Resuscitation最新文献

{"title":"High-Quality CPR: From Process to Perfusion.","authors":"James Price, Gabriel Palti, Neil Berry, Kate Lachowycz, Ed Bg Barnard","doi":"10.1016/j.resuscitation.2026.111297","DOIUrl":"https://doi.org/10.1016/j.resuscitation.2026.111297","url":null,"abstract":"","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":" ","pages":"111297"},"PeriodicalIF":6.0,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148891498","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 the incidence and outcomes of cardiopulmonary resuscitation-induced consciousness in out-of-hospital cardiac arrest: a retrospective study.","authors":"Jack Howard, Dion Stub, Timothy Kennett, Matthew Humar, Alexander Olaussen, Ziad Nehme","doi":"10.1016/j.resuscitation.2026.111287","DOIUrl":"https://doi.org/10.1016/j.resuscitation.2026.111287","url":null,"abstract":"<p><strong>Objective: </strong>To examine the incidence, trends, characteristics, and patient outcomes associated with cardiopulmonary resuscitation induced consciousness (CPRIC) in out-of-hospital cardiac arrest (OHCA).</p><p><strong>Methods: </strong>We conducted a retrospective cohort study of adult (≥16 years) OHCA events between 1st January 2008 and 31st December 2024. Patients with CPRIC were identified from prehospital patient care records and linked to data from the Victorian Ambulance Cardiac Arrest Registry (VACAR). Poisson regression was used to assess temporal trends in CPRIC incidence and multivariable logistic regression to examine the association between CPRIC and survival to hospital discharge.</p><p><strong>Results: </strong>Among 43,402 OHCA events, 1,438 patients (3.3%) experienced CPRIC. The annual incidence of CPRIC increased over time in the overall cohort (IRR 1.083, 95% CI 1.07-1.10) and across all arrest rhythms (p < 0.001 for all). Factors independently associated with CPRIC included younger age, calendar year, cardiac aetiology, public location, witnessed arrest, initial shockable rhythm and use of mechanical CPR. In adjusted analysis, CPRIC was independently associated with improved survival to hospital discharge (OR 2.71, 95% CI: 2.38-3.09), with similar findings for both interfering (OR 2.36, 95% CI: 2.04-2.74) and non-interfering phenotypes (OR 4.09, 95% CI: 3.17-5.29). CPRIC was also associated with return of spontaneous circulation and survival to hospital admission.</p><p><strong>Conclusion: </strong>Over the 16-year study period, the annual incidence of CPRIC increased, and patients with CPRIC found to have better OHCA survival outcomes. CPRIC may help identify patients with favourable physiology and is associated with improved survival outcomes.</p>","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":" ","pages":"111287"},"PeriodicalIF":6.0,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148892074","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":"Pulseless electrical activity versus asystole as initial pulseless rhythm in children: challenging convention regarding non-shockable rhythms.","authors":"Rudolph Wong, Javier J Lasa, Alexis Topjian, Benny L Joyner, Tian Jiang, Yilun Li, Juan Zhao, Anne-Marie Guerguerian, Vinay Nadkarni, Tia Raymond","doi":"10.1016/j.resuscitation.2026.111289","DOIUrl":"https://doi.org/10.1016/j.resuscitation.2026.111289","url":null,"abstract":"<p><strong>Background: </strong>Pulseless electrical activity (PEA) and asystole are the predominant initial rhythms in pediatric in-hospital cardiac arrest (IHCA) and are often grouped as \"non-shockable.\" Whether they represent distinct entities in children remains unclear.</p><p><strong>Methods: </strong>We analyzed pediatric (<18 years) IHCA cases from the American Heart Association Get With The Guidelines-Resuscitation (GWTG®-R) registry (2000-2023). Patients with an initial rhythm of PEA or asystole were included. Outcomes were return of spontaneous circulation (ROSC), restoration of circulation (ROC, defined as ROSC or ROC with ECMO), and survival to hospital discharge. Mixed-effects regression adjusted for demographics, comorbidities, event features, and hospital factors. Additional analyses excluded NICU events and stratified patients by age.