Resuscitation最新文献

{"title":"Prehospital Antiplatelet Therapy In Patients With Out-Of-Hospital Cardiac Arrest Suspected Of Acute Coronary Syndrome.","authors":"Pierre Charleux, Juliette Chommeloux, Anthony Elhadad, Niki Procopi, Paul Guedeney, Clélia Martinez, Stéphanie Rouanet, Patrick Ecollan, Eric Vicaut, Alain Combes, Martin Dres, A Demoule, Mathieu Kerneis, Johanne Silvain, Gilles Montalescot, Michel Zeitouni","doi":"10.1016/j.resuscitation.2025.110596","DOIUrl":"https://doi.org/10.1016/j.resuscitation.2025.110596","url":null,"abstract":"<p><strong>Background: </strong>There are currently no specific guidelines for prehospital antiplatelet therapy in patients with out-of-hospital cardiac arrest (OHCA) associated with acute coronary syndrome (ACS). This study aims to evaluate the efficacy and safety of a prehospital antiplatelet loading dose in patients with OHCA suspected of ACS referred to a cardiac catheterization laboratory (cath lab).</p><p><strong>Methods: </strong>We included consecutive patients referred for coronary angiography within 24 hours after OHCA from 2012 to 2024. Prehospital antiplatelet treatment was defined as prescribing aspirin alone and/or a P2Y12 inhibitor before admission to the cath lab. Outcomes included: all-cause death at 30 days, in-hospital major adverse cardiovascular events (MACE), defined as a composite of all-cause death, myocardial infarction, stent thrombosis, or stroke, and in-hospital major bleeding (BARC ≥ 3). An inverse probability weighting approach was used to compare outcomes between the two groups.</p><p><strong>Results: </strong>Of the 411 patients admitted to the cath lab within 24 hours after OHCA, 217 (52.8%) received prehospital antiplatelet therapy, either aspirin alone (44.5%) or aspirin plus a P2Y12 inhibitor (8.3%). There was no difference in 30-day all-cause death between patients who received a prehospital treatment and those who did not (56.7%[50.0%;63.1%] vs 59.8%[52.8%;66.4%], p=0.280). Rates of in-hospital MACE and major bleeding were not significantly different between the two strategies. Results appear to be consistent in subgroups of patients with ST-segment elevation or successfully resuscitated patients.</p><p><strong>Conclusions: </strong>Prehospital antiplatelet therapy was safe, but showed no apparent improvement in survival or cardiovascular outcomes in patients with OHCA suspected of ACS.</p>","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":" ","pages":"110596"},"PeriodicalIF":6.5,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754250","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Low diversity of manikins used in the \"Get Trained Save Lives\" campaign.","authors":"Christoph Veigl, Sebastian Schnaubelt","doi":"10.1016/j.resuscitation.2025.110595","DOIUrl":"https://doi.org/10.1016/j.resuscitation.2025.110595","url":null,"abstract":"","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":" ","pages":"110595"},"PeriodicalIF":6.5,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143743547","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How Stepwise Interventions in Pre-Hospital Emergency Care Enhance Out-of-Hospital Cardiac Arrest Management in a Megacity in China.","authors":"Hanbing Xu, Hong Zhu, Qing He, Lin Zhang","doi":"10.1016/j.resuscitation.2025.110594","DOIUrl":"https://doi.org/10.1016/j.resuscitation.2025.110594","url":null,"abstract":"<p><strong>Objective: </strong>A series of improvements have been formulated and implemented to prompt the inadequate pre-hospital care capacity for out-of-hospital cardiac arrest (OHCA) management in China. The aim of this study is to investigate the combined association of those stepwise interventions with OHCA management in Shenzhen, as a representative city in China.</p><p><strong>Methods: </strong>This registry-based retrospective study included emergency medical services (EMS)-treated adult OHCA patients with presumed cardiac etiology in Shenzhen, China, covering the period from January 1, 2011 to December 31, 2022. During this period, three key interventions were implemented sequentially: a public access defibrillation (PAD) program on October 1, 2017, a civilian cardiopulmonary resuscitation (CPR) training program on July 1, 2020, and telecommunicator cardiopulmonary resuscitation (T-CPR) on November 23, 2021. The outcomes of bystander CPR and return of spontaneous circulation (ROSC) were compared with pre-intervention controls.