Resuscitation最新文献

{"title":"Recovery after rescue: The green shoots of bystander aftercare.","authors":"Vicky L Joshi, Anna Marie Moe Øvstebø, Thomas Werner Lindner, Gareth Clegg, Conrad Arnfinn Bjørshol","doi":"10.1016/j.resuscitation.2025.110658","DOIUrl":"https://doi.org/10.1016/j.resuscitation.2025.110658","url":null,"abstract":"","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":" ","pages":"110658"},"PeriodicalIF":6.5,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144151547","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":"Automated Detection of Severe Cerebral Edema Using Explainable Deep Transfer Learning after Hypoxic Ischemic Brain Injury.","authors":"Zihao Wang, Annelise M Kulpanowski, William A Copen, Eric S Rosenthal, Jacob A Dodelson, David E McCrory, Brian L Edlow, W Taylor Kimberly, Edilberto Amorim, MBrandon Westover, MingMing Ning, Morteza Zabihi, Pamela W Schaefer, Rajeev Malhotra, Joseph T Giacino, David M Greer, Ona Wu","doi":"10.1016/j.resuscitation.2025.110652","DOIUrl":"https://doi.org/10.1016/j.resuscitation.2025.110652","url":null,"abstract":"<p><strong>Background: </strong>Substantial gaps exist in the neuroprognostication of cardiac arrest patients who remain comatose after the restoration of spontaneous circulation. Most studies focus on predicting survival, a measure confounded by the withdrawal of life-sustaining treatment decisions. Severe cerebral edema (SCE) may serve as an objective proximal imaging-based surrogate of neurologic injury.</p><p><strong>Methods: </strong>We retrospectively analyzed data from 288 patients to automate SCE detection with machine learning (ML) and to test the hypothesis that the quantitative values produced by these algorithms (ML_SCE) can improve predictions of neurologic outcomes. Ground-truth SCE (GT_SCE) classification was based on radiology reports.</p><p><strong>Results: </strong>The model attained a cross-validated testing accuracy of 87% [95% CI: 84%, 89%] for detecting SCE. Attention maps explaining SCE classification focused on cisternal regions (p<0.05). Multivariable analyses showed that older age (p<0.001), non-shockable initial cardiac rhythm (p=0.004), and greater ML_SCE values (p<0.001) were significant predictors of poor neurologic outcomes, with GT_SCE (p=0.064) as a non-significant covariate.</p><p><strong>Conclusion: </strong>Our results support the feasibility of automated SCE detection. Future prospective studies with standardized neurologic assessments are needed to substantiate the utility of quantitative ML_SCE values to improve neuroprognostication.</p>","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":" ","pages":"110652"},"PeriodicalIF":6.5,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144143427","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":"Automated Cardiac Arrest Detection and Emergency Service Alerting Using Device-Independent Smartwatch Technology: Proof-of-Principle.","authors":"Wisse M F van den Beuken, Beat Nideröst, Sebastiaan A Goossen, Tom A Kooy, Derya Demirtas, Daryl Autar, Stephan A Loer, Susanne Eberl, Vokko P van Halm, Bernd E Winkler, Hans van Schuppen, Pieter Roel Tuinman, Lothar A Schwarte, Patrick Schober","doi":"10.1016/j.resuscitation.2025.110657","DOIUrl":"https://doi.org/10.1016/j.resuscitation.2025.110657","url":null,"abstract":"<p><strong>Introduction: </strong>Out-of-hospital cardiac arrest (OHCA) is a leading cause of mortality. Automated detection could improve survival by reducing delays in first responder activation. This study provides proof-of-principle for a device-independent technology that can (A) distinguish presence versus absence of spontaneous circulation, and (B) reliably alert emergency medical services (EMS).</p><p><strong>Methods: </strong>Circulatory arrest data were collected from three groups: (1) volunteers undergoing temporarily restricted blood flow to the arm using a cuff, (2) patients undergoing cardioplegic cardiac arrest for heart surgery, and (3) domestic swine, slaughtered in food industry. Data were collected using Samsung Watch5 and Watch5 Pro. An algorithm was developed to analyze photoplethysmography signals and detect circulatory arrest. Emergency response was tested via the Dutch community first responder network HartslagNu, using their test environment to activate test responders and EMS.</p><p><strong>Results: </strong>Nineteen participants were analyzed. Across all three groups, 28 of 31 circulatory arrests were correctly identified, sensitivity 90.3% (95% CI: 74.2% - 98.0%), and hour-level specificity was 94.1% (95% CI: 71.3% - 99.9%). Triggering a circulatory arrest consistently resulted in an audiovisual smartwatch alarm and an instantaneous alert to the virtual EMS at the HartslagNu test server.