Resuscitation最新文献

{"title":"Waking up sooner: EEG-guided early cessation of sedation after cardiac arrest.","authors":"Claudio Sandroni, Marion Moseby-Knappe","doi":"10.1016/j.resuscitation.2026.111120","DOIUrl":"https://doi.org/10.1016/j.resuscitation.2026.111120","url":null,"abstract":"","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":" ","pages":"111120"},"PeriodicalIF":4.6,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147842288","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":"Manufactured futility: prehospital system failure as the primary determinant of resuscitation outcomes in India.","authors":"Meghnil Chowdhury","doi":"10.1016/j.resuscitation.2026.111119","DOIUrl":"https://doi.org/10.1016/j.resuscitation.2026.111119","url":null,"abstract":"","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":" ","pages":"111119"},"PeriodicalIF":4.6,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147842298","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":"A randomised controlled trial of defibrillation with manual pressure augmentation during out-of-hospital cardiac arrest.","authors":"Ziad Nehme, Emily Mahony, Emily Nehme, David Anderson, Daniel Okyere, Tegwyn McManamny, Jocasta Ball, Belinda Delardes, Karen Smith, Peter M Kistler, Jason Bloom, Dion Stub, Aleksandr Voskoboinik","doi":"10.1016/j.resuscitation.2026.111121","DOIUrl":"https://doi.org/10.1016/j.resuscitation.2026.111121","url":null,"abstract":"<p><strong>Aim: </strong>To determine whether defibrillation with manual pressure augmentation (MPA) reduces transthoracic impedance and improves cardioversion and survival from initially shockable out-of-hospital cardiac arrest (OHCA) compared with standard defibrillation.</p><p><strong>Methods: </strong>Investigator-initiated, open-label, two-arm, cluster-randomised controlled trial across 216 ambulance stations in Victoria, Australia (April 1, 2022-January 31, 2023). Adults (≥18 years) with OHCA and a shockable rhythm receiving an attempted resuscitation were eligible. Intervention clusters applied MPA during shock delivery using a choreographed sequence and safety protocols; control clusters performed standard defibrillation. All shocks were biphasic at 200 joules with anterior-lateral pad position. Primary outcome was survival to hospital discharge.</p><p><strong>Results: </strong>The intention-to-treat (ITT) population included 560 patients, (intervention, n=279; control, n=281). Survival to hospital discharge was 39.8% (111/279) in the intervention group vs 39.9% (112/281) in the control (absolute risk difference [AR] -0.1% [95% CI -8.2%, 8.0%]; adjusted odds ratio [AOR] 1.00 [95% CI 0.71, 1.40]; p=0.99). Twelve‑month survival, favourable neurologic outcome, and quality of life were similar between groups. Transthoracic impedance was significantly reduced with MPA (AR -8.5 ohms [95% CI -12.9, -4.1]; p<0.001), and larger in per‑protocol analyses (AR -15.0 ohms [95% CI -22.8, -7.2]; p<0.001). Compliance with MPA was low (23.6%). Perceptible shocks were uncommon and comparable across groups (0.75 vs 0.71 per 1,000 shocks delivered); no serious injuries occurred. The trial was prematurely terminated due to external safety reviews and operational delays, without outcome unblinding at the time of termination.</p><p><strong>Conclusions: </strong>In this prematurely terminated RCT, MPA reduced transthoracic impedance but did not improve survival or other clinical outcomes in initially shockable OHCA. Trial registration ACTRN12621000804886.</p>","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":" ","pages":"111121"},"PeriodicalIF":4.6,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147842249","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 letter titled” Streamlining trials in the acute care setting – Potential benefits of simulation training and optimized trial designs” regarding the manuscript “Vasopressin and steroids in addition to adrenaline in cardiac arrest (VAST-A) – A randomised pilot study”","authors":"Malin Albert,&nbsp;Sune Forsberg,&nbsp;Peter Lundgren","doi":"10.1016/j.resuscitation.2025.110627","DOIUrl":"10.1016/j.resuscitation.2025.110627","url":null,"abstract":"","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":"222 ","pages":"Article 110627"},"PeriodicalIF":4.