Resuscitation最新文献

{"title":"A novel TEE-guided algorithm for identifying pump mechanisms in cardiopulmonary resuscitation via cardiac morphology changes","authors":"Chih-Jung Chang, Sheng-En Chu, Matthew Huei‐Ming Ma, Wen‐Chu Chiang, Jen-Tang Sun","doi":"10.1016/j.resuscitation.2025.110640","DOIUrl":"10.1016/j.resuscitation.2025.110640","url":null,"abstract":"","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":"212 ","pages":"Article 110640"},"PeriodicalIF":6.5,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144086108","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":"Pre-hospital ECPR for refractory cardiac arrest – The PRECARE pilot feasibility study","authors":"Natalie Kruit ,&nbsp;Brian Burns ,&nbsp;Nicolas Shearer ,&nbsp;Jason Hui ,&nbsp;Andrew Coggins ,&nbsp;Hergen Buscher ,&nbsp;Emily Granger ,&nbsp;Kevin Ostrowski ,&nbsp;Brian Plunkett ,&nbsp;Timothy J. Southwood ,&nbsp;Paul Forrest ,&nbsp;Hannah Braithwaite ,&nbsp;Jan Dieleman ,&nbsp;Aidan Burrell ,&nbsp;Anthony Keech ,&nbsp;Mark Dennis","doi":"10.1016/j.resuscitation.2025.110631","DOIUrl":"10.1016/j.resuscitation.2025.110631","url":null,"abstract":"<div><h3>Background</h3><div>Survival from refractory out of hospital cardiac arrest (OHCA) treated with conventional cardiopulmonary resuscitation (CCPR) remains low. Extracorporeal cardiac resuscitation (ECPR) is increasingly be utilised in refractory OHCA, with outcomes influenced by the duration of cardiac arrest prior establishing ECMO flow (low flow time). Pre-hospital ECPR aims to reduce the low flow time. Pre-hospital physicians may represent a workforce who could deliver ECPR, increasing access and sustainability.</div></div><div><h3>Methods</h3><div>A single-arm open-label feasibility trial of pre-hospital ECPR delivered by pre-hospital physicians. Patients under the age of 70 years with a witnessed collapse, an initial shockable rhythm and within a 45-minute radius of the mobile team were eligible for pre-hospital ECPR. Once extracorporeal support flow was established, patients were transported to one of three ECMO capable centers. The primary aim was to assess the feasibility of pre-hospital ECPR in this setting.</div></div><div><h3>Results</h3><div>From August 2023 to June 2024, over 103 recruitment days, the pre-hospital ECPR team attended 123 confirmed cardiac arrests, 12 (10%) patients received pre-hospital ECPR equating to one case per 8 shifts. All patients were successfully cannulated on scene while the patient was in cardiac arrest. The mean time from dispatch to team arrival was 18.5 min (range 9–29); mean time from decision to ECMO flow was 17 min (range 10–34) and the mean total low flow time (arrest to ECMO flow) was 39 min (range 24–56). Four (33%) patients were successfully liberated from VA ECMO support, 3 (25%) patients survived to hospital discharge neurologically intact (CPC 1–2).</div></div><div><h3>Conclusions</h3><div>Pre-hospital ECPR delivery by trained pre-hospital medical teams is possible and reduces OHCA low flow times. Larger studies are required to assess efficacy and cost effectiveness.</div></div>","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":"212 ","pages":"Article 110631"},"PeriodicalIF":6.5,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144079790","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":"Dispatch-assisted cardiopulmonary resuscitation and prior bystander training influence neurological outcomes after out-of-hospital cardiac arrest","authors":"Guillaume Debaty,&nbsp;Nicolas Segond","doi":"10.1016/j.resuscitation.2025.110637","DOIUrl":"10.1016/j.resuscitation.2025.110637","url":null,"abstract":"","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":"212 ","pages":"Article 110637"},"PeriodicalIF":6.5,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144054376","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 hemodynamic response to epinephrine during CPR: a renewed call for precision resuscitation","authors":"Ryan W. Morgan ,&nbsp;Robert A. Berg","doi":"10.1016/j.resuscitation.2025.110635","DOIUrl":"10.1016/j.resuscitation.2025.110635","url":null,"abstract":"","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":"212 ","pages":"Article 110635"},"PeriodicalIF":6.5,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144036595","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 Gordian challenge of selective vulnerability in post-cardiac arrest brain injury: the problem or the solution?","authors":"Anthony Bishara,&nbsp;Annie Kathuria,&nbsp;Romergryko G. Geocadin","doi":"10.1016/j.resuscitation.2025.110636","DOIUrl":"10.1016/j.resuscitation.2025.110636","url":null,"abstract":"","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":"212 ","pages":"Article 110636"},"PeriodicalIF":6.5,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144042350","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":"Intraosseous