Resuscitation最新文献

{"title":"Aiming for the right Pressure! - clinical impact of recently published research regarding post-cardiac arrest blood pressure thresholds in children.","authors":"A Wordie, K Mustafa","doi":"10.1016/j.resuscitation.2025.110492","DOIUrl":"https://doi.org/10.1016/j.resuscitation.2025.110492","url":null,"abstract":"","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":" ","pages":"110492"},"PeriodicalIF":6.5,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142954140","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":"Resuscitative hysterotomy in out-of-hospital cardiac arrest: time to deliver for mothers and babies.","authors":"Peter J McGuigan, Glenn M Eastwood","doi":"10.1016/j.resuscitation.2025.110493","DOIUrl":"https://doi.org/10.1016/j.resuscitation.2025.110493","url":null,"abstract":"","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":" ","pages":"110493"},"PeriodicalIF":6.5,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142954146","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":"Apple iOS Update Enables Dispatchers to Stream Live Video and Record Media During Emergency Calls.","authors":"Nino Fijačko, Robert Greif","doi":"10.1016/j.resuscitation.2025.110494","DOIUrl":"https://doi.org/10.1016/j.resuscitation.2025.110494","url":null,"abstract":"","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":" ","pages":"110494"},"PeriodicalIF":6.5,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142954141","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":"Extracorporeal Cardiopulmonary Resuscitation Outcomes in Pre-Glenn Single Ventricle Infants: Analysis of A Ten-Year Dataset.","authors":"Ivie Esangbedo, Thomas Brogan, Titus Chan, Yuen Lie Tjoeng, Marshall Brown, DMichael McMullan","doi":"10.1016/j.resuscitation.2025.110490","DOIUrl":"https://doi.org/10.1016/j.resuscitation.2025.110490","url":null,"abstract":"<p><strong>Background: </strong>While several studies have reported on outcomes of extracorporeal membrane oxygenation (ECMO) in patients with single ventricle physiology, few studies have described outcomes of extracorporeal cardiopulmonary resuscitation (ECPR) in this unique population. The objective of this study was to determine survival and risk factors for mortality after ECPR in single ventricle patients prior to superior cavopulmonary anastomosis, using a large sample from the Extracorporeal Life Support Organization (ELSO) Registry.</p><p><strong>Methods: </strong>We included single ventricle patients who underwent ECPR for in-hospital cardiac arrest (IHCA) between January 2012 and December 2021. We excluded patients who had undergone a superior cavopulmonary anastomosis, inferior cavopulmonary anastomosis, or who were older than 180 days at the time of ECPR. We collected data on mortality, ECMO course and ECMO complications. Subjects who survived to hospital discharge after ECPR were compared to subjects who did not survive to hospital discharge. We then performed univariate logistic regression followed by multivariable logistic regression analysis for associations with survival to hospital discharge.</p><p><strong>Results: </strong>There were 420 subjects included who had index ECPR events. Median age was 14 days, median weight was 3.14 kg. Hypoplastic left heart syndrome was the most common diagnosis (354/420; 84.2%), and 47.4% of the cohort (199/420) had undergone a Norwood operation. Survival to hospital discharge occurred in 159/420 (37.9%) of subjects. Median number of hours on ECMO (122 vs. 93 hours; p<0.001), presence of seizures by electroencephalography (24% vs. 15%; p=0.033), and need for renal replacement therapy (45% vs. 34%; p=0.023) were significantly higher among non-survivors compared to survivors. In the subgroup of Norwood patients, survival was 43.2% after ECPR. Presence of Norwood variable was 54% among ECPR survivors in the overall cohort, compared to 43% among non-survivors (p=0.032). In a multivariable logistic regression model to test association with survival to discharge, number of ECMO hours and presence of seizures were associated with decreased odds of survival to hospital discharge [adjusted odds ratio 0.95 (95% C.I. 0.92-0.98) and 0.57 (95% C.I. 0.33-0.97) respectively]. The odds ratio for ECMO hours demonstrated a decrease in odds of survival by 5% for every 12 hours on ECMO. Presence of Norwood operation pre-arrest was associated with increased odds of survival [adjusted odds ratio 1.53 (95% C.I. 1.01-2.32)].</p><p><strong>Conclusion: </strong>In our cohort of pre-Glenn single ventricle infants, survival after ECPR for in-hospital cardiac arrest was 37.9%. Number of hours on ECMO and seizures post-ECMO cannulation were associated with decreased odds of survival. Single ventricle infants who had undergone Norwood palliation pre-arrest were more likely to survive to hospital discharge.