Resuscitation最新文献

{"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}

{"title":"We’re no longer flying blind—resuscitation in the ECPR era","authors":"Maxwell A. Hockstein, Joseph E. Tonna","doi":"10.1016/j.resuscitation.2025.110648","DOIUrl":"10.1016/j.resuscitation.2025.110648","url":null,"abstract":"","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":"213 ","pages":"Article 110648"},"PeriodicalIF":6.5,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144128106","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":"How should shock-resistant ventricular fibrillation best be analyzed and handled?","authors":"Trond Nordseth","doi":"10.1016/j.resuscitation.2025.110643","DOIUrl":"10.1016/j.resuscitation.2025.110643","url":null,"abstract":"","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":" ","pages":"110643"},"PeriodicalIF":6.5,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144128046","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, Sune Forsberg, 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":" ","pages":"110627"},"PeriodicalIF":6.5,"publicationDate":"2025-05-19","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":"Attenuation of mitochondrial dysfunction in a ventricular fibrillation swine model of cardiac arrest treated with carbon monoxide.","authors":"Tiffany S Ko, John C Greenwood, Ryan W Morgan, Benjamin S Abella, Frances S Shofer, McKenna Mason, Devora Weintraub, Devesh Bungatavula, Alistair Lewis, Nicolina R Ranieri, Arjun G Yodh, Wesley B Baker, Rodrigo M Forti, Shih-Han Kao, Samuel S Shin, Todd J Kilbaugh, David H Jang","doi":"10.1016/j.resuscitation.2025.110647","DOIUrl":"https://doi.org/10.1016/j.resuscitation.2025.110647","url":null,"abstract":"<p><strong>Background: </strong>Out-of-hospital cardiac arrest (OHCA) affects over 360,000 adults in the United States each year with a 50-80% mortality. Despite aggressive supportive care and use of targeted temperature management, half of adults do not live to hospital discharge and nearly one-third of survivors have significant neurologic injury. Development of neuroprotective therapeutics is critical to improving outcomes. One promising readily available agent that has shown benefit is carbon monoxide (CO).</p><p><strong>Methods: </strong>We utilize a swine model of ventricular fibrillation (VF) arrest to assess the therapeutic effect of CO on cellular measures. All animals underwent VF arrest followed by cardiopulmonary resuscitation until achievement of return of spontaneous circulation (ROSC) or the 20 min mark. One hour following ROSC, animals were randomized to the Cardiac Arrest group (VF alone) versus the CO group (VF treated with CO). Animals in the CO group were administered low dose CO of 200 ppm for two hours. At three hours post-ROSC period, all animals were euthanized for tissue and blood collection for mitochondrial respiration (cortical and hippocampal tissue) and the downstream biomolecular analysis.</p><p><strong>Results: </strong>The primary findings were an overall improvement in mitochondrial respiration and ATP concentrations in the brain from animals in the Carbon Monoxide group. In addition, we also report the use of cell-free DNA as a biomarker to localize the site of tissue injury and our non-invasive optical measuring device to assess cerebral metabolism.</p><p><strong>Conclusions: </strong>CO may be a potential therapeutic to attenuate cellular injury in post-arrest.</p>","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":" ","pages":"110647"},"PeriodicalIF":6.5,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144094736","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":"Metrics that matter: benchmarking in pediatric in-hospital cardiac arrest","authors":"Amanda O’Halloran,&nbsp;Ryan W. Morgan","doi":"10.1016/j.resuscitation.2025.110641","DOIUrl":"10.1016/j.resuscitation.2025.110641","url":null,"abstract":"","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":"212 ","pages":"Article 110641"},"PeriodicalIF":6.5,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144094746","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":"Could it be end-tidal carbon dioxide? the quest for the holy grail of resuscitation","authors":"Van de Voorde Patrick","doi":"10.1016/j.resuscitation.2025.110646","DOIUrl":"10.1016/j.resuscitation.2025.110646","url":null,"abstract":"","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":"212 ","pages":"Article 110646"},"PeriodicalIF":6.5,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144094738","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":"Neurologic etiologies of cardiac arrest are associated with early withdrawal of life-sustaining therapy.","authors":"Laura Faiver, Jonathan Tam, Patrick J Coppler, Cecelia R Ratay, Nicholas Case, Jonathan Elmer","doi":"10.1016/j.resuscitation.2025.110644","DOIUrl":"10.1016/j.resuscitation.2025.110644","url":null,"abstract":"<p><strong>Background: </strong>Neurologic etiologies of cardiac arrest are uncommon and understudied. We described the characteristics of patients who arrested from neurologic etiologies and tested the hypotheses that survival, rate of withdrawal of life-sustaining therapy for perceived poor neurologic prognosis (WLST-N), and early (≤1 day from arrest) WLST-N would differ between those who did and did not arrest from neurologic etiologies.</p><p><strong>Methods: </strong>We conducted a retrospective study of patients resuscitated from cardiac arrest. We described the cohort who arrest from neurologic causes. We assessed survival between patients with and without neurologic arrest etiologies using multivariable logistic regression. We used Fisher's exact test to compare proportion of patients with early WLST-N by arrest etiology. We performed a time-to-event analysis and used Cox regression to test the association between arrest etiology and rate of WLST-N, censoring for death from other cause and survival at hospital discharge.</p><p><strong>Results: </strong>We included 4,414 patients, of whom 158 (3.6%) arrested from neurologic causes. Compared to patients to non-neurologic arrest etiologies, patients who arrested from neurologic etiologies had lower odds of survival (OR 0.39; 95% CI, 0.21-0.70) and worse functional outcomes (p < 0.001). Patients with neurologic arrest etiologies had increased hazard of WLST-N (HR 2.4; 95% CI, 1.87-3.15) and a greater proportion had early WLST-N (p < 0.001).