vs. intravenous access during out-of-hospital cardiac arrest: a Bayesian secondary analysis of a randomised clinical trial","authors":"Mikael Fink Vallentin ,&nbsp;Mathias J. Holmberg ,&nbsp;Asger Granfeldt ,&nbsp;Thomas Lass Klitgaard ,&nbsp;Søren Mikkelsen ,&nbsp;Fredrik Folke ,&nbsp;Helle Collatz Christensen ,&nbsp;Amalie Ling Povlsen ,&nbsp;Alberthe Hjort Petersen ,&nbsp;Sofie Winther ,&nbsp;Lea Wildt Frilund ,&nbsp;Carsten Meilandt ,&nbsp;Kristian Blumensaadt Winther ,&nbsp;Allan Bach ,&nbsp;Thomas H. Dissing ,&nbsp;Christian Juhl Terkelsen ,&nbsp;Steffen Christensen ,&nbsp;Line Kirkegaard Rasmussen ,&nbsp;Lone Riis Mortensen ,&nbsp;Mads Ladefoged Loldrup ,&nbsp;Lars W. Andersen","doi":"10.1016/j.resuscitation.2025.110634","DOIUrl":"10.1016/j.resuscitation.2025.110634","url":null,"abstract":"<div><h3>Aim of the study</h3><div>This study aimed to apply a Bayesian probabilistic framework to the Intravenous vs. Intraosseous Vascular Access for Out-of-Hospital Cardiac Arrest (IVIO) trial data to evaluate the likelihood of benefit for each vascular access method while incorporating various prior beliefs.</div></div><div><h3>Methods</h3><div>The IVIO trial was a randomised trial comparing intraosseous to intravenous access in 1,479 adults with non-traumatic out-of-hospital cardiac arrest. Bayesian analyses were pre-planned in the protocol and conducted using both non-informative and informative priors to calculate posterior probabilities for sustained return of spontaneous circulation, 30-day survival, and 30-day survival with a favourable neurologic outcome.</div></div><div><h3>Results</h3><div>Using non-informative priors for return of spontaneous circulation, the posterior probabilities that the effect of either vascular access exceeds the hypothesised difference were 1.2% (risk ratio &gt; 1.27, favouring intraosseous access) and &lt; 0.1% (risk ratio &lt; 0.79 [1/1.27], favouring intravenous access). For 30-day survival and survival with a favourable neurologic outcome, the posterior probability that the risk ratio for intraosseous compared to intravenous access is between 0.83 (1/1.2) and 1.2 was 58% and 55%, respectively. For all analyses with informative priors, the results did not provide probabilities strongly favouring either intraosseous or intravenous access.</div></div><div><h3>Conclusions</h3><div>The probability of a clinically meaningful difference in return of spontaneous circulation between intraosseous and intravenous access for out-of-hospital cardiac arrest was very low, while results for 30-day outcomes were uncertain, with no strong evidence favouring either method.</div></div><div><h3>Trial registration</h3><div>EU Clinical Trials number: 2022-500744-38-00.</div><div><span><span>ClinicalTrials.gov</span><svg><path></path></svg></span> number: NCT05205031.</div></div>","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":"212 ","pages":"Article 110634"},"PeriodicalIF":6.5,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144054378","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 postresuscitation 12-lead ECG features and long-term neurological outcome after out-of-hospital cardiac arrest: a post-hoc subanalysis of the PEACE study","authors":"Sebastian Schnaubelt ,&nbsp;Andrea Kornfehl ,&nbsp;Enrico Baldi ,&nbsp;Benedikt Schnaubelt ,&nbsp;Johannes Vilsmeier ,&nbsp;Bianca Citterio ,&nbsp;Roberto Primi ,&nbsp;Sara Bendotti ,&nbsp;Alessia Currao ,&nbsp;Maria Luce Caputo ,&nbsp;Christoph Schriefl ,&nbsp;Mario Krammel ,&nbsp;Patrick Sulzgruber ,&nbsp;Hans Domanovits ,&nbsp;Simone Savastano ,&nbsp;Michael Holzer","doi":"10.1016/j.resuscitation.2025.110630","DOIUrl":"10.1016/j.resuscitation.2025.110630","url":null,"abstract":"<div><h3>Background</h3><div>Out-of-hospital cardiac arrest (OHCA) has low survival rates worldwide. For the diagnosis of acute coronary syndrome causing OHCA and the identification of patients eligible for immediate coronary angiography, the post-return of spontaneous circulation electrocardiogram (post-ROSC ECG) is crucial. However, it is still unclear whether post-ROSC ECG features also pose a sensible feature for outcome prediction.</div></div><div><h3>Methods</h3><div>This retrospective study analysed adult non-traumatic OHCA cases with post-ROSC ECGs admitted to one of the three participating centers in Vienna (Austria), Pavia (Italy) and Lugano (Switzerland) between 01/2015 and 12/2018, and reports ECG features, survival and neurological outcome (at hospital discharge and after one year). Univariable and multivariable logistic regression assessed associations between ECG features and neurological outcome.