</p><p><strong>Results: </strong>Of 9423 patients, 5416 (57.5%) had PEA and 4007 (42.5%) had asystole. Compared with PEA, asystole was associated with lower odds of ROSC (aOR 0.70, 95% CI 0.64-0.77), ROC (aOR 0.71, 95% CI 0.64-0.78), and survival to discharge (aOR 0.89, 95% CI 0.81-0.99). In the NICU-excluded cohort, asystole remained associated with lower odds of ROSC and ROC, but survival to discharge no longer differed between rhythms (36.1% vs 34.1%; aOR 0.99, 95% CI 0.90-1.11). Age-stratified analyses showed the overall survival difference was driven by neonates; in older age groups, survival to discharge did not differ between PEA and asystole.</p><p><strong>Conclusion: </strong>PEA and asystole differ in patient characteristics and short-term resuscitation outcomes in pediatric IHCA. However, the overall survival difference appears driven by neonates and NICU-associated events, with no significant survival difference in older children.</p>","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":" ","pages":"111289"},"PeriodicalIF":6.0,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148888440","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":"Selection bias introduced in a randomized clinical trial due to employee instigated deletion of newborn resuscitation videos.","authors":"Eila Tvedt Hoven, Frida Marie Meling Røine, Frederikke Buskov, Sara Brunner, Joanna Haynes, Hege Ersdal, Siren Rettedal","doi":"10.1016/j.resuscitation.2026.111288","DOIUrl":"https://doi.org/10.1016/j.resuscitation.2026.111288","url":null,"abstract":"<p><strong>Objective: </strong>Evaluating if employee instigated deletion of newborn resuscitation videos resulted in selection bias compromising the validity of the NeoBeat trial.</p><p><strong>Method: </strong>The NeoBeat randomized clinical trial was conducted at Stavanger University Hospital, Norway, to evaluate if continuously displayed ECG heart rate starting from birth resulted in a higher proportion of treated newborns receiving ventilation within 60 seconds. Videos of resuscitations were used to evaluate time to ventilation. Employees could request deletion of videos by e-mail. Halfway through the trial, protests over video recordings led to 12-month pause in data collection. An anonymous solution for employee video deletion request was implemented, resulting in a surge of video deletions. To investigate possible selection bias, proxies for severity of birth asphyxia before and after introduction of the anonymous opt-out solution were compared.</p><p><strong>Result: </strong>In total, 7343/10,362 (71%) newborns of gestational age ≥34 weeks were enrolled before and 2566/4417 (58%) after implementation of the anonymous opt-out solution. Time of birth and video were available for 171 and 80 newborns, respectively. Implementation of an anonymous deletion request solution resulted in loss of 0 and 14 cases before and after, leaving 171 and 66 cases for comparison. There were no differences in participant characteristics, but significantly higher Apgar scores, shorter duration of ventilation, and fewer admissions after implementation of the anonymous opt-out solution.</p><p><strong>Conclusion: </strong>The introduction of anonymous employee deletion of videos resulted in systematic differences among included newborns, strongly suggesting a selection bias. The trial was terminated halfway without power to conclude on outcomes.</p>","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":" ","pages":"111288"},"PeriodicalIF":6.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148875113","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":"Under-reporting of hypoxic-ischaemic brain injury on routine CT and MRI during neuroprognostication after out-of-hospital cardiac arrest","authors":"Uzma Sajjad,Maria Maccaroni,Dana Prisenznakova,Branimir Nevajda,Thomas R. Keeble,Saneesh Suresh","doi":"10.1016/j.resuscitation.2026.111298","DOIUrl":"https://doi.org/10.1016/j.resuscitation.2026.111298","url":null,"abstract":"","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":"84 1","pages":"111298"},"PeriodicalIF":6.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148893893","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":"Assessing Global Cerebral Hemodynamics after Cardiac Arrest","authors":"Dorothee Goulet,Mypinder S. Sekhon","doi":"10.1016/j.resuscitation.2026.111285","DOIUrl":"https://doi.org/10.1016/j.resuscitation.2026.111285","url":null,"abstract":"","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":"28 1","pages":"111285"},"PeriodicalIF":6.