</p>","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":" ","pages":"110490"},"PeriodicalIF":6.5,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142954145","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":"Pre-Hospital ECPR cost analysis and cost effectiveness modelling study.","authors":"Fredrick Zmudzki, Brian Burns, Natalie Kruit, Changle Song, Emily Moylan, Hemal Vachharajani, Hergen Buscher, Timothy J Southwood, Paul Forrest, Mark Dennis","doi":"10.1016/j.resuscitation.2024.110488","DOIUrl":"https://doi.org/10.1016/j.resuscitation.2024.110488","url":null,"abstract":"<p><strong>Background: </strong>The use of extracorporeal membrane oxygenation (ECMO) during cardiopulmonary resuscitation (ECPR) is increasing. Prehospital ECPR (PH-ECPR) for out-of-hospital cardiac arrest (OHCA) may improve both equity of access and outcomes but its cost effectiveness has yet to be determined.</p><p><strong>Methods: </strong>Cost analyses of PH-ECPR was performed utilizing current PH-ECPR trial, NSW Ambulance Cardiac Arrest Registry (CAR), geospatial modelling and in-hospital costings data. Markov modelling was completed to combine the PH-ECPR cost analysis with reported patient outcomes across multiple ECPR strategies. Bridging formulae from ECPR survivor cerebral performance category (CPC) scores were used to estimate cost per quality adjusted life years (QALY) and Incremental Cost Effectiveness Ratios (ICERs). Probabilistic Sensitivity Analysis was completed to assess the probability of cost effectiveness for base case and PH-ECPR strategy variations.</p><p><strong>Results: </strong>Assuming a base case of 100 patients per year, with a 25% team allocation to ECPR, the average pre-hospital ECPR cost per patient was $12,741 and total of $88,656 AUD equating to approximately $44,000 per QALY. Addition of a conservative 10% kidney organ donation rate reduces the cost per QALY to $22,000. Patient survival rate, the proportion of time the pre-hospital ECPR team are allocated to ECPR and organ donation significantly impact PH-ECPR cost effectiveness.</p><p><strong>Conclusion: </strong>Initial cost analysis and modelling indicate PH-ECPR service strategies are likely to be cost effective and comparable to other medical interventions. Survival rate and service integration into non ECPR clinical tasks are key aspects contributing to cost effectiveness.</p>","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":" ","pages":"110488"},"PeriodicalIF":6.5,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142932068","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":"Association between increasing institutional experience with ECPR and outcomes in patients with out-of-hospital cardiac arrest: a nationwide multicenter observational study in Japan (the JAAM-OHCA registry).","authors":"Kazuya Kikutani, Mitsuaki Nishikimi, Shinichiro Ohshimo, Nobuaki Shime","doi":"10.1016/j.resuscitation.2024.110487","DOIUrl":"https://doi.org/10.1016/j.resuscitation.2024.110487","url":null,"abstract":"<p><strong>Aim: </strong>To determine the association between institutional experience with extracorporeal cardiopulmonary resuscitation (ECPR) and outcomes after out-of-hospital cardiac arrest (OHCA).</p><p><strong>Methods: </strong>We analyzed data from the JAAM-OHCA registry, a nationwide multicenter database containing information on patients who experienced OHCA in Japan between June 2014 and December 2020. The study population consisted of patients with OHCA who were in cardiac arrest on hospital arrival and treated with extracorporeal membrane oxygenation (ECMO). Each patient was assigned a sequential number based on the order of initiation of ECPR at each facility. The primary outcome was 30-day survival and the secondary outcome was the interval between hospital admission and initiation of ECMO.</p><p><strong>Results: </strong>Data for a total of 2,315 patients with OHCA and cardiac arrest on hospital arrival who were treated with ECPR at any of 87 facilities were analyzed. On admission, 1,047 patients had shockable rhythm and 1,268 had non-shockable rhythm. The 30-day survival rate was not significantly associated with the accumulated case volume of ECPR. The interval between hospital arrival and initiation of ECMO decreased significantly with increasing experience of ECPR (p<0.001, Jonckheere-Terpstra test). In non-shockable cases, 30-day survival tended to improve with increasing experience of ECPR (p=0.04, Cochran-Armitage trend test).</p><p><strong>Conclusion: </strong>Increasing institutional experience of ECPR did not significantly improve 30-day survival after OHCA but was associated with a shorter interval between hospital arrival and initiation of ECMO. In patients with non-shockable OHCA, increasing experience of ECPR improved 30-day survival. (246/250 words).</p>","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":" ","pages":"110487"},"PeriodicalIF":6.5,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142932108","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":"Post Resuscitation Oxygen Supplementation: Throw It Away?","authors":"Robert Klemisch, Graham Nichol","doi":"10.1016/j.resuscitation.2024.110485","DOIUrl":"https://doi.org/10.1016/j.resuscitation.2024.110485","url":null,"abstract":"","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":" ","pages":"110485"},"PeriodicalIF":6.5,"publicationDate":"2025-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142927911","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":"Using OpenAI's Text-to-video Model Sora to Generate Cardiopulmonary Resuscitation Content.","authors":"Nino Fijačko, Gregor Štiglic, Maxim Topaz, Robert