Resuscitation最新文献

{"title":"Potassium disorders at intensive care unit admission and functional outcomes after cardiac arrest.","authors":"Holm Aki, Lascarrou Jean Baptiste, Cariou Alain, Reinikainen Matti, Laitio Timo, Kirkegaard Hans, Søreide Eldar, Taccone Fabio Silvio, Lääperi Mitja, B Skrifvars Markus","doi":"10.1016/j.resuscitation.2024.110439","DOIUrl":"https://doi.org/10.1016/j.resuscitation.2024.110439","url":null,"abstract":"<p><strong>Background: </strong>Abnormal serum potassium levels are commonly found in the intensive care unit (ICU) population. We aimed to determine the prevalence of potassium disorders at ICU admission and its association with functional outcomes in comatose patients resuscitated from cardiac arrest.</p><p><strong>Methods: </strong>We performed a post hoc analysis of pooled data from four randomised clinical trials involving comatose post-cardiac arrest patients admitted to ICU after return of spontaneous circulation (ROSC). Reference serum potassium levels were defined as between 3.0 and 4.9  mmol/L. An unfavourable functional outcome was defined as a cerebral performance category of 3 to 5 at 180 days. We compared potassium disturbances categorically in a mixed effects logistic regression model including initial rhythm, delay from collapse to return of spontaneous circulation, bystander cardiopulmonary resuscitation, lactate and urea at ICU admission, with normokalaemia set as the reference group.</p><p><strong>Results: </strong>We included 1133 patients (557 from the HYPERION, 346 from the TTH48, 120 from the COMACARE, and 110 from the Xe-HYPOTHECA trials) with a median age of 64 years (interquartile range 55-72) and a predominance of males (72 %); a total of 712 (64 %) patients had unfavourable functional outcomes. On admission, 221 patients (19.5 %) experienced hyperkalaemia and 35 (3.1 %) patients experienced hypokalaemia. Fewer patients in the normokalaemia group (513/877, 58.5 %) had an unfavourable functional outcome compared to the hypokalaemia (24/35, 68.6 %) and hyperkalaemia groups (180/221, 81.4 %; p < 0.001). Hyperkalaemia was associated with higher odds for an unfavourable functional outcome (adjusted odds ratio (OR) 1.85, 95 % confidence interval (CI) 1.10-3.12, p = 0.02), while hypokalaemia was not (OR 1.36 95 % CI 0.51-3.60, p = 0.53). The associations were not significant in a subgroup analysis adjusted for the modified cardiac arrest hospital prognosis score in 833 patients (OR 1.74, 95 % CI 0.91-3.34, p = 0.10 for hyperkalaemia and OR 1.48, 95 % CI 0.40-5.44, p = 0.55 for hypokalaemia).</p><p><strong>Conclusions: </strong>Of the comatose patients admitted to ICU after cardiac arrest, one in five experienced a potassium disorder on ICU admission. Hyperkalaemia was associated with unfavourable functional outcomes at 180 days, while hypokalaemia was not.</p>","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":" ","pages":"110439"},"PeriodicalIF":6.5,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142692951","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":"Spindles of hope: A new Frontier in adult neuroprognostication following cardiac arrest.","authors":"Anthony Bishara, Romergryko G Geocadin","doi":"10.1016/j.resuscitation.2024.110438","DOIUrl":"10.1016/j.resuscitation.2024.110438","url":null,"abstract":"","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":" ","pages":"110438"},"PeriodicalIF":6.5,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142682377","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":"All hands to the scopes - Time to rethink airway management in out of hospital cardiac arrest?","authors":"Richard A Field","doi":"10.1016/j.resuscitation.2024.110434","DOIUrl":"10.1016/j.resuscitation.2024.110434","url":null,"abstract":"","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":" ","pages":"110434"},"PeriodicalIF":6.5,"publicationDate":"2024-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142648949","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":"Left Percutaneous Stellate Ganglion Block to treat refractory in-hospital cardiac arrest.","authors":"Silvia Miette Pontremoli, Enrico Baldi, Alessia Currao, Simone Savastano","doi":"10.1016/j.resuscitation.2024.110436","DOIUrl":"10.1016/j.resuscitation.2024.110436","url":null,"abstract":"","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":" ","pages":"110436"},"PeriodicalIF":6.5,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142644690","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 in relation to number of defibrillation attempts in out-of-hospital cardiac arrest.","authors":"Linn