</p><p><strong>Conclusion: </strong>This study demonstrates the feasibility of detecting circulatory arrest using commercially available smartwatch sensors, achieving high sensitivity and specificity. Additionally, we integrated an automated alerting system with emergency networks to notify first responders. While this technology shows promise to improve survival, higher specificity is needed to prevent overburdening EMS. Future research should focus on real-world validation using actual cardiac arrest data.</p>","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":" ","pages":"110657"},"PeriodicalIF":6.5,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144143423","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":"Reply to: streamlining defibrillation for refractory ventricular fibrillation","authors":"Sheldon Cheskes,&nbsp;Ian R. Drennan,&nbsp;Sandeep Pandit,&nbsp;Robert G. Walker,&nbsp;Paul Dorian","doi":"10.1016/j.resuscitation.2025.110656","DOIUrl":"10.1016/j.resuscitation.2025.110656","url":null,"abstract":"","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":"213 ","pages":"Article 110656"},"PeriodicalIF":6.5,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144132917","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":"Does cardiopulmonary resuscitation before donor death affect solid organ transplant function? A systematic review and meta-analysis","authors":"Claudio Sandroni ,&nbsp;Tommaso Scquizzato ,&nbsp;Sofia Cacciola ,&nbsp;Matteo Aldo Bonizzoni ,&nbsp;Stephen West ,&nbsp;Sonia D’Arrigo ,&nbsp;Jasmeet Soar ,&nbsp;International Liaison Committee on Resuscitation ILCOR Advanced Life Support Task Force","doi":"10.1016/j.resuscitation.2025.110654","DOIUrl":"10.1016/j.resuscitation.2025.110654","url":null,"abstract":"<div><h3>Introduction</h3><div>Patients who die after cardiopulmonary resuscitation (CPR) are an important source of solid organs, but ischaemia–reperfusion injury may lead to worse recipient outcomes. This systematic review and <em>meta</em>-analysis assessed if solid organs transplanted from donors who underwent CPR had worse outcomes compared to organs from donors who did not receive CPR.</div></div><div><h3>Methods</h3><div>PubMed, Embase, and the Cochrane Central Register of Controlled Trials were searched until January 1, 2025. The primary outcome (graft survival at the longest follow-up) and secondary outcomes (30-day and 1-year graft survival) were calculated separately for each organ and pathway (brain/circulatory death).</div></div><div><h3>Results</h3><div>We included 33 studies (26 in adults; 72,994 donors), of which three compared multiple organs and pathways. In 24 studies comparing brain-dead donors with <em>vs</em> without CPR in all organs, outcomes did not differ between groups. In nine studies, donation after uncontrolled circulatory death compared to donation after brain death showed a lower long-term survival for livers (OR 0.51 [0.32–0.83]) and lower short-term but not long-term survival (OR 0.64[0.36–1.15]) for kidneys. Two studies in kidneys compared donation in controlled <em>vs</em> uncontrolled circulatory death showing no different long-term survival (OR 0.73[0.27–1.99]).</div></div><div><h3>Conclusions</h3><div>Organs transplanted from donors who received CPR demonstrated comparable outcomes at the longest follow-up compared to organs from donors who did not receive CPR. Kidneys and livers after uncontrolled donation after circulatory death showed worse outcomes compared to donation after brain death.</div></div>","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":"213 ","pages":"Article 110654"},"PeriodicalIF":6.5,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144132908","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":"Serum neurofilament light chain and multimodal neuroprognostication after cardiac arrest – A retrospective cohort study","authors":"Constanze Czimmeck ,&nbsp;Jens Nee ,&nbsp;Carl Hinrichs ,&nbsp;Christian Endisch ,&nbsp;Péter Körtvélyessy ,&nbsp;Christoph J. Ploner ,&nbsp;Christoph Leithner ,&nbsp;Martin Kenda","doi":"10.1016/j.resuscitation.2025.110650","DOIUrl":"10.1016/j.resuscitation.2025.110650","url":null,"abstract":"<div><h3>Background and purpose</h3><div>Most patients remain comatose within the first days after cardiac arrest (CA) and resuscitation. Guidelines recommend multimodal neuroprognostication including neuron specific enolase (NSE) as serum biomarker. Neurofilament light-chain (NFL) may have higher prognostic accuracy earlier after cardiac arrest and a lower risk of confounders. This study investigates the prognostic value of serum NFL in clinical routine compared to established prognostic tests.