Resuscitation最新文献

{"title":"Association of emergency physician critical care training on outcomes after non-traumatic out-of-hospital cardiac arrest (OHCA).","authors":"Julian Kreutz, Susanne Betz, Franziska Hof, Birgit Markus, Klevis Mihali, Tobias Gruebl, Martin C Sassen, Bernhard Schieffer, Andreas Jerrentrup","doi":"10.1016/j.resuscitation.2026.111264","DOIUrl":"10.1016/j.resuscitation.2026.111264","url":null,"abstract":"<p><strong>Background: </strong>In physician-staffed emergency medical services (EMS) systems, emergency physicians may differ in postgraduate specialist and critical care training. Whether such differences are associated with outcomes after out-of-hospital cardiac arrest (OHCA) remains uncertain. We investigated the association between emergency physician qualification and outcomes after non-traumatic OHCA.</p><p><strong>Methods: </strong>This retrospective cohort study included adult patients with non-traumatic OHCA from the Marburg-Biedenkopf EMS region from 2018 to 2024. Patients were treated by residents, specialists without additional critical care training, or specialists with additional critical care training. The primary outcome was survival to discharge. Secondary outcomes included return of spontaneous circulation (ROSC), hospital admission with ROSC, 24-h survival, and favorable neurological outcome. Multivariable logistic regression was performed for each endpoint with residents as reference.</p><p><strong>Results: </strong>Among 1426 patients, any ROSC did not differ significantly between groups (39.9%, 42.5%, and 45.7%; p = 0.211). Operational response times and time to first ROSC were comparable. Specialists with additional critical care training achieved faster vascular access and earlier vasopressor administration, with fewer access failures. Survival to discharge increased across groups (12.2%, 14.4%, and 18.0%; p = 0.047). In adjusted analyses, specialists with additional critical care training had higher odds of hospital admission with ROSC (OR 1.42, 95% CI 1.05-1.93) and survival to discharge (OR 1.59, 95% CI 1.05-2.40) compared with residents.</p><p><strong>Conclusions: </strong>Additional critical care training was associated with selected prehospital procedural measures and higher odds of hospital admission with ROSC and survival to discharge. These observational findings are hypothesis-generating and do not establish causality.</p>","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":" ","pages":"111264"},"PeriodicalIF":6.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148761960","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":"Traumatic Emergency Thoracotomy for Resuscitation in Shock (TETRiS): a national service evaluation of resuscitative thoracotomy practice outside the operating theatre.","authors":"Lisa Ramage, Harriet Tucker, Max Er Marsden, Jared M Wohlgemut, Salman Naeem, Michael Christian, Ross Davenport, Zane B Perkins","doi":"10.1016/j.resuscitation.2026.111371","DOIUrl":"https://doi.org/10.1016/j.resuscitation.2026.111371","url":null,"abstract":"<p><strong>Background: </strong>Resuscitative thoracotomy (RT) is performed in patients with traumatic cardiac arrest or peri-arrest to treat potentially reversible causes of circulatory collapse. Optimal patient selection and timing remain uncertain, and existing evidence is largely retrospective, often excluding prehospital deaths. This prospective service evaluation examined contemporary RT practice and outcomes across a national major trauma system, including prehospital and emergency department settings.</p><p><strong>Methods: </strong>Prospective 12-month observational study across 20 UK Helicopter Emergency Medical Services and 26 Major Trauma Centre Emergency Departments, using the PHOTON, TERN, and NaTRIC research networks.</p><p><strong>Results: </strong>A total of 116 patients underwent RT, of which 82 (70.7%) were performed prehospital. Median age was 30 years, 97 patients (83.6%) were male, and 81 (69.8%) sustained penetrating injury. Suspected cardiac tamponade was the most common indication for RT (72/116 [62.1%]), although operative findings demonstrated exsanguinating haemorrhage in 82 patients (70.7%). Overall, 50 patients (43.1%) achieved return of spontaneous circulation and eight (6.9%) survived to hospital discharge. Survival was strongly associated with pathophysiological cause, duration of arrest, and physiological state at the time of intervention, with substantially better outcomes observed in patients with cardiac tamponade than exsanguination. Patients undergoing emergency department RT demonstrated shorter arrest durations, more favourable physiology, and higher survival than those undergoing prehospital RT. There were no survivors beyond 10 minutes of traumatic cardiac arrest.</p><p><strong>Conclusion: </strong>In this prospective national evaluation of RT practice, outcomes were strongly associated with the pathophysiological cause and duration of arrest, and the residual physiology present at the time of intervention. The most favourable outcomes were observed in patients with cardiac tamponade and those undergoing RT before irreversible physiological deterioration.