Resuscitation最新文献

{"title":"Pitfalls in assessing graft outcomes from donors initially treated with ECPR for out-of-hospital cardiac arrest","authors":"Tal Soumagnac, Jean-Herlé Raphalen, Damien Vimpere, Alice Hutin, Lionel Lamhaut","doi":"10.1016/j.resuscitation.2026.111368","DOIUrl":"https://doi.org/10.1016/j.resuscitation.2026.111368","url":null,"abstract":"","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":"1 1","pages":""},"PeriodicalIF":6.5,"publicationDate":"2026-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149231812","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":"Fatigue, Anxiety and Depression 12 Months After Out-of-Hospital Cardiac Arrest: A Population Based Cohort Study.","authors":"Daniel O Okyere, Emily Nehme, Janet Bray, Katie N Dainty, Ashanti Dantanarayana, Ziad Nehme","doi":"10.1016/j.resuscitation.2026.111359","DOIUrl":"https://doi.org/10.1016/j.resuscitation.2026.111359","url":null,"abstract":"<p><strong>Aim: </strong>To determine the prevalence and factors associated with fatigue, anxiety, and depression 12 months after out-of-hospital cardiac arrest (OHCA); examine their associations with health-related quality of life (HRQoL) and functional recovery; and compare symptom burden with population norms.</p><p><strong>Methods: </strong>This prospective, population-based cohort study included adults (≥18 years) who received EMS-attempted resuscitation and survived to hospital discharge following non-traumatic OHCA in Victoria, Australia, between July 2019 and June 2022. Survivors were identified from a statewide OHCA registry and completed a 12-month telephone interview. Primary outcomes were fatigue (Modified Fatigue Impact Scale), anxiety and depression (Hospital Anxiety and Depression Scale). Secondary outcomes included HRQoL (EQ-5D, SF-12), functional recovery (GOSE), living arrangement, and return to work.</p><p><strong>Results: </strong>Of 1068 eligible 12-month survivors, 728 (68.2%) completed follow-up (median age 61 years; 555 [76.2%] male). Fatigue was reported by 35.8% (250/699), anxiety by 22.6% (162/716), and depression by 18.0% (129/716). Higher symptom burden was associated with lower EQ-5D and SF-12 scores, worse GOSE outcomes (all p<0.001) and reduced return-to-work rates. Compared with population norms, survivors reported greater fatigue (SMD 0.64; 95%CI, 0.50-0.78;p<0.001), and depression (SMD, 0.12; 95%CI, 0.02,0.21;p=0.02) but lower anxiety (SMD, -0.27; 95%CI, -0.35 to -0.18;p<0.001). In adjusted models, younger age, preexisting anxiety or depression, diabetes and initial non-shockable arrest were associated with higher symptom burden, whereas EMS-witnessed arrests were associated with lower symptom burden.</p><p><strong>Conclusions: </strong>Fatigue, anxiety, and depression were common at 12 months after OHCA and are associated with poorer recovery. Fatigue exceeded population norms and may be an under-recognised component of cardiac arrest survivorship.</p>","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":" ","pages":"111359"},"PeriodicalIF":6.0,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149228552","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":"Identifying the Operational Bottleneck to Shock Delivery After Automated External Defibrillator Activation.","authors":"Tsuyoshi Nojima, Tetsuya Yumoto, Takafumi Obara, Kohei Tokioka, Takashi Hongo, Yoshinori Kosaki, Kohei Tsukahara, Atsunori Nakao, Hiromichi Naito","doi":"10.1016/j.resuscitation.2026.111361","DOIUrl":"https://doi.org/10.1016/j.resuscitation.2026.111361","url":null,"abstract":"<p><strong>Introduction: </strong>Cardiac arrest registries record automated external defibrillator (AED) use and shock delivery but not post-activation operational timing. We aimed to identify the largest measurable bottleneck and an exploratory pad-application target for shock delivery within 60 seconds of AED power-on.</p><p><strong>Methods: </strong>We retrospectively analyzed timestamps from remotely monitored Nihon Kohden AEDs between January 2018 and February 2026. After excluding inspection records, we grouped records into activation events and quantified intervals. Shock-timing and receiver operating characteristic (ROC) analyses were restricted to initially shock-advised events with recorded shock delivery.