</p><p><strong>Conclusion: </strong>Neurologic etiologies of cardiac were associated with worse functional outcomes and increased in-hospital mortality. Early mortality among patients with neurologic arrest etiologies was driven by withdrawal of life-sustaining treatment for perceived poor neurologic prognosis, suggesting prognostic nihilism.</p>","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":" ","pages":"110644"},"PeriodicalIF":6.5,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144094748","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 smartphone activated first responders on provision of bystander CPR, bystander AED and outcomes for out-of-hospital cardiac arrest (OHCA)","authors":"Haruka Takahashi ,&nbsp;Nurul Ain ,&nbsp;Stephanie Fook-Chong ,&nbsp;Fan Qiao ,&nbsp;Nur Shahidah ,&nbsp;Yohei Okada ,&nbsp;Yih Yng Ng ,&nbsp;Dehan Hong ,&nbsp;Benjamin SH Leong ,&nbsp;Michael YC Chia ,&nbsp;Desmond R Mao ,&nbsp;Ling Tiah ,&nbsp;Wei Ming Mg ,&nbsp;Nausheen E Doctor ,&nbsp;Scott Compton ,&nbsp;Marcus EH Ong ,&nbsp;Singapore PAROS Investigators","doi":"10.1016/j.resuscitation.2025.110645","DOIUrl":"10.1016/j.resuscitation.2025.110645","url":null,"abstract":"<div><h3>Background</h3><div>The smartphone application to activate a community first responder (myResponder) was launched in 2015 to activate volunteer first responders for Out-of-Hospital Cardiac Arrest (OHCA) patients in Singapore. This study aimed to investigate the impact of myResponder on provision of bystander CPR, bystander AED, and patient survival outcomes.</div></div><div><h3>Methods</h3><div>This was a retrospective analysis using the Singapore Pan-Asian Resuscitation Outcomes Study between 2016 and 2019 that included adult non-traumatic OHCA patients. Patients were categorized into myResponder activated and non-activated groups. The primary outcomes were bystander CPR and bystander AED. The secondary outcome was survival at 30-days with favourable neurological outcomes (cerebral performance category 1–2). A multivariable logistic regression analysis was performed and we reported adjusted odds ratio [aOR] and 95% confidence interval for the effect of activation.</div></div><div><h3>Results</h3><div>9,167 patients were included in this analysis. The median (Interquartile range, IQR) age was 71 (59–82) years. The activated group comprised 5,499 (60%) of cases. The activated group was associated with higher bystander CPR (aOR [95%CI]: 5.69 [4.89–6.62]) and bystander AED (aOR [95% CI]: 2.23 [1.82–2.74]) compared to non-activated group. The activated group was associated with better survival at 30 days with favourable neurological outcomes (aOR [95% CI]: 1.54 [1.11–2.15]).</div></div><div><h3>Conclusion</h3><div>We found that the implementation of technology-activated first responders was associated with an improvement in the performance of bystander CPR, bystander AED application, and OHCA outcomes in an urban area. Further efforts should be made to promote the use of activated first responders in EMS systems.</div></div>","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":"212 ","pages":"Article 110645"},"PeriodicalIF":6.5,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144094743","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":"The significance of possible non-occlusive mesenteric ischemia in relation to neurological outcomes in patients with refractory cardiac arrest - Secondary analysis of the Prague OHCA study.","authors":"Jana Smalcova, Jacky Suen, Michal Huptych, Ondrej Franek, Petra Kavalkova, Helena Lahoda Brodska, Martin Balik, Jan Malik, Jan Pudil, Ondrej Smid, Martin Fajkus, Molly-Rose McInerney, Jan Belohlavek","doi":"10.1016/j.resuscitation.2025.110642","DOIUrl":"10.1016/j.resuscitation.2025.110642","url":null,"abstract":"<p><strong>Background: </strong>Intestinal injury as a consequence of ischemia-reperfusion injury after refractory cardiac arrest is not fully understood. This study evaluates the occurrence of clinical signs reflecting possible non-occlusive mesenteric ischemia (NOMI) to outcomes in patients with refractory cardiac arrest.</p><p><strong>Methods: </strong>In a post-hoc analysis of a randomized, prospective Prague OHCA study comparing ECPR vs. CPR approaches in refractory out-of-hospital CA, all patients who survived longer than one hour after hospital admission were analyzed. We assessed possible NOMI based on clinical signs (mainly profuse diarrhea and abdominal distension) and their onset within 12 h of admission. Its occurrence was correlated with neurologically unfavorable outcome (Cerebral Performance Category (CPC) Scale 3-5) at 180 days. Cox regression was used to evaluate the relationship of particular variables to adverse neurological outcomes.</p><p><strong>Results: </strong>Of the 256 study participants, 61 developed possible NOMI: 46 (51.7%) in the ECPR group and 15 (16.5%) in the CPR group. Adverse neurological outcomes occurred in 41 (89%) and nine (60%) patients, respectively. The number of patients developing possible NOMI was higher in those treated with ECPR (p > 0.01). Its occurrence correlated with cardiac arrest length, elevated levels of neuron-specific enolase and procalcitonin at 48 and 72 h. It was independently associated with adverse outcomes. In Cox regression, possible NOMI was associated with poor neurological outcomes in ECPR patients.</p><p><strong>Conclusion: </strong>The development of profuse diarrhea, abdominal distension and other signs suggesting non-occlusive mesenteric ischemia in patients with refractory out-of-hospital cardiac arrest are observed more frequently in patients with poor neurological outcome at day 180, especially in patients treated with ECPR.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov: NCT01511666.</p>","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":" ","pages":"110642"},"PeriodicalIF":6.5,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144094753","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}