</p>","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":" ","pages":"111371"},"PeriodicalIF":6.0,"publicationDate":"2026-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149288706","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":"Lessons learned from a paediatric OHCA ECPR program embedded in a regional program.","authors":"Anne-Marie Guerguerian","doi":"10.1016/j.resuscitation.2026.111374","DOIUrl":"https://doi.org/10.1016/j.resuscitation.2026.111374","url":null,"abstract":"","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":" ","pages":"111374"},"PeriodicalIF":6.0,"publicationDate":"2026-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149288615","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":"Beyond the stopwatch: the physiological cost of pulse checks during CPR.","authors":"Sonia D'Arrigo, Claudio Sandroni","doi":"10.1016/j.resuscitation.2026.111377","DOIUrl":"https://doi.org/10.1016/j.resuscitation.2026.111377","url":null,"abstract":"","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":" ","pages":"111377"},"PeriodicalIF":6.0,"publicationDate":"2026-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149288653","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":"Reduced montage EEG in neuro-prognostication after pediatric cardiac arrest.","authors":"Tanner Hoke, Réjean M Guerriero","doi":"10.1016/j.resuscitation.2026.111369","DOIUrl":"https://doi.org/10.1016/j.resuscitation.2026.111369","url":null,"abstract":"","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":" ","pages":"111369"},"PeriodicalIF":6.0,"publicationDate":"2026-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149288629","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":"Closest to the patient, furthest from survival? Reframing the family witness for out-of-hospital cardiac arrest in our aging world.","authors":"Parker Frankiewicz, Audrey L Blewer","doi":"10.1016/j.resuscitation.2026.111367","DOIUrl":"https://doi.org/10.1016/j.resuscitation.2026.111367","url":null,"abstract":"","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":" ","pages":"111367"},"PeriodicalIF":6.0,"publicationDate":"2026-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149288709","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":"Comparison of delivery room wrist versus earlobe pulse oximetry in newborns: A randomized controlled trial.","authors":"Sushil Kumar, Kirti Naranje, Anita Singh, Akanksha Verma, Abhishek Paul, Abhijeet Roy, Prabhakar Mishra","doi":"10.1016/j.resuscitation.2026.111365","DOIUrl":"https://doi.org/10.1016/j.resuscitation.2026.111365","url":null,"abstract":"<p><strong>Objective: </strong>Rapid acquisition of reliable pulse oximetry signals in delivery room is challenging due to transitional circulation, low peripheral perfusion, motion artifact, vernix, and skin edema. This randomized controlled trial compared right earlobe and right wrist pulse oximetry to determine differences in time to reliable signal acquisition.</p><p><strong>Methods: </strong>Pregnant women at ≥34 weeks gestation were randomized before delivery. Pulse oximetry probe was applied to either the right earlobe or right wrist immediately after birth using sensor-to-oximeter-first technique with Masimo® SET® rainbow® Radical-7® CO-Oximeter®. The primary outcome was time from completion of sensor application to reliable display of oxygen saturation and heart rate. Secondary outcomes included time from birth to start of sensor application, sensor application time, time from birth to reliable signal, perfusion index, and number of probe reapplications.</p><p><strong>Results: </strong>Ninety-six neonates were randomized, with 48 in each group. Time from completion of sensor application to reliable signal was similar between ear and wrist groups (67.1±41.4 vs 74.5±48.2 seconds; mean difference -7.4 seconds; 95% CI -25.6 to 10.8; P=0.42). Sensor application time was shorter in ear group (mean difference -16.3 seconds; 95% CI -17.7 to -14.9; P<0.001), resulting in shorter time from birth to reliable signal (mean difference -28.8 seconds; 95% CI -53.9 to -3.7; P=0.02). Perfusion index was lower, and reapplication rates were higher in ear group.</p><p><strong>Conclusion: </strong>Time to reliable signal acquisition after probe placement did not differ between the earlobe and wrist. Further studies using neonatal-specific ear probes are warranted.</p>","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":" ","pages":"111365"},"PeriodicalIF":6.0,"publicationDate":"2026-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149246248","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":"Pitfalls in assessing graft outcomes from donors initially treated with ECPR for out-of-hospital cardiac arrest","authors":"Tal Soumagnac, Jean-Herlé Raphalen, Damien Vimpere, Alice Hutin, Lionel Lamhaut","doi":"10.1016/j.resuscitation.2026.111368","DOIUrl":"https://doi.org/10.1016/j.resuscitation.2026.111368","url":null,"abstract":"","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":"1 1","pages":""},"PeriodicalIF":6.5,"publicationDate":"2026-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149231812","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":"Fatigue, Anxiety and Depression 12 Months After Out-of-Hospital Cardiac Arrest: A Population Based Cohort Study.","authors":"Daniel O Okyere, Emily Nehme, Janet Bray, Katie N Dainty, Ashanti Dantanarayana, Ziad Nehme","doi":"10.1016/j.resuscitation.2026.111359","DOIUrl":"https://doi.org/10.1016/j.resuscitation.2026.111359","url":null,"abstract":"<p><strong>Aim: </strong>To determine the prevalence and factors associated with fatigue, anxiety, and depression 12 months after out-of-hospital cardiac arrest (OHCA); examine their associations with health-related quality of life (HRQoL) and functional recovery; and compare symptom burden with population norms.