</p><p><strong>Results: </strong>We analyzed 8,115 activation events. Median times were 42 seconds (interquartile range [IQR], 30-56) from power-on to completion of pad application, nine seconds (IQR, 9-11) from pad application to the first analysis, and 52 seconds (IQR, 40-66) from power-on to the first analysis endpoint. The power-on-to-pad-application interval accounted for a median of 81% (IQR, 75-85) of the total power-on-to-first-analysis interval, increasing to 87% (IQR, 85-90) when first analysis occurred more than 60 seconds after power-on. Among 900 initially shock-advised events with recorded shock delivery, the median pad-application-to-shock interval was 15 seconds (IQR 13-17). Exploratory ROC analysis yielded a power-on to pad-application threshold of ≥ 51 seconds in relation to first recorded shock delivery occurring more than 60 seconds after AED power-on.</p><p><strong>Conclusions: </strong>The interval from AED power-on to electronically detected completion of pad application, encompassing all intervening actions, was the largest measurable post-activation bottleneck. Completion within 50 seconds may serve as an exploratory process target for first recorded shock delivery within 60 seconds among initially shock-advised events.</p>","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":" ","pages":"111361"},"PeriodicalIF":6.0,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149228535","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":"Regional implementation of a prehospital advanced life support program with video-assisted physician direction and outcomes after out-of-hospital cardiac arrest.","authors":"Yongyeon Choi","doi":"10.1016/j.resuscitation.2026.111362","DOIUrl":"https://doi.org/10.1016/j.resuscitation.2026.111362","url":null,"abstract":"<p><strong>Background: </strong>The smart advanced life support (SALS) program was introduced to provide prehospital advanced life support under real-time video-assisted physician direction for out-of-hospital cardiac arrest (OHCA). This study evaluated the association between regional SALS implementation and OHCA outcomes.</p><p><strong>Methods: </strong>This retrospective cohort study used difference-in-differences and event-study analyses with data from the OHCA surveillance system in South Korea and included adult OHCA cases (aged ≥19 years) from 2 years before through 4 years after SALS implementation in August 2015. The exposure was region-level implementation of SALS. Outcomes were the prehospital time interval, prehospital return of spontaneous circulation (ROSC), survival to discharge, and favorable neurological outcome. Pre- to post-implementation changes were compared between regions with and without SALS.</p><p><strong>Results: </strong>A total of 129,207 cases were included. SALS regions had greater increases in the prehospital time interval (4.12 minutes; 95% confidence interval [CI], 2.91 to 5.33) and prehospital ROSC (1.35 percentage points; 95% CI, 0.56 to 2.15) than regions without SALS. No significant additional improvements were observed in survival to discharge (-0.35 percentage points; 95% CI, -1.31 to 0.62) or favorable neurological outcome (-0.35 percentage points; 95% CI, -1.08 to 0.37). Event-study analyses suggested differential pre-intervention trends for prehospital time, but not for the other outcomes.</p><p><strong>Conclusion: </strong>SALS regions showed greater increases in prehospital time and prehospital ROSC without significant improvements in survival to discharge or favorable neurological outcome, but the finding for prehospital time should be interpreted cautiously because differential pre-intervention trends were observed.</p>","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":" ","pages":"111362"},"PeriodicalIF":6.0,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149228661","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 burst-suppression with identical bursts and multimodal measures of cerebral oxygenation after cardiac arrest.","authors":"Laura Faiver, Jonathan Tam, Cecelia R Ratay, Jonathan Elmer, Patrick J Coppler","doi":"10.1016/j.resuscitation.2026.111360","DOIUrl":"https://doi.org/10.1016/j.resuscitation.2026.111360","url":null,"abstract":"<p><strong>Objective: </strong>Burst-suppression with identical bursts (BSIB) is an electroencephalographic (EEG) pattern associated with severe post-cardiac arrest brain injury (PCABI). Whether modifiable mechanisms of brain injury underlie BSIB is unknown. We hypothesized BSIB is associated with impaired cerebral oxygen metabolism, reflected as pathologically elevated jugular bulb venous oxygen saturation (SjvO₂), higher brain tissue oxygen tension (PbtO₂), normal jugular bulb venous-to-arterial carbon dioxide gradient (PbCO₂ gap, and lower intracranial pressure (ICP) compared to other EEG patterns.