Greif","doi":"10.1016/j.resuscitation.2024.110484","DOIUrl":"10.1016/j.resuscitation.2024.110484","url":null,"abstract":"","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":" ","pages":"110484"},"PeriodicalIF":6.5,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142922779","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":"Intraosseous and intravenous vascular access during adult cardiac arrest: a systematic review and meta-analysis.","authors":"Keith Couper, Lars W Andersen, Ian R Drennan, Brian E Grunau, Peter J Kudenchuk, Ranjit Lall, Eric J Lavonas, Gavin D Perkins, Mikael Fink Vallentin, Asger Granfeldt","doi":"10.1016/j.resuscitation.2024.110481","DOIUrl":"https://doi.org/10.1016/j.resuscitation.2024.110481","url":null,"abstract":"<p><strong>Objective: </strong>To summarise evidence on the clinical effectiveness of initial vascular attempts via the intraosseous route compared to the intravenous route in adult cardiac arrest.</p><p><strong>Methods: </strong>We searched MEDLINE and Embase (OVID platform), the Cochrane library, and the International Clinical Trials Registry Platform from inception to September 4^th 2024 for randomised clinical trials comparing the intraosseous route with the intravenous route in adult cardiac arrest. Our primary outcome was 30-day survival. Secondary outcomes included favourable neurological outcome at 30-days/ hospital discharge and return of spontaneous circulation (both any ROSC and sustained ROSC). We performed meta-analyses using a fixed-effect model. We assessed risk of bias using the Cochrane Risk of Bias-2 tool and evidence certainty using the GRADE approach.</p><p><strong>Results: </strong>We included three randomised clinical trials encompassing 9,332 participants with out-of-hospital cardiac arrest. Initial attempts via the intraosseous, compared with intravenous, route did not increase the odds of 30-day survival (odds ratio 0.99, 95% confidence interval 0.84-1.17; 9,272 participants; three trials; moderate-certainty evidence) or favourable neurological outcome at 30-days/ hospital discharge (odds ratio 1.07, 95% confidence interval 0.88-1.30; 9,186 participants; three trials; low-certainty evidence). The odds of achieving sustained return of spontaneous circulation were lower in the intraosseous group (odds ratio 0.89, 95% confidence interval 0.80-0.99; 7,518 participants; two trials; moderate-certainty evidence).</p><p><strong>Conclusion: </strong>Initial vascular access attempts via the intraosseous, compared with intravenous, route in adult cardiac arrest did not improve 30-day survival and may reduce the odds of a sustained return of spontaneous circulation.</p>","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":" ","pages":"110481"},"PeriodicalIF":6.5,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142915535","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":"Impact of Mild Hypercapnia on Renal Function After Out-of-Hospital Cardiac Arrest.","authors":"Glenn M Eastwood, Michael Bailey, Alistair D Nichol, Rachael Parke, Niklas Nielsen, Josef Dankiewicz, Rinaldo Bellomo","doi":"10.1016/j.resuscitation.2024.110480","DOIUrl":"https://doi.org/10.1016/j.resuscitation.2024.110480","url":null,"abstract":"<p><strong>Background: </strong>Acute kidney injury (AKI) is a serious complication of out-of-hospital cardiac arrest (OHCA). Post-resuscitation cardiogenic shock (CS) is a key contributing factor. Targeting a higher arterial carbon dioxide tension may affect AKI after OHCA in patients with or without CS.</p><p><strong>Methods: </strong>Pre-planned exploratory study of a multi-national randomised trial comparing targeted mild hypercapnia or targeted normocapnia. The primary outcome was AKI defined by Kidney Disease: Improving Global Outcomes (KDIGO) criteria with modifications. Secondary outcomes included use of renal replacement therapy (RRT) and favourable neurological outcome (Glasgow Outcome Scale Extended, score 5-8) at six-months according to AKI. Exploratory objectives included evaluation of secondary outcomes in patients with both CS and AKI.</p><p><strong>Results: </strong>We studied 1668 of 1700 TAME patients. AKI occurred in 1203 patients (72.1%) with 596 (49.6%) in the targeted mild hypercapnia group and 607 (50.4%) in the targeted normocapnia group. Stage 3 AKI occurred in 193 patients (23.3%) and 196 patients (23.4%), respectively and RRT in 82 (9.9%) vs 75 patients (8.9%), respectively. At six-months, 237 of 429 no-AKI patients (55.2%) had a favourable neurological outcome compared to 445 of 1111 AKI patients (40.1%) (p <0.0001). AKI occurred more frequently (P<0.001) in patients with CS, affecting 936 patients (77.8%). For CS and AKI patients, there were no significant differences any secondary outcome.</p><p><strong>Conclusions: </strong>AKI occurred in approximately two-thirds and RRT in approximately one in ten TAME patients without differences according to treatment allocation. CS significantly increased the prevalence of AKI but this effect was not modified by carbon dioxide allocation.</p>","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":" ","pages":"110480"},"PeriodicalIF":6.5,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142915572","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}