</p><p><strong>Methods: </strong>This prospective, population-based cohort study included adults (≥18 years) who received EMS-attempted resuscitation and survived to hospital discharge following non-traumatic OHCA in Victoria, Australia, between July 2019 and June 2022. Survivors were identified from a statewide OHCA registry and completed a 12-month telephone interview. Primary outcomes were fatigue (Modified Fatigue Impact Scale), anxiety and depression (Hospital Anxiety and Depression Scale). Secondary outcomes included HRQoL (EQ-5D, SF-12), functional recovery (GOSE), living arrangement, and return to work.</p><p><strong>Results: </strong>Of 1068 eligible 12-month survivors, 728 (68.2%) completed follow-up (median age 61 years; 555 [76.2%] male). Fatigue was reported by 35.8% (250/699), anxiety by 22.6% (162/716), and depression by 18.0% (129/716). Higher symptom burden was associated with lower EQ-5D and SF-12 scores, worse GOSE outcomes (all p<0.001) and reduced return-to-work rates. Compared with population norms, survivors reported greater fatigue (SMD 0.64; 95%CI, 0.50-0.78;p<0.001), and depression (SMD, 0.12; 95%CI, 0.02,0.21;p=0.02) but lower anxiety (SMD, -0.27; 95%CI, -0.35 to -0.18;p<0.001). In adjusted models, younger age, preexisting anxiety or depression, diabetes and initial non-shockable arrest were associated with higher symptom burden, whereas EMS-witnessed arrests were associated with lower symptom burden.</p><p><strong>Conclusions: </strong>Fatigue, anxiety, and depression were common at 12 months after OHCA and are associated with poorer recovery. Fatigue exceeded population norms and may be an under-recognised component of cardiac arrest survivorship.</p>","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":" ","pages":"111359"},"PeriodicalIF":6.0,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149228552","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":"Identifying the Operational Bottleneck to Shock Delivery After Automated External Defibrillator Activation.","authors":"Tsuyoshi Nojima, Tetsuya Yumoto, Takafumi Obara, Kohei Tokioka, Takashi Hongo, Yoshinori Kosaki, Kohei Tsukahara, Atsunori Nakao, Hiromichi Naito","doi":"10.1016/j.resuscitation.2026.111361","DOIUrl":"https://doi.org/10.1016/j.resuscitation.2026.111361","url":null,"abstract":"<p><strong>Introduction: </strong>Cardiac arrest registries record automated external defibrillator (AED) use and shock delivery but not post-activation operational timing. We aimed to identify the largest measurable bottleneck and an exploratory pad-application target for shock delivery within 60 seconds of AED power-on.</p><p><strong>Methods: </strong>We retrospectively analyzed timestamps from remotely monitored Nihon Kohden AEDs between January 2018 and February 2026. After excluding inspection records, we grouped records into activation events and quantified intervals. Shock-timing and receiver operating characteristic (ROC) analyses were restricted to initially shock-advised events with recorded shock delivery.</p><p><strong>Results: </strong>We analyzed 8,115 activation events. Median times were 42 seconds (interquartile range [IQR], 30-56) from power-on to completion of pad application, nine seconds (IQR, 9-11) from pad application to the first analysis, and 52 seconds (IQR, 40-66) from power-on to the first analysis endpoint. The power-on-to-pad-application interval accounted for a median of 81% (IQR, 75-85) of the total power-on-to-first-analysis interval, increasing to 87% (IQR, 85-90) when first analysis occurred more than 60 seconds after power-on. Among 900 initially shock-advised events with recorded shock delivery, the median pad-application-to-shock interval was 15 seconds (IQR 13-17). Exploratory ROC analysis yielded a power-on to pad-application threshold of ≥ 51 seconds in relation to first recorded shock delivery occurring more than 60 seconds after AED power-on.</p><p><strong>Conclusions: </strong>The interval from AED power-on to electronically detected completion of pad application, encompassing all intervening actions, was the largest measurable post-activation bottleneck. Completion within 50 seconds may serve as an exploratory process target for first recorded shock delivery within 60 seconds among initially shock-advised events.</p>","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":" ","pages":"111361"},"PeriodicalIF":6.0,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149228535","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}