Harrysson, Emma Blick, Akil Awad, Martin Jonsson, Andreas Claesson, Carl Magnusson, Lis Abazi, Johan Israelsson, Robin Hofmann, Per Nordberg, Gabriel Riva","doi":"10.1016/j.resuscitation.2024.110435","DOIUrl":"10.1016/j.resuscitation.2024.110435","url":null,"abstract":"<p><strong>Introduction/aim: </strong>Out-of-hospital cardiac arrest (OHCA) with shockable pulseless ventricular tachycardia or fibrillation not responding to defibrillation is a medical challenge. Novel treatment strategies have emerged for so-called refractory ventricular fibrillation not responding to three or more defibrillations but the evidence for optimal timing for these strategies is sparse. The primary aim of this observational study was to assess survival in relation to total numbers of defibrillations in OHCA.</p><p><strong>Methods: </strong>This is a registry-based retrospective cohort study based on data reported by the emergency medical services to the Swedish Registry of Cardiopulmonary Resuscitation and the National Patient Registry. All OHCA patients aged 18 years or older with an initial shockable rhythm in Sweden from January 1, 2010 and December 31, 2020 were included. Exposure was total number of defibrillations, and primary outcome was survival to 30 days. Logistic regression was used to adjust for patient and resuscitation characteristics.</p><p><strong>Results: </strong>Over the study period a total of 10,549 patients were included. Among them, 3,006 (28.5%) received only one shock, 1,665 (15.8%) two shocks, 1,336 (12.9%) three shocks, 1,064 (10.1%) four shocks and 3,478 (33.0%) five or more shocks. In the adjusted analysis an exponential decrease in the 30-day survival was found for each additional defibrillation. For patients receiving one, two, three and four defibrillations, the adjusted probability of survival was 42%, 36%, 30% and 25% respectively.</p><p><strong>Conclusions: </strong>In this registry-based retrospective cohort study, additional defibrillations were associated with a lower survival. This association persisted after adjustments for patient and resuscitation characteristics.</p>","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":" ","pages":"110435"},"PeriodicalIF":6.5,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142644691","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":"Drug therapy versus placebo or usual care for comatose survivors of cardiac arrest; a systematic review with meta-analysis.","authors":"Peter J McGuigan, Ellen Pauley, Glenn Eastwood, Leanne M C Hays, Janus C Jakobsen, Marion Moseby-Knappe, Alistair D Nichol, Niklas Nielsen, Markus B Skrifvars, Bronagh Blackwood, Daniel F McAuley","doi":"10.1016/j.resuscitation.2024.110431","DOIUrl":"10.1016/j.resuscitation.2024.110431","url":null,"abstract":"<p><strong>Background: </strong>In Europe, approximately 291,000 cardiac arrests occur annually. Despite critical care therapy, hospital mortality remains high. This systematic review assessed whether, in comatose survivors of cardiac arrest, any drug therapy, compared to placebo or usual care, improves outcomes.</p><p><strong>Methods: </strong>We searched Medline, EMBASE, the Cochrane Central Register of Controlled Trials, and The International Clinical Trials Registry Platform for randomized controlled trials of drug therapy in comatose survivors of cardiac arrest (last searched 20th October 2024). The primary outcome was mortality at 30 days/hospital discharge. Other outcomes reflected those of the Core Outcome Set for Cardiac Arrest. Risk of bias was assessed using Cochrane Risk-Of-Bias Version 1. Studies of steroids, coenzyme Q10 and thiamine were meta-analysed.</p><p><strong>Results: </strong>From 2562 records, 207 full texts were screened and 45 studies (5800 patients) investigating 30 therapies were included. Studies were grouped thematically as supportive drug therapies (n = 10), neuroprotective agents (n = 19), and anti-inflammatory/antioxidants (n = 16). Four studies reported reduced mortality at 30 days/hospital discharge: one of the anticholinergic penehyclidine hydrochloride, two of intra-arrest vasopressin and methylprednisolone plus hydrocortisone for post resuscitation shock, and one of the traditional Chinese medicine, shenfu. Studies of steroids, coenzyme Q10 and thiamine were meta-analysed. We could not detect an effect on mortality with steroids (n = 739, risk ratio (RR), 0.93; 95 % CI 0.83-1.04, p = 0.21; I² = 60 %, low certainty), coenzyme Q10 (n = 107, RR, 0.91; 95 % CI 0.61-1.37, p = 0.65; I² = 0 %, low certainty), or thiamine (n = 149, RR, 1.11; 95 % CI 0.88-1.40, p = 0.39; I² = 0 %, very low certainty).