). Furthermore, this paper does not give us any numbers on survival to discharge with good neurologic outcome.
Anyway these numbers tell us the absence of cardiac motion on its own does not mean you are dealing with a hopeless case as some of these patients may still achieve ROSC or better. On the other hand, combined with duration of CRP, underlying disease and age it can certainly help make the call to stop resuscitation efforts.
Ultrasound in Cardiac Arrest