</p><p><strong>Methods: </strong>This single-center retrospective study included patients resuscitated from cardiac arrest who underwent EEG and SjvO₂ or PbtO₂ monitoring. We categorized EEG patterns as BSIB, malignant without BSIB, and non-malignant. Using mixed effects linear regression, we examined associations between EEG and SjvO₂, PbCO₂ gap, PbtO₂, and ICP.</p><p><strong>Results: </strong>The SjvO₂ and PbtO₂ cohorts included 109 and 33 patients, respectively. SjvO₂ did not differ between BSIB and malignant EEGs (β=3; 95% CI, -0.6 to 7.0), butwas higher with BSIB compared to non-malignant patterns (β=12; 95% CI, 7.0 to 16.0). BSIB was associated with lower PbCO₂ gap compared to malignant (β=-1.4; 95% CI, -2.6 to -0.3) and non-malignant (β=-2.6; 95% CI, -4.1 to -1.0) patterns. PbtO₂ was highest with BSIB, but not significantly higher compared to malignant patterns in our adjusted model (β=4.0; 95% CI, -4.7 to 13.0). ICP was lower in those with BSIB compared to malignant patterns (β=-19.0; 95% CI, -32.5 to -5.6). Interpretation BSIB may represent a distinct subtype of PCABI characterized by impaired oxygen metabolism with preserved oxygen delivery and diffusion.</p>","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":" ","pages":"111360"},"PeriodicalIF":6.0,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149228516","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":"Real-time feedback during bag-valve-mask ventilation for out-of-hospital cardiac arrest: a before-and-after study (VEntilation during Cardiac Arrest Resuscitation Study, VECARS-2).","authors":"Daniel Jost, Alexandre Petermann, Bruno Tassart, Marina Salome, Frédéric Lemoine, Justin Liscia, Benoît Frattini, Clément Derkenne, Michael Lemaire, Stéphane Travers","doi":"10.1016/j.resuscitation.2026.111364","DOIUrl":"https://doi.org/10.1016/j.resuscitation.2026.111364","url":null,"abstract":"<p><p>This study compared bag-valve-mask ventilation quality and adherence to the guideline-recommended ventilation volume range during 30:2 cardiopulmonary resuscitation for out-of-hospital cardiac arrest before and after the implementation of real-time feedback. We conducted a before-and-after observational study of two sequential adult cohorts with out-of-hospital cardiac arrest managed by basic life support teams from the Paris Fire Brigade. A bidirectional sensor measured insufflated volume (Vi) and expiratory tidal volume (Vt). The display was masked during Period-1 and provided real-time feedback during Period-2. We assessed adherence to the guideline-recommended range using mixed-effects regression; we analyzed Vt and leak volume using gamma log-link generalized linear mixed models. We analyzed 4,300 ventilations in 163 patients, 96 without feedback and 67 with feedback. Median Vi was lower with feedback (471 mL) than without (513 mL, p=0.03 for the first ventilation of each cycle) but median Vt was unchanged (235 vs. 243 mL, p=0.84). Vi dispersion was reduced by 35% (mean within-patient IQR ratio 0.65 [95%-CI, 0.53-0.77]). Vi was 400-600 mL in 68% of ventilations with feedback vs. 42% without feedback. In contrast, Vt was 400-600 mL in only 14% of ventilations with feedback vs. 15% without feedback. In multivariable analysis, leak volume was 12% lower with feedback (mean ratio, 0.88 [95%-CI, 0.77-0.99]). Real-time feedback was associated with improved adherence to the guideline-recommended range for Vi, less dispersed Vi,and lower leak volume. Causal inference, clinical significance, and generalizability warrant further evaluation.