</p><p><strong>Conclusion: </strong>In comatose survivors of cardiac arrest, the majority of trials of drug therapy reported no effect on mortality. Meta-analyses of steroids, coenzyme Q10 and thiamine demonstrated no evidence of an effect on mortality. However, the low certainty of evidence warrants further research.</p>","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":" ","pages":"110431"},"PeriodicalIF":6.5,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142639672","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":"2024 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations: Summary From the Basic Life Support; Advanced Life Support; Pediatric Life Support; Neonatal Life Support; Education, Implementation, and Teams; and First Aid Task Forces.","authors":"Robert Greif, Janet E Bray, Therese Djärv, Ian R Drennan, Helen G Liley, Kee-Chong Ng, Adam Cheng, Matthew J Douma, Barnaby R Scholefield, Michael Smyth, Gary Weiner, Cristian Abelairas-Gómez, Jason Acworth, Natalie Anderson, Dianne L Atkins, David C Berry, Farhan Bhanji, Bernd W Böttiger, Richard N Bradley, Jan Breckwoldt, Jestin N Carlson, Pascal Cassan, Wei-Tien Chang, Nathan P Charlton, Sung Phil Chung, Julie Considine, Andrea Cortegiani, Daniela T Costa-Nobre, Keith Couper, Thomaz Bittencourt Couto, Katie N Dainty, Vihara Dassanayake, Peter G Davis, Jennifer A Dawson, Allan R de Caen, Charles D Deakin, Guillaume Debaty, Jimena Del Castillo, Maya Dewan, Bridget Dicker, Jana Djakow, Aaron J Donoghue, Kathryn Eastwood, Walid El-Naggar, Raffo Escalante-Kanashiro, Jorge Fabres, Barbara Farquharson, Joe Fawke, Maria Fernanda de Almeida, Shannon M Fernando, Emer Finan, Judith Finn, Gustavo E Flores, Elizabeth E Foglia, Fredrik Folke, Craig A Goolsby, Asger Granfeldt, Anne-Marie Guerguerian, Ruth Guinsburg, Carolina Malta Hansen, Tetsuo Hatanaka, Karen G Hirsch, Mathias J Holmberg, Stuart Hooper, Amber V Hoover, Ming-Ju Hsieh, Takanari Ikeyama, Tetsuya Isayama, Nicholas J Johnson, Justin Josephsen, Anup Katheria, Mandira D Kawakami, Monica Kleinman, David Kloeck, Ying-Chih Ko, Peter Kudenchuk, Amy Kule, Hiroshi Kurosawa, Jorien Laermans, Anthony Lagina, Kasper G Lauridsen, Eric J Lavonas, Henry C Lee, Swee Han Lim, Yiqun Lin, Andrew S Lockey, Jesus Lopez-Herce, George Lukas, Finlay Macneil, Ian K Maconochie, John Madar, Abel Martinez-Mejas, Siobhan Masterson, Tasuku Matsuyama, Richard Mausling, Christopher J D McKinlay, Daniel Meyran, William Montgomery, Peter T Morley, Laurie J Morrison, Ari L Moskowitz, Michelle Myburgh, Sabine Nabecker, Vinay Nadkarni, Firdose Nakwa, Kevin J Nation, Ziad Nehme, Tonia Nicholson, Nikolaos Nikolaou, Chika Nishiyama, Tatsuya Norii, Gabrielle Nuthall, Shinichiro Ohshimo, Theresa Olasveengen, Alexander Olaussen, Gene Ong, Aaron Orkin, Michael J Parr, Gavin D Perkins, Helen Pocock, Yacov Rabi, Violetta Raffay, James Raitt, Tia Raymond, Giuseppe Ristagno, Antonio Rodriguez-Nunez, Joseph Rossano, Mario Rüdiger, Claudio Sandroni, Taylor L Sawyer, Stephen M Schexnayder, Georg Schmölzer, Sebastian Schnaubelt, Anna Lene Seidler, Federico Semeraro, Eunice M Singletary, Markus B Skrifvars, Christopher M Smith, Jasmeet Soar, Anne Lee Solevåg, Roger Soll, Willem Stassen, Takahiro Sugiura, Kaushila Thilakasiri, Janice Tijssen, Lokesh Kumar Tiwari, Alexis Topjian, Daniele Trevisanuto, Christian Vaillancourt, Michelle Welsford, Myra H Wyckoff, Chih-Wei Yang, Joyce Yeung, Carolyn M Zelop, David A Zideman, Jerry P Nolan, Katherine M Berg","doi":"10.1016/j.resuscitation.2024.110414","DOIUrl":"10.1016/j.resuscitation.2024.110414","url":null,"abstract":"<p><p>This is the eighth annual summary of the International Liaison Committee on Resuscitation International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations; a more comprehensive review was done in 2020. This latest summary addresses the most recent published resuscitation evidence reviewed by the International Liaison Committee on Resuscitation task force science experts. Members from 6 International Liaison Committee on Resuscitation task forces have assessed, discussed, and debated the quality of the evidence, using Grading of Recommendations Assessment, Development, and Evaluation criteria, and their statements include consensus treatment recommendations. Insights into the deliberations of the task forces are provided in the Justification and Evidence-to-Decision Framework Highlights sections. In addition, the task forces list priority knowledge gaps for further research.