Resuscitation最新文献

{"title":"Sub30: Feasibility study of a pre-hospital extracorporeal membrane oxygenation (ECMO) in patients with refractory out-of-hospital cardiac arrest in London, United Kingdom","authors":"Ben Singer ,&nbsp;Teddy Tun Win HLA ,&nbsp;Mamoun Abu-Habsa ,&nbsp;Gareth Davies ,&nbsp;Fenella Wrigley ,&nbsp;Mark Faulkner ,&nbsp;Simon J Finney","doi":"10.1016/j.resuscitation.2024.110455","DOIUrl":"10.1016/j.resuscitation.2024.110455","url":null,"abstract":"<div><h3>Aim</h3><div>Sub30 study is an open-label, prospective, single-arm feasibility study with the primary objective of assessing the logistics, feasibility, and safety of ECPR delivery in a pre-hospital setting for refractory out-of-hospital cardiac arrest patients in London, United Kingdom.</div></div><div><h3>Results</h3><div>Forty-three eligible patients were identified by London Ambulance Service over 27 trial recruitment days during a 13-month study period resulting in the despatch of the pre-hospital ECPR team to 18 patients. Five patients met full criteria and were cannulated for ECPR. All patients were male with a median age of 61 years and received ECPR full flows at a mean of 47 min (range 37–59 min) from initial collapse after a median travel time to scene of 14 min (range 3–20 min). No patient met the primary outcome measure of being established on pre-hospital ECPR within 30 min of the call to the emergency services. Out of 5 patients, 3 patients had treatment withdrawn and 2 survived to hospital discharge (both CPC score 3 and modified Rankin Score (mRS) score 4 and 5 respectively).</div></div><div><h3>Methods</h3><div>Open-label, single-arm, feasibility, prospective study.</div></div><div><h3>Conclusions</h3><div>Whilst our study did not meet primary outcome of achieving full ECPR flow within 30-minute of collapse, it demonstrated safe, timely and effective delivery of ECPR with comparable survival rates by pre-hospital teams in a large metropolitan city and this has potential to improve outcomes in refractory out-of-hospital cardiac arrest patients.</div></div>","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":"207 ","pages":"Article 110455"},"PeriodicalIF":6.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142792103","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,&nbsp;Robert Greif","doi":"10.1016/j.resuscitation.2025.110494","DOIUrl":"10.1016/j.resuscitation.2025.110494","url":null,"abstract":"","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":"207 ","pages":"Article 110494"},"PeriodicalIF":6.5,"publicationDate":"2025-02-01","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":"Public access defibrillators: The stark reality","authors":"Bruno Thomas-Lamotte,&nbsp;Nordine Benameur,&nbsp;Louis Soulat,&nbsp;Tomislav Petrovic,&nbsp;Frédéric Lapostolle","doi":"10.1016/j.resuscitation.2025.110502","DOIUrl":"10.1016/j.resuscitation.2025.110502","url":null,"abstract":"","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":"207 ","pages":"Article 110502"},"PeriodicalIF":6.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143010657","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":"Unraveling some of the myth about drowning, out-of-hospital cardiac arrest and outcomes: Many critical factors and processes, most of them disappointingly difficult to manage","authors":"Gerrit J. Noordergraaf,&nbsp;Alyssa Venema","doi":"10.1016/j.resuscitation.2025.110518","DOIUrl":"10.1016/j.resuscitation.2025.110518","url":null,"abstract":"","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":"207 ","pages":"Article 110518"},"PeriodicalIF":6.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143047314","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":"Expedited conveyance of out-of-hospital-cardiac arrest patients with STEMI and shockable rhythms to Cardiac Arrest Centres − A feasibility pilot study of the British Cardiovascular Intervention Society conveyance algorithm","authors":"Rupert F.G. Simpson ,&nbsp;Thomas Johnson ,&nbsp;Paul Rees ,&nbsp;Guy Glover ,&nbsp;Uzma Sajjad ,&nbsp;Samer Fawaz ,&nbsp;Sarosh Khan ,&nbsp;Emma Beadle ,&nbsp;Daryl Perilla ,&nbsp;Maria Maccaroni ,&nbsp;Christopher Cook ,&nbsp;Marco Mion ,&nbsp;Qiang Xue ,&nbsp;Rohan Jagathesan ,&nbsp;Gerald J. Clesham ,&nbsp;Tom Quinn ,&nbsp;Johannes Von Vopelius-Feldt ,&nbsp;Sean Gallagher ,&nbsp;Abdul Mozid ,&nbsp;Ellie Gudde ,&nbsp;Thomas R. Keeble","doi":"10.1016/j.resuscitation.2025.110491","DOIUrl":"10.1016/j.resuscitation.2025.110491","url":null,"abstract":"<div><h3>Background and aims</h3><div>Guidelines suggest non-traumatic out-of-hospital cardiac arrest (OHCA) be conveyed to cardiac arrest centres (CAC). We hypothesised that (a) a pre-hospital conveyance algorithm based on initial presenting rhythm following OHCA is feasible and (b) that would demonstrate survival advantage.