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144045351","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":"Context-dependent nature of the obesity paradox in cardiac events","authors":"Artur Dziewierz","doi":"10.1016/j.resuscitation.2025.110702","DOIUrl":"10.1016/j.resuscitation.2025.110702","url":null,"abstract":"","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":"222 ","pages":"Article 110702"},"PeriodicalIF":4.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144560991","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":"Intubation during cardiac arrest: defibrillator trace analysis should be the ultimate judge","authors":"Simon-Pierre Corcostegui,&nbsp;Clotilde Dupré la Tour,&nbsp;Stéphane Travers,&nbsp;Daniel Jost,&nbsp;Clément Derkenne","doi":"10.1016/j.resuscitation.2025.110679","DOIUrl":"10.1016/j.resuscitation.2025.110679","url":null,"abstract":"","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":"222 ","pages":"Article 110679"},"PeriodicalIF":4.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144304963","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: When ground truth is not static: rethinking AI performance in occlusive MI detection from post-MI ECGs","authors":"Claudio Silwanis ,&nbsp;Max Groche ,&nbsp;Clemens Steinwender ,&nbsp;Thomas Lambert","doi":"10.1016/j.resuscitation.2025.110928","DOIUrl":"10.1016/j.resuscitation.2025.110928","url":null,"abstract":"","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":"222 ","pages":"Article 110928"},"PeriodicalIF":4.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145782743","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":"Cost-utility analysis of the British Cardiovascular Interventional Society conveyance algorithm for patients with out-of-hospital cardiac arrest","authors":"Guilherme Movio ,&nbsp;Uzma Sajjad ,&nbsp;Rupert Simpson ,&nbsp;Haroun Butt ,&nbsp;Abdalla Ibrahim ,&nbsp;Vasileios Kontogiannis ,&nbsp;Eoin Moloney ,&nbsp;Mehdi Javanbakht ,&nbsp;Maria Rita Maccaroni ,&nbsp;Gerald Clesham ,&nbsp;Grigoris V. Karamasis ,&nbsp;Rohan Jagathesan ,&nbsp;Nick Curzen ,&nbsp;Tom W. Johnson ,&nbsp;Paul Rees ,&nbsp;Nilesh Pareek ,&nbsp;John R. Davies ,&nbsp;Thomas R. Keeble","doi":"10.1016/j.resuscitation.2026.111021","DOIUrl":"10.1016/j.resuscitation.2026.111021","url":null,"abstract":"<div><h3>Background</h3><div>Out-of-hospital cardiac arrest is associated with high mortality and substantial healthcare costs. The British Cardiovascular Interventional Society’s conveyance algorithm prioritises direct transfer of patients with an initial shockable rhythm to specialist Cardiac Arrest Centres to support access to advanced cardiac intervention, neurocritical care, and structured rehabilitation. This study evaluated the cost-effectiveness of implementing the conveyance algorithm in a large regional population.</div></div><div><h3>Methods</h3><div>A hybrid decision-analytic model, combining a decision tree and Markov model was developed to assess the cost-effectiveness of the algorithm, compared with standard of care over a lifetime horizon. Model inputs were derived from a contemporary, observational pilot study. Health outcomes were expressed in quality-adjusted life years, and healthcare costs were discounted at an annual rate of 3.5%. Cost-effectiveness was assessed using the incremental cost-effectiveness ratio and net monetary benefit.</div></div><div><h3>Results</h3><div>The conveyance algorithm was cost-effective, with an incremental cost-effectiveness ratio of £2926 per quality-adjusted life year gained. Reductions in intensive care, hospital ward, post-assessment, and ambulance costs were partially offset by slightly higher costs related to admission, neuroprognostication, and longer-term care. Probabilistic analysis showed an 86.0% probability of cost-effectiveness at a willingness-to-pay threshold of £35,000 per quality-adjusted life year.