</p><p><strong>Results: </strong>A total of 6,571 EMS-treated presumed cardiac etiology adult OHCA patients were included, among which were 623 cases with bystander-witnessed OHCA and a shockable rhythm. Across four periods, the rates of both bystander CPR (8.55 vs. 12.60 vs. 18.31 vs. 23.10%) and ROSC (6.01 vs. 5.29 vs. 9.59 vs. 8.33%) showed an increasing trend. For the rate of bystander CPR, the likelihood was significantly increased after implementation of the PAD program (OR 1.64 [95% CI 1.21-2.23]) and civilian CPR training program (OR 2.12 [95% CI: 1.52-2.95]), and after the addition of the T-CPR application (OR 3.06 [95% CI: 2.14-4.39]), compared with the pre-period. Similarly, cumulative interventions were associated with a higher ROSC (OR 0.84 [95% CI: 0.62-1.14], OR 1.52 [95% CI: 1.07-1.89], OR 1.42 [95% CI: 1.07-1.89]) when compared with the pre-period. In subgroup analysis, cumulative interventions significantly improved the rate of bystander CPR in cases where OHCA occurred in public locations, and ROSC in cases where the time from symptom onset to calling 120 was within 10 min.</p><p><strong>Conclusion: </strong>Stepwise interventions in pre-hospital emergency care increased likelihood of bystander CPR and ROSC following pre-hospital resuscitation significantly. This improvement is attributed to the coordination and cumulative effect of multiple positive interventions for OHCA management.</p>","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":" ","pages":"110594"},"PeriodicalIF":6.5,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143743544","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vasopressin and Steroids in addition to Adrenaline in Cardiac Arrest (VAST-A) - A Randomised Pilot Study.","authors":"Malin Albert, Sune Forsberg, Mattias Ringh, Frida Lindgren, Marie Thonander, Meena Thuccani, Araz Rawshani, Therese Djärv, Jacob Hollenberg, Leif Svensson, Johan Herlitz, Martin Jonsson, Per Nordberg, Peter Lundgren","doi":"10.1016/j.resuscitation.2025.110593","DOIUrl":"https://doi.org/10.1016/j.resuscitation.2025.110593","url":null,"abstract":"<p><strong>Background: </strong>The potential benefit of combining adrenaline, vasopressin, and corticosteroids in in-hospital cardiac arrest (IHCA) needs to be confirmed in a large clinical trial. This pilot study assesses feasibility and safety of randomising patients to this combination therapy compared to standard care.</p><p><strong>Material and methods: </strong>A randomised, double-blind, placebo-controlled pilot study was conducted from December 2022 to June 2024 across three Swedish hospitals (NCT05139849). Witnessed IHCAs meeting criteria for adrenaline were randomised 1:1 to adrenaline, vasopressin, and corticosteroids (intervention) or adrenaline and placebo (control). Primary outcomes included feasibility (e.g., protocol adherence, event times, enrolment rate), and safety. Secondary outcome was return of spontaneous circulation.</p><p><strong>Results: </strong>Of 183 screened IHCAs, 39 patients (median age 77, 64% male) were randomised (16 intervention, 23 control), with an enrolment rate of 0.8 patients/hospital bed/month. Most cardiac arrests occurred in general wards (n=17/39, 44%). In the feasibility analysis, four patients at the scene of the arrest and three patients in the intensive care unit experienced protocol deviations. Median time (minutes) from cardiac arrest to rapid response team arrival was similar between groups. Median time to adrenaline administration was 7:00 (IQR 3:00-10:00) (intervention) vs 5:00 (IQR 2:30-8:30) (control) and to vasopressin/placebo 10:30 (IQR 9:30-12:15) vs 9:00 (IQR 5:00-11:00). Return of spontaneous circulation occurred in 38% (6/16) in the intervention group and 17% (4/23) in controls.</p><p><strong>Conclusion: </strong>In this IHCA pilot study, randomisation to adrenaline, vasopressin, and corticosteroids compared to controls was safe, but feasibility needs improvement for adequate enrolment in the VAST-A main study.