</div></div><div><h3>Methods</h3><div>This observational pilot study included all consecutive patients with OHCA from suspected cardiac aetiology from the county of Essex, United Kingdom from April 2022-April 2023. For the first 6 months, OHCA patients had conveyance as standard of care. For the next 6 months, consecutive OHCA patients with STEMI or initial shockable rhythm were directly conveyed to the CAC, initial non-shockable rhythm without STEMI continued to be taken to the nearest Emergency Department (BCIS protocol). Primary outcome was death from any cause at 30 days. Secondary outcome was survival with favourable neurological outcome.</div></div><div><h3>Results</h3><div>Of 330 patients (mean age 67.5 ± 13.1, 66% male), 162 patients were in the standard care group and 168 in the BCIS conveyance group. Algorithm implementation was associated with numerically lower all cause 30-day mortality [(81% vs 73%, RR 1.10 (95% CI 0.98–1.24) <em>p</em> = 0.10] and numerically higher 30-day survival with favourable neurological outcome [15% vs 19%, RR 1.05 (0.95–1.15), <em>p</em> = 0.38]. Post hoc analysis showed that the BCIS conveyance algorithm was associated with lower 30 day mortality in those with an initial shockable rhythm [(61% vs 41%, RR 1.5 (95% CI 1.05–2.13) <em>p</em> = 0.02 and in those with a MIRACLE₂ score ≤ 5 [(63%% vs 38%, RR 0.59 (95% CI 0.61–0.86) <em>p</em> = 0.005].</div></div><div><h3>Conclusions</h3><div>The BCIS algorithm is feasible and did not impact overall mortality, but there is signal that direct conveyance of OHCA patients with an initial shockable rhythm and low MIRACLE₂ score, to a dedicated CAC may improve survival.</div></div>","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":"207 ","pages":"Article 110491"},"PeriodicalIF":6.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143071273","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 ventricular energetics in patients receiving veno-arterial extracorporeal membrane oxygenation for extracorporeal cardiopulmonary resuscitation","authors":"Rajat Kalra ,&nbsp;Christopher Gaisendrees ,&nbsp;Tamas Alexy ,&nbsp;Marinos Kosmopoulos ,&nbsp;Sebastian Voicu ,&nbsp;Jason A. Bartos ,&nbsp;Sergey G. Gurevich ,&nbsp;Ganesh Raveendran ,&nbsp;Deborah Jaeger ,&nbsp;Despoina Koukousaki ,&nbsp;Andrea M. Elliott ,&nbsp;Alejandra Gutierrez Bernal ,&nbsp;Mark Dennis ,&nbsp;Brian Burns ,&nbsp;Demetris Yannopoulos","doi":"10.1016/j.resuscitation.2024.110475","DOIUrl":"10.1016/j.resuscitation.2024.110475","url":null,"abstract":"<div><h3>Introduction</h3><div>The haemodynamic effects veno-arterial extracorporeal membrane oxygenation (VA-ECMO) remain inadequately understood. We investigated invasive left ventricular (LV) haemodynamics in patients who underwent treatment with an intensive care strategy involving extracorporeal cardiopulmonary resuscitation (ECPR).</div></div><div><h3>Methods</h3><div>We conducted invasive haemodynamic assessments on 15 patients who underwent ECPR and achieved return of spontaneous circulation. Left ventricular end-diastolic pressure (LVEDP), ejection fraction (LVEF), end-diastolic volume (LVEDV), and stroke work (LVSW) were evaluated using simultaneous invasive left heart catheterization and 3D echocardiography. Paired comparisons between high and low VA-ECMO flow were performed.</div></div><div><h3>Results</h3><div>Invasive haemodynamic studies were performed in 15 patients aged 58 (43,65) years at 3.0 (2.0, 4.0) days after cannulation. Six patients survived the index hospitalization, and 9 expired during the index hospitalization. Among the total cohort, transitioning from the highest VA-ECMO flow (median 4.0 L/min) to the lowest VA-ECMO flow (median 2.0 L/min) led to increases in LVEDV from 85 (68,125) mL to 106 (70,153) mL (p = 0.005) and LVEDP from 14 (8,23) mmHg to 17 (12,30) mmHg (p = 0.001), respectively. Similarly, the LVSW increased from 2051 ± 1525 mL*mmHg at the highest level of VA-ECMO flow to 2627 ± 1559 at the lowest VA-ECMO flow (p = 0.01).</div></div><div><h3>Conclusion</h3><div>High VA-ECMO flow significantly reduced LVEDP, LVEDV, and LVSW compared to low VA-ECMO flow.</div></div>","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":"207 ","pages":"Article 110475"},"PeriodicalIF":6.