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148893894","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":"Cerebral Tissue Oxygen Saturation at Defibrillation and Return of Spontaneous Circulation in Out-of-Hospital Cardiac Arrest With a Shockable Rhythm.","authors":"Hitoshi Kano, Hirokazu Onishi, Yuki Yasutake, Toru Takiguchi, Takuro Hamaguchi, Kenta Shigeta, Jun Hagiwara, Wataru Takayama, Masaaki Hino, Jun Nakata, Yutaka Igarashi, Ryuta Nakae, Shoji Yokobori","doi":"10.1016/j.resuscitation.2026.111286","DOIUrl":"https://doi.org/10.1016/j.resuscitation.2026.111286","url":null,"abstract":"<p><strong>Background: </strong>We examined the association between cerebral tissue oxygen saturation (SctO₂) at each patient's first defibrillation after in-hospital monitoring began and return of spontaneous circulation (ROSC) after that defibrillation in patients requiring continued resuscitation after out-of-hospital cardiac arrest (OHCA).</p><p><strong>Methods: </strong>We included adult patients with out-of-hospital cardiac arrest who underwent SctO₂ monitoring during ongoing CPR and received in-hospital defibrillation for ventricular fibrillation or pulseless ventricular tachycardia. The first monitored defibrillation per patient was analyzed using multivariable Firth penalized logistic regression. All 194 monitored defibrillations were analyzed secondarily using a logistic generalized linear mixed-effects model (GLMM) with a patient-level random intercept. Both models adjusted for site.</p><p><strong>Results: </strong>Nineteen patients achieved ROSC after the first monitored defibrillation. Median SctO₂ was 48.8% [interquartile range, 47.2-53.6] with ROSC and 38.1% [33.8-41.8] without ROSC. After adjusting for site, arrest-to-defibrillation time, and epinephrine within 2 min, the odds ratio (OR) was 1.48 for each 1% increase in SctO₂ (95% confidence interval [CI], 1.22-1.80; P<0.001). The area under the receiver operating characteristic curve was 0.961 (95% CI, 0.917-0.991). At an SctO₂ cut-off of 44.5%, the sensitivity was 94.7% (18/19; 95% CI, 74.0%-99.9%) and the specificity was 89.7% (61/68; 95% CI, 79.9%-95.8%). In the adjusted GLMM of all 194 defibrillations (41 followed by ROSC), the association remained consistent (OR, 1.56; 95% CI, 1.34-1.82; P<0.001).</p><p><strong>Conclusions: </strong>In this selected population, higher SctO₂ at defibrillation was associated with ROSC. This indirect marker and exploratory cutoff need external validation and should not delay guideline-directed defibrillation.</p>","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":" ","pages":"111286"},"PeriodicalIF":6.0,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148866699","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":"Interpreting Event-Average Oxygen Saturation During CPR: Physiology, Missingness, and Timing.","authors":"Zhichao Zhao, Ting Shen","doi":"10.1016/j.resuscitation.2026.111281","DOIUrl":"https://doi.org/10.1016/j.resuscitation.2026.111281","url":null,"abstract":"","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":" ","pages":"111281"},"PeriodicalIF":6.0,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148851222","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":"Mobile-AED Deployment by Community First Responders: Delivering Early Defibrillation in Out-of-Hospital Cardiac Arrest.","authors":"Yuval Bitan, Eli Jaffe","doi":"10.1016/j.resuscitation.2026.111282","DOIUrl":"https://doi.org/10.1016/j.resuscitation.2026.111282","url":null,"abstract":"","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":" ","pages":"111282"},"PeriodicalIF":6.0,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148851204","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 Witness Status: Implications for Resuscitation Pathways in Paediatric Out-of-Hospital Cardiac Arrest.","authors":"Kentaro Kajino, Mohamud R Daya","doi":"10.1016/j.resuscitation.2026.111280","DOIUrl":"https://doi.org/10.1016/j.resuscitation.2026.111280","url":null,"abstract":"","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":" ","pages":"111280"},"PeriodicalIF":6.0,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148851154","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}