</div></div><div><h3>Conclusion</h3><div>Selective rhythm-based transfer to specialist cardiac arrest centres improved resource efficiency with minimal additional cost. Although clinical outcome differences remain exploratory due to observational data, this economic evaluation supports further prospective, multi-centre evaluation to confirm broader clinical and health system benefits.</div></div>","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":"222 ","pages":"Article 111021"},"PeriodicalIF":4.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146258760","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":"Predictors of brain death after hanging-induced cardiac arrest","authors":"Boris Barrovecchio ,&nbsp;Gwenhael Colin ,&nbsp;Laurent Argaud ,&nbsp;Isabelle Desmeulles ,&nbsp;Pierre Bailly ,&nbsp;Nicholas Sedillot ,&nbsp;Helene Nougue ,&nbsp;Nicolas Pichon ,&nbsp;Shidasp Siami ,&nbsp;Gaetan Plantefeve ,&nbsp;Guillaume Schnell ,&nbsp;Maleka Schenck ,&nbsp;Pierrick Cronier ,&nbsp;Sebastien Perbet ,&nbsp;Anais Curtiaud ,&nbsp;Michael Piagnerelli ,&nbsp;Mehran Monchi ,&nbsp;Nicolas Deye ,&nbsp;Juliette Audibert ,&nbsp;Charles Cerf ,&nbsp;Stephane Legriel","doi":"10.1016/j.resuscitation.2026.111017","DOIUrl":"10.1016/j.resuscitation.2026.111017","url":null,"abstract":"<div><h3>Background</h3><div>Brain death after hanging–induced cardiac arrest is a fatal complication about which few data are available. We aimed at identifying the early predictors of progression to brain death in patients with hanging-induced cardiac arrest.</div></div><div><h3>Methods</h3><div>Retrospective study including adults with return of spontaneous circulation from hanging-induced cardiac arrest admitted to 34 ICUs in France and Belgium between 2000 and 2024. Logistic multivariate regression was performed to identify factors associated with progression to brain death.</div></div><div><h3>Results</h3><div>Of the 554 patients with hanging-induced cardiac arrest, brain imaging was performed on admission in 443 (80.0%) patients. Overall, 169/554 (30.5%) and 142/443 (32.1%) patients progressed to brain death within a median time of 3 days, and up to 12 days, after the hanging-induced cardiac arrest. In 443 patients with brain imaging, five factors were independently associated with a higher risk of progression to brain death: female (OR, 1.76; 95% CI, 1.06–2.90; <em>p</em> = 0.03), asystole as first recorded rhythm (OR, 2.03; 95% CI, 1.27–3.29; <em>p</em> = 0.004), low-flow time &gt; 30 min (OR, 1.84; 95% CI, 1.07–3.17; <em>p</em> = 0.03), total Logistic Organ Dysfunction System Score at day 1 (OR, 1.93/per point; 95% CI, 1.14–3.29; <em>p</em> = 0.02), and cerebral oedema and/or ischemic complication on brain CT scan at ICU admission (OR, 1.62; 95% CI, 1.01–2.61, <em>p</em> = 0.04). Conversely, age &gt; 50 years (OR, 0.59; 95%CI, 0.35–0.98, <em>p</em> = 0.04) and status myoclonus ≤ day 2 (OR, 0.24; 95%CI, 0.09–0.54, <em>p</em> = 0.001) were associated with a lower risk of progression to brain death after hanging-induced cardiac arrest.</div></div><div><h3>Conclusion</h3><div>Our findings emphasise the very high rate of brain death after hanging-induced cardiac arrest. In our population, factors associated with brain death after hanging induced cardiac arrest predominantly reflect initial injury severity.</div></div>","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":"222 ","pages":"Article 111017"},"PeriodicalIF":4.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146776483","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":"uDCD organs are still valid","authors":"Alonso A. Mateos Rodriguez,&nbsp;Carlos Rubio Chacon,&nbsp;Eduardo Miñambres Garcia","doi":"10.1016/j.resuscitation.2025.110781","DOIUrl":"10.1016/j.resuscitation.2025.110781","url":null,"abstract":"","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":"222 ","pages":"Article 110781"},"PeriodicalIF":4.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144883524","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}