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142872390","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":"Management of acute hyperkalemia: Where’s the data behind the old dogma?","authors":"Lindsay N. Shepard,&nbsp;Robert A. Berg","doi":"10.1016/j.resuscitation.2025.110525","DOIUrl":"10.1016/j.resuscitation.2025.110525","url":null,"abstract":"","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":"208 ","pages":"Article 110525"},"PeriodicalIF":6.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143123494","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":"Learn to drive, learn CPR: Advancing road safety and life-saving skills across Europe","authors":"Lorenzo Gamberini,&nbsp;Sebastian Schnaubelt,&nbsp;Manuel Picardi,&nbsp;Federico Semeraro,&nbsp;Koenraad G. Monsieurs","doi":"10.1016/j.resuscitation.2025.110526","DOIUrl":"10.1016/j.resuscitation.2025.110526","url":null,"abstract":"","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":"207 ","pages":"Article 110526"},"PeriodicalIF":6.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143075343","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":"Defining a core outcome comparator for patients treated with extracorporeal cardiopulmonary resuscitation","authors":"Matthias Mueller,&nbsp;Ingrid Magnet,&nbsp;Heidrun Losert,&nbsp;Michael Holzer,&nbsp;Michael Poppe","doi":"10.1016/j.resuscitation.2025.110504","DOIUrl":"10.1016/j.resuscitation.2025.110504","url":null,"abstract":"","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":"207 ","pages":"Article 110504"},"PeriodicalIF":6.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143010620","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":"Practice patterns for acquiring neuroimaging after pediatric in-hospital cardiac arrest","authors":"Matthew P. Kirschen ,&nbsp;Natalie L. Ullman ,&nbsp;Ron W. Reeder ,&nbsp;Tageldin Ahmed ,&nbsp;Michael J. Bell ,&nbsp;Robert A. Berg ,&nbsp;Candice Burns ,&nbsp;Joseph A. Carcillo ,&nbsp;Todd C. Carpenter ,&nbsp;J. Wesley Diddle ,&nbsp;Myke Federman ,&nbsp;Ericka L. Fink ,&nbsp;Aisha H. Frazier ,&nbsp;Stuart H. Friess ,&nbsp;Kathryn Graham ,&nbsp;Christopher M. Horvat ,&nbsp;Leanna L. Huard ,&nbsp;Todd J. Kilbaugh ,&nbsp;Tensing Maa ,&nbsp;Arushi Manga ,&nbsp;Craig A. Press","doi":"10.1016/j.resuscitation.2025.110506","DOIUrl":"10.1016/j.resuscitation.2025.110506","url":null,"abstract":"<div><h3>Aims</h3><div>To determine which patient and cardiac arrest factors were associated with obtaining neuroimaging after in-hospital cardiac arrest, and among those patients who had neuroimaging, factors associated with which neuroimaging modality was obtained.</div></div><div><h3>Methods</h3><div>Retrospective cohort study of patients who survived in-hospital cardiac arrest (IHCA) and were enrolled in the ICU-RESUS trial (NCT02837497).</div></div><div><h3>Results</h3><div>We tabulated ultrasound (US), CT, and MRI frequency within 7 days following IHCA and identified patient and cardiac arrest factors associated with neuroimaging modalities utilized. Multivariable models determined which factors were associated with obtaining neuroimaging. Of 1000 patients, 44% had ≥ 1 neuroimaging study (US in 31%, CT in 18%, and MRI in 6% of patients). Initial USs were performed a median of 0.3 [0.1,0.5], CTs 1.4 [0.4,2.8], and MRIs 4.1 [2.2,5.1] days post-arrest. Neuroimaging timing and frequency varied by site. Factors associated with greater odds of neuroimaging were cardiac arrest in CICU (versus PICU), longer duration CPR, receiving ECMO post-arrest, and post-arrest care with targeted temperature management or EEG monitoring. US performance was associated with congenital heart disease. CT was associated with age ≥ 1-month, greater pre-arrest disability, and receiving CPR for ≥ 16 min. MRI utilization increased with pre-existing respiratory insufficiency and respiratory decompensation as arrest cause, and medical cardiac and surgical non-cardiac or trauma illness category. Overall, if neuroimaging was obtained, US was more common in CICU while CT/MRI were utilized more in PICU.</div></div><div><h3>Conclusions</h3><div>Practice patterns for acquiring neuroimaging after IHCA are variable and influenced by patient, cardiac arrest, and site factors.</div></div>","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":"207 ","pages":"Article 110506"},"PeriodicalIF":6.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143029482","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}