</p>","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":" ","pages":"111364"},"PeriodicalIF":6.0,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149228591","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 Capnographic Changes During Pulse Checks of Varying Durations and Clinical Outcomes During Cardiopulmonary Resuscitation: A Multicenter Study From Türkiye (CaPTuRe).","authors":"Gökhan Yılmaz, Muhammet Raşit Özer, Ramazan Köylü, Ejder Saylav Bora, Şakir Hakan Aksu, Cüneyt Arıkan, Bora Çekmen, İsmail Ataş, Gülin İnan, Müge Arslan, Oğuzhan Bol, Ozan Demir, Neslihan Şahin, Hüseyin Şahin, Arife Erdoğan, Hüseyin Avni Demir, Kadir Küçükceran, Mustafa Kürşat Ayrancı, Nazire Belgin Akıllı, Ecem Ermete Güler, Bedriye Müge Sönmez, Alanur Tarhan, Gökhan Ersunan, Özlem Bilir, Necmi Baykan, İbrahim Toker, Ahmet Çelik, İzzettin Hür, Hayriye Gönüllü, Abdulhalik Bekfelavi, Emine Kadıoğlu, Oğuzhan Can, İsmail Aktaş","doi":"10.1016/j.resuscitation.2026.111358","DOIUrl":"https://doi.org/10.1016/j.resuscitation.2026.111358","url":null,"abstract":"<p><strong>Aim: </strong>To investigate the association between capnographic changes during pulse checks of different durations and cardiopulmonary resuscitation (CPR) outcomes.</p><p><strong>Methods: </strong>This multicenter, prospective, controlled, quasi-randomized study categorized patients according to pulse check duration: Group A (≤5 seconds) and Group B (>5 to ≤10 seconds). Five measurements were obtained during the first six CPR cycles. Four capnographic parameters were evaluated for each measurement: Post-CPR end-tidal carbon dioxide (ETCO₂), Pre-CPR ETCO₂, loss rate (percentage decrease between Post- and Pre-CPR ETCO₂), and recovery time (time required to regain the previous cycle's Post-CPR ETCO₂).</p><p><strong>Results: </strong>The study included 252 cardiac arrest patients (Group A, n=124; Group B, n=128). In Group A, patients with return of spontaneous circulation (ROSC) had markedly lower loss rates and shorter recovery times than non-survivors, together with higher pre- and post-CPR ETCO₂ values (all p<0.001). Group A also had a higher ROSC rate than Group B (36.3% vs. 19.5%; p=0.005). Logistic regression identified pulse check duration as an independent predictor of ROSC, with Group A having 2.39-fold higher odds of ROSC than Group B (odds ratio [OR]=2.39, 95% confidence interval [CI]=1.347-4.242; p=0.003). Pre-CPR ETCO₂ was strongly negatively correlated with loss rate (ρ=-0.770), whereas Pre- and Post-CPR ETCO₂ values (ρ=0.96) and loss rate and recovery time (ρ=0.89) were strongly positively correlated.</p><p><strong>Conclusion: </strong>Pulse checks completed within 5 seconds were associated with more favorable capnographic dynamics and higher ROSC rates than those lasting 6-10 seconds. These findings are hypothesis-generating and warrant prospective validation.</p>","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":" ","pages":"111358"},"PeriodicalIF":6.0,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149228575","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 Selection Bias: Post-Event Video Deletion and Trust in Healthcare.","authors":"Sameer Al-Abdi","doi":"10.1016/j.resuscitation.2026.111354","DOIUrl":"https://doi.org/10.1016/j.resuscitation.2026.111354","url":null,"abstract":"","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":" ","pages":"111354"},"PeriodicalIF":6.0,"publicationDate":"2026-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149216741","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":"Where Are the Female Manikins? Representation of Female Anatomy Across Two European Resuscitation Congresses.","authors":"Nino Fijačko, Guglielmo Imbriaco, Robert Greif, Kristin Alm-Kruse, Sergio Cazorla-Calderón","doi":"10.1016/j.resuscitation.2026.111366","DOIUrl":"https://doi.org/10.1016/j.resuscitation.2026.111366","url":null,"abstract":"","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":" ","pages":"111366"},"PeriodicalIF":6.0,"publicationDate":"2026-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149216681","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":"Making blood work: Toward precision care after cardiac arrest.","authors":"Nicholas Case, Jonathan Elmer","doi":"10.1016/j.resuscitation.2026.111363","DOIUrl":"https://doi.org/10.1016/j.resuscitation.2026.111363","url":null,"abstract":"","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":" ","pages":"111363"},"PeriodicalIF":6.0,"publicationDate":"2026-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149216655","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}