</p>","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":" ","pages":"110593"},"PeriodicalIF":6.5,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143743564","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Survival and neurological outcomes among OHCA patients in middle- and high-income countries in the Asia-Pacific.","authors":"Kexin Fang, Stephanie Fook-Chong, Yohei Okada, Fahad Siddiqui, Nur Shahidah, Hideharu Tanaka, Sang Do Shin, Matthew Huei-Ming Ma, Kentaro Kajino, Chih-Hao Lin, Chan-Wei Kuo, Sarah Karim, Supasaowapak Jirapong, Christina Chen, Marcus Eng Hock Ong","doi":"10.1016/j.resuscitation.2025.110592","DOIUrl":"https://doi.org/10.1016/j.resuscitation.2025.110592","url":null,"abstract":"<p><strong>Background: </strong>Currently, there is a knowledge gap on how OHCA impacts lower-resourced areas, and how they fare compared to their higher-resourced counterparts. This study aims to explore the relationship between a country's income category and neurological outcomes after OHCA in the Asia-Pacific region.</p><p><strong>Methods: </strong>A multivariable logistic regression model was applied to the prospective Pan-Asian Resuscitation Outcomes Study (PAROS) dataset. The main exposure was country income status (defined by the World Bank), and the main outcome was neurological outcomes (measured by cerebral performance category score). Sensitivity analyses were run to evaluate the robustness of our findings.</p><p><strong>Results: </strong>Out of a total of 207,450 PAROS cases between 2009-2018, 168,967 OHCA cases were included in the study. 165,404 cases were from high-income countries and 3563 cases were from middle-income countries. All pediatric, pronounced dead at scene, unknown on-scene survival status, no resuscitation attempted, and traumatic cases were excluded from the analysis. A larger proportion of OHCA patients in high-income countries survived with favorable neurological outcomes (3.65%) compared to middle-income countries (0.75%). High-income countries were associated with better neurological outcomes (AOR 9.05; 95% CI 6.27 to 13.72). Results remained consistent throughout sensitivity analyses.</p><p><strong>Conclusion: </strong>In the PAROS cohort, high-income countries outperform middle income countries in post-OHCA neurological outcomes. Further research is needed to obtain better quality data in middle-income countries and expand reach into low-income countries.</p>","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":" ","pages":"110592"},"PeriodicalIF":6.5,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143731511","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Getting to use your (defibrillation) energy, when it’s the right time","authors":"Gerrit J. Noordergraaf ,&nbsp;Bart Spruijt","doi":"10.1016/j.resuscitation.2025.110591","DOIUrl":"10.1016/j.resuscitation.2025.110591","url":null,"abstract":"","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":"210 ","pages":"Article 110591"},"PeriodicalIF":6.5,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143731481","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Eye movement detection using electrooculography and machine learning in cardiac arrest patients.","authors":"Cameron J Hill, Chelsea A Sykora, Stephen Schmugge, Samuel Tate, Michael F M Cronin, Joseph Sisto, Leigh Ann Mallinger, Allyson Reinert, Rebecca A Stafford, Brian S Tao, Naveen Arunachalam Sakthiyendran, Kerry Nguyen, Ashwin Krishnaswamy, Shruti Patil, Abrar Al-Faraj, Ika Noviawaty, Mary Russo, Brian Pugsley, Jong Woo Lee, David Greer, Min Shin, Charlene J Ong","doi":"10.1016/j.resuscitation.2025.110577","DOIUrl":"https://doi.org/10.1016/j.resuscitation.2025.110577","url":null,"abstract":"<p><strong>Aim: </strong>To train a machine learning algorithm to identify eye movement from electrooculography (EOG) in cardiac arrest (CA) patients. Neuroprognostication of comatose post-CA patients is challenging, requiring novel biomarkers to guide decision making. Eye movement may be a promising marker of arousal recovery, as pathways for eye movement and arousal share common anatomic structures. Continuous quantification of eye movement is feasible through electroencephalogram (EEG) with EOG, but manual quantification is resource-intensive.</p><p><strong>Methods: </strong>We conducted a retrospective, single-center cohort study of post-CA patients who underwent standard-of-care EEG/EOG monitoring in the intensive care unit from 2020 to 2023. We trained a machine learning algorithm to detect eye movement on one-hour of EOG data from 145,800 one-second samples from 48 patients. Performance was assessed on a reserved test set of 12-hours of EOG data from 705,600 one-second samples from 24 patients using area under the curve (AUC), sensitivity, and specificity.