</div></div><div><h3>Methods</h3><div>Monocentric retrospective observational study of patients with serum NFL between 24–96 h after CA. Neurological outcome was evaluated at hospital discharge via the Cerebral Performance Category score (CPC), dichotomized as good (CPC 1–3) and poor (CPC 4–5). Prognostic performance for good and poor neurological outcome prediction was analysed for NFL, NSE, electroencephalography (EEG), somatosensory evoked potentials (SSEP), and head computed tomography (CT). NFL was measured using the SIMOA Quanterix assay.</div></div><div><h3>Results</h3><div>152 patients were included, median age was 61 years, 24% were female. 10 patients were discharged in vegetative state or comatose (7%), and 78 died before discharge (51%). NFL &gt; 2000 pg/ml predicted poor outcome with 53% (43–63%) sensitivity and 100% (94–100%) specificity. Most patients (69%) with NFL &lt; 55 pg/ml had a good outcome. Predictive accuracy was similar to other neuroprognostic tests (AUC 0.89, 0.84–0.94). In head-to-head comparisons with the other neuroprognostic tests, NFL identified 16–41% additional poor outcome patients.</div></div><div><h3>Conclusion</h3><div>NFL (SIMOA) &gt; 2000 pg/ml predicts poor neurological outcome with high specificity, while low concentrations strongly argue against severe HIE. Adding NFL to established neuroprognostication tests increases sensitivity of poor outcome prediction.</div></div>","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":"213 ","pages":"Article 110650"},"PeriodicalIF":6.5,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144132925","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 time taken to start Dispatch Assisted-Bystander Cardiopulmonary Resuscitation (DA-CPR) and outcomes for Out-of-Hospital Cardiac Arrest (OHCA).","authors":"Haruka Takahashi, Yohei Okada, Dehan Hong, Dennis Quah, Benjamin Sh Leong, Yih Yng Ng, Nur Shahidah, Geraldine Sy Goh, Muhammad Yazid, Kensuke Suzuki, Robert W Neumar, Marcus Eh Ong","doi":"10.1016/j.resuscitation.2025.110651","DOIUrl":"https://doi.org/10.1016/j.resuscitation.2025.110651","url":null,"abstract":"<p><strong>Background: </strong>We aimed to investigate the association between the time taken to start dispatcher-assisted cardiopulmonary resuscitation (DA-CPR) and survival outcomes for OHCA.</p><p><strong>Methods: </strong>This was a retrospective analysis using the Singapore Pan-Asian Resuscitation Outcomes Study data between 2012 and 2021. We included all adult, witnessed, non-traumatic OHCA patients who received DA-CPR. The exposure of interest was time interval from emergency call to start of DA-CPR. Patients were divided into three groups based on previous studies. The outcome was defined as survival to 30-days with favorable neurological outcomes. Multivariable logistic regression analysis was performed. Restricted cubic spline curves were used to explore non-linear relationships.</p><p><strong>Results: </strong>3,861 OHCA patients were included in this analysis.　Patients were grouped as follows: short (0-179 seconds), medium (180-239 seconds), and long (≥240 seconds) to start DA-CPR. Adjusted odds ratios [95% CI] for survival to 30-days with favorable neurological outcomes were: medium 0.82 [0.52-1.28], long 0.63 [0.40-0.98]. The restricted cubic spline curve showed a monotonic decrease in the odds ratio for survival to 30-days with favorable neurological outcomes.</p><p><strong>Conclusions: </strong>This study found that among non-traumatic, witnessed OHCA patients who received DA-CPR, a shorter time to start DA-CPR was associated with better 30-day survival with favorable neurological outcomes.</p>","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":" ","pages":"110651"},"PeriodicalIF":6.5,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144132901","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":"Early ADL ability assessment and cognitive screening as markers of post-discharge outcomes after surviving an out-of-hospital cardiac arrest. A prospective cohort study.","authors":"Lola Qvist Kristensen, Hans Eiskjær, Maurits van Tulder, Eva Elisabet Ejlersen Wæhrens, Lotte Sørensen, John Bro-Jeppesen, Glenn Eastwood, Lisa Gregersen Oestergaard","doi":"10.1016/j.resuscitation.2025.110653","DOIUrl":"10.1016/j.resuscitation.2025.110653","url":null,"abstract":"<p><p>Background Assessment of activities of daily living (ADL) and cognitive screening are widely used in the care of out-of-hospital cardiac arrest (OHCA) survivors. Evidence linking them to post-discharge outcomes is limited, but could support targeted rehabilitation efforts. Aim To assess whether ADL ability measures and cognitive screening at hospital discharge were associated