</p>","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":" ","pages":"110414"},"PeriodicalIF":6.5,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142644689","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":"Intra-aortic balloon pump synchronized with chest compressions improves outcome during cardiopulmonary resuscitation in experimental cardiac arrest.","authors":"Emanuel M Dogan, Erika A Dogan, Kristofer F Nilsson, Måns Edström","doi":"10.1016/j.resuscitation.2024.110433","DOIUrl":"10.1016/j.resuscitation.2024.110433","url":null,"abstract":"<p><strong>Background: </strong>Intra-aortic balloon pump (IABP) and resuscitative endovascular balloon occlusion of the aorta (REBOA) are two endovascular intervention methods for circulatory support. The aim of this study was to compare the hemodynamic effects of simultaneous mechanical chest compressions (MCC) with IABP, REBOA and those with only MCC (overall and detailed in the MCC cycle) and return of spontaneous circulation (ROSC) during cardiopulmonary resuscitation (CPR) in experimental non-traumatic cardiac arrests (CA).</p><p><strong>Method: </strong>CA was electrically induced (ventricular fibrillation) in 24 anesthetized pigs, which then were randomized to MCC synchronized IABP (n = 8), total occluded REBOA (n = 8), or control (n = 8). After 10 min of CA, CPR with MCC was started followed by one of the interventions after one minute of CPR. Every other minute after MCC start, the pigs were defibrillated with 200 J if VF/ventricular tachycardia, and after six minutes, adrenaline was administered and repeated every four minutes. The proportions of ROSC were calculated. Hemodynamic variables, including systemic blood and coronary perfusion pressures (CPP), and carotid and iliac blood flows, were collected and analyzed with 0.02 s resolution.</p><p><strong>Results: </strong>In both the IABP and REBOA groups, 7 of 8 animals (87.5 %) achieved ROSC, in contrast with 2 of 8 (25 %) in the control group (P = 0.04). IABP and REBOA significantly increased systemic arterial pressure (P = 0.002 and P = 0.015, respectively), and REBOA also increased CPP and carotid blood flow when compared to controls (P = 0.007 and P = 0.03, respectively). Animals with IABP had a preserved blood flow in the iliac artery during CPR. No differences were detected after ROSC in hemodynamic, metabolic, and organ injury variables between the REBOA and IABP groups.</p><p><strong>Conclusion: </strong>Both IABP and REBOA increased the proportion of ROSC compared to controls. However, REBOA occluded distal blood flow, while IABP maintained it. This study suggests that MCC synchronized IABP could be an adjunct in the treatment of non-traumatic CA.</p>","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":" ","pages":"110433"},"PeriodicalIF":6.5,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142626326","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":"Trends in cardiac arrest outcomes & management in children with cardiac illness category compared to non-cardiac illness category: An analysis from the AHA Get With The Guidelines®-Resuscitation Registry","authors":"Monique M. Gardner, Ryan W. Morgan, Ron Reeder, Kimia Ghaffari, Laura Ortmann, Tia Raymond, Javier J. Lasa, Jessica Fowler, Maya Dewan, Vinay Nadkarni, Robert A. Berg, Robert Sutton, Alexis Topjian, for the American Heart Association’s Get With The Guidelines ®-Resuscitation Investigators","doi":"10.1016/j.resuscitation.2024.110430","DOIUrl":"https://doi.org/10.1016/j.resuscitation.2024.110430","url":null,"abstract":"Contemporary rates of survival after pediatric in-hospital CPR events and trends in survival over the last 20 years have not been compared based on illness category. We hypothesized that survival to hospital discharge for surgical-cardiac category is higher than the non-cardiac category, and rates of survival after in-hospital CPR increased over time in all categories.","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":"81 1","pages":""},"PeriodicalIF":6.5,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142691118","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":"Observational studies and causal questions in resuscitation research– lessons from vascular access studies","authors":"Lars W. Andersen ,&nbsp;Mathias J. Holmberg ,&nbsp;Nikola Stankovic ,&nbsp;Mikael Fink Vallentin ,&nbsp;Asger Granfeldt","doi":"10.1016/j.resuscitation.2024.110432","DOIUrl":"10.1016/j.resuscitation.2024.110432","url":null,"abstract":"","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":"205 ","pages":"Article 110432"},"PeriodicalIF":6.5,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142626338","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}