</p><p><strong>Results: </strong>Of 72 eligible patients, average age was 56.9 years, and 46 (63.9%) were female. In the training group of 48 patients, 35 (72.9%) survived and 32 (66.7%) followed commands. In the test group, 16 (66.7%) survived and 7 (29.2%) followed commands. Our final algorithm identified eye movement with sensitivity of 94.0%, specificity of 82.0%, and an AUC of 94.2%.</p><p><strong>Conclusion: </strong>Automated eye movement detection from EOG is highly sensitive in CA patients. Potential applications include using eye movement quantification to evaluate associations with recovery.</p>","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":" ","pages":"110577"},"PeriodicalIF":6.5,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143711078","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From surviving to thriving: A call for comprehensive cardiac arrest survivor care","authors":"Cecelia Ratay,&nbsp;Patrick J. Coppler","doi":"10.1016/j.resuscitation.2025.110590","DOIUrl":"10.1016/j.resuscitation.2025.110590","url":null,"abstract":"","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":"209 ","pages":"Article 110590"},"PeriodicalIF":6.5,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693118","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Population-based longitudinal cardiac arrest and resuscitation registry - the added value of NORCAR.","authors":"Anne-Marie Guerguerian","doi":"10.1016/j.resuscitation.2025.110587","DOIUrl":"https://doi.org/10.1016/j.resuscitation.2025.110587","url":null,"abstract":"","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":" ","pages":"110587"},"PeriodicalIF":6.5,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143674524","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of different airway devices on ventilation during cardiopulmonary resuscitation","authors":"N. Segond ,&nbsp;M. Fischer ,&nbsp;J. Fontecave-Jallon ,&nbsp;P. Podsiadlo ,&nbsp;K. Lurie ,&nbsp;A. Bellier ,&nbsp;G. Debaty","doi":"10.1016/j.resuscitation.2025.110584","DOIUrl":"10.1016/j.resuscitation.2025.110584","url":null,"abstract":"<div><h3>Purpose</h3><div>This study compared face mask, supraglottic airway device (SGA), and endotracheal tube (ETT) ventilation with mechanical ventilation (MV) during cardiopulmonary resuscitation (CPR) in the flat position and with head and thorax elevation (HTE).</div></div><div><h3>Methods</h3><div>Using thawed, fresh-frozen human cadavers this randomized cross-over study compared face mask, SGA, and ETT ventilation using an automated ventilator in the flat and HTE positions. Tidal volume (TV) was set to 8 mL/kg ideal predicted body weight, and expiratory TV (VTe) (mL/kg) was the primary endpoint. Secondary endpoints included inspiratory TV (VTi), maximal inspiratory airway pressure (Pmax), and leakage between inspiratory and expiratory tidal volumes (VTi-VTe).</div></div><div><h3>Results</h3><div>Data from 8 cadavers and 2302 ventilation cycles were analyzed. In the flat position, VTe was 7.66 ± 3.75 with ETT, 5.01 ± 3.14 with SGA, and 5.63 ± 2.83 with face mask, respectively. A mixed linear model showed the airway device significantly impacted VTe, VTi, Pmax, and VTi-VTe (<em>p</em> &lt; 0.001 for each). Compared with intubation, both face mask and SGA ventilation resulted in lower VTe, lower Pmax, and higher VTi-VTe (<em>p</em> &lt; 0.001 for each). No significant differences were observed between face mask and SGA ventilation. There were higher VTe and lower VTi-VTe values (<em>p</em> &lt; 0.001 for each) with HTE versus the flat position (<em>p</em> &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>In human cadavers undergoing CPR, mechanical ventilation through a face mask or SGA versus an ETT was associated with lower VTe, lower Pmax, and higher leakage values in human cadavers during CPR. Head and thorax elevation reduce face mask and SGA airway leakage during CPR and increase VTe.</div></div>","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":"210 ","pages":"Article 110584"},"PeriodicalIF":6.5,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143674522","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}