with post-discharge ADL ability, health-related quality of life (HRQoL) and return to work. Methods This prospective cohort study included 200 OHCA survivors admitted to Aarhus University Hospital. Self-reported ADL ability was measured using the Activities of Daily Living Interview (ADL-I). Observed ADL ability was measured with the Assessment of Motor and Process Skills (AMPS), dichotomised into age-matched or below-ability. Cognitive function was assessed with Montreal Cognitive Assessment (MoCA). Multivariable regressions, with multiple imputation, analysed associations between variables and outcomes, adjusting for age, sex, and comorbidities. Results Adjusted analyses showed significant associations between personal ADL-I (βadjusted = 0.3, 95%CI: 0.2;0.5) and AMPS (βadjusted = -0.6, 95%CI:-1.2;-0.03) at discharge and self-reported ADL ability six months after cardiac arrest. Baseline AMPS was statistically significantly associated with age-matched ADL ability six months after cardiac arrest (ORadjusted 5.5, 95%CI: 1.5;10.0), and personal ADL-I (VAS: βadjusted = 3.00, 95%CI: 1.3;4.6/index score: βadjusted = 0.03, 95%CI 0.01;0.05) and MoCA (index: βadjusted = -0.09, 95%CI: -0.2;-0.02) with HRQoL. The association between MoCA and return to work one-year after cardiac arrest showed an OR of 3.0 (95%CI: 0.5;9.0), although not statistically significant (p = 0.06). Conclusions Decreased ADL ability at hospital discharge was associated with poorer post-discharge outcomes in OHCA survivors, while cognitive screening was also associated with certain aspects of recovery.</p>","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":" ","pages":"110653"},"PeriodicalIF":6.5,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144132914","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 ventilation modes in non-traumatic out-of-hospital cardiac arrest: SYMEVECA phase 2","authors":"Alberto Hernández-Tejedor,&nbsp;Vanesa González Puebla,&nbsp;Ervigio Corral Torres,&nbsp;Sara Isabel Montero Hernández,&nbsp;Consuelo Caniego Rodrigo,&nbsp;María Isabel Vázquez García,&nbsp;Carmen Camacho Leis","doi":"10.1016/j.resuscitation.2025.110655","DOIUrl":"10.1016/j.resuscitation.2025.110655","url":null,"abstract":"<div><h3>Aim</h3><div>To compare clinical outcomes associated with different ventilation approaches during cardiac arrest.</div></div><div><h3>Methods</h3><div>Pragmatic prospective quasi-experimental study in non-traumatic out-of-hospital cardiac arrest in adults attended by an emergency medical service between April-2021 and September-2024. Patients were classified in three groups according to the ventilation method during CPR: Chest Compression Synchronized Ventilation-CCSV (inspiratory time 205 ms), intermittent positive pressure ventilation-IPPV (tidal volume 7 ml/kg, rate 10–12 bpm) or manual resuscitator bag. Main outcome was survival at hospital discharge or 28 days with good neurological recovery (CPC 1–2). We also measured blood gas values 15 min after tracheal intubation or when spontaneous circulation was achieved.</div></div><div><h3>Results</h3><div>Of the 773 cardiac arrests recorded, 252 were excluded due to very early recovery (193), airway difficulty (54) or protocol violations (5). Patients were analyzed by groups: CCSV (100), IPPV (145) or resuscitator bag (276). In patients with a venous control sample, pH was 7.01 ± 0.15 in CCSV group, 7.00 ± 0.14 in IPPV and 6.96 ± 0.15 in the bag group (<em>p</em> = 0.02). The pCO₂ was 76.9 ± 31.8, 78.3 ± 25.4 and 84.7 ± 30.1 mmHg, respectively (<em>p</em> = 0.13). A spontaneous circulation was achieved in 61% with CCSV, 57.2% with IPPV and 49.3% with bag (<em>p</em> = 0.08). Survival with good neurological outcome was 16% in CCSV group, 12.4% in IPPV and 9.4% with bag (<em>p</em> = 0.19; <em>p</em> = 0.07 between CCSV and bag groups).</div></div><div><h3>Conclusion</h3><div>Successful resuscitation may vary according to ventilation mode – the use of a mechanical ventilation and different modes such as CCSV requires further study.</div></div>","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":"213 ","pages":"Article 110655"},"PeriodicalIF":6.5,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144132905","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":"Streamlining defibrillation for refractory ventricular fibrillation.","authors":"Renxian Xie, Qishuo Zhang, Lifeng Xiao","doi":"10.1016/j.resuscitation.2025.110649","DOIUrl":"10.1016/j.resuscitation.2025.110649","url":null,"abstract":"","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":" ","pages":"110649"},"PeriodicalIF":6.5,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144132927","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}