</div></div><div><h3>Results</h3><div>STEMI was diagnosed in 53.5% of post-ROSC ECGs. 68.1% of patients were discharged, with 59.5% having a favorable neurological outcome. One year later, 61.6% of non-STEMI patients had a favorable outcome compared to 54% of STEMI patients. Univariable analysis indicated that ST-elevations in II, III, and aVF, as well as a broader QRS complex significantly influenced neurological outcomes at one year.</div></div><div><h3>Conclusions</h3><div>ECG after ROSC can identify patients at high risk of death after OHCA earlier than other prognostic methods, not only in terms of short-term mortality, but also in terms of neurological outcome one year after OHCA. Wider QRS complex and ST-elevations in II, III, or aVF were identified as specific prognosticators.</div></div>","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":"212 ","pages":"Article 110630"},"PeriodicalIF":6.5,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143936904","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":"Inclusive intent, unequal output: GPT-4o image generation is not yet the answer to the visual resource gap in resuscitation education","authors":"David Purkarthofer,&nbsp;Valentina Bachner","doi":"10.1016/j.resuscitation.2025.110632","DOIUrl":"10.1016/j.resuscitation.2025.110632","url":null,"abstract":"","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":"212 ","pages":"Article 110632"},"PeriodicalIF":6.5,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144009713","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":"Incidence and outcomes of out-of-hospital cardiac arrest from initial asystole: a systematic review and meta-analysis","authors":"Dhiraj Bhatia Dwivedi ,&nbsp;Jocasta Ball ,&nbsp;Karen Smith ,&nbsp;Ziad Nehme","doi":"10.1016/j.resuscitation.2025.110629","DOIUrl":"10.1016/j.resuscitation.2025.110629","url":null,"abstract":"<div><h3>Aim</h3><div>To examine global variation in the incidence and outcomes of Emergency Medical Services (EMS) attended and treated out-of-hospital cardiac arrest (OHCA) from initial asystole.</div></div><div><h3>Data sources</h3><div>We systematically reviewed electronic databases for studies between 1990 and August 2024 reporting EMS-attended or treated asystolic OHCA populations. The primary outcome was survival to hospital discharge or 30-days. Random-effects models were used to pool primary and secondary outcomes and meta-regression was used to examine sources of heterogeneity. Study quality was assessed using the Joanna Briggs Institute critical appraisal tool for prevalence studies.</div></div><div><h3>Results</h3><div>The search returned 4464 articles, of which 82 studies were eligible for inclusion encompassing 540,054 EMS-treated patients across 35 countries. Five studies reported on EMS attended populations (<em>n</em> = 35,561). The studies included in the review had high clinical and statistical heterogeneity. The pooled proportion of EMS-treated initial asystolic OHCA was 53.0% (95% CI: 49.0%, 58.0%; I² = 100%). The overall pooled proportion of survivors to hospital discharge or 30-days was 1.5% (95% CI: 1.2%, 1.8%, I² = 97%). The pooled proportion of event survivors was 11.6% (95% CI 6.5%, 17.8%, I² = 99%), the pooled proportion of prehospital ROSC was 16.0% (95% CI 14.0%, 17.0%, I² = 100%) and the pooled proportion of neurologically favourable survival at longest follow-up was 0.6% (95% CI 0.5%, 0.8%, I² = 100%). The overall pooled incidence of EMS-treated asystolic OHCA was 11.0 cases per 100,000 person-years (95% CI: 10.5, 11.5, I² = 100%). In stratified analysis of survival to hospital discharge or 30-days, population type, study duration, study design and aetiology were the only variables that were significantly associated with survival to hospital discharge or 30-days. In adjusted analysis, population type, study duration, highest EMS skill level and region were significantly associated with the primary outcome. In the multivariable analysis of incidence, study region, arrest aetiology, sample size, year of publication, study population, study duration and study quality significantly explained variation in incidence across studies.</div></div><div><h3>Conclusion</h3><div>Initial asystolic OHCA made up 53% of all EMS-treated patients and pooled survival rates were extremely poor. Research efforts in this population should focus on developing prevention strategies as well as adherence to termination or withholding of resuscitation guidelines for asystolic OHCA.</div></div>","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":"212 ","pages":"Article 110629"},"PeriodicalIF":6.5,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144031816","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 Resuscitation Olympic Games: a blend of fun competition and serious clinical performance benchmarking at the European Resuscitation Council congress","authors":"Johannes Wittig,&nbsp;Ahmed Elshaer,&nbsp;Roshani Karunarathne,&nbsp;Bernhard Kowalski,&nbsp;Giuseppe Ristagno","doi":"10.1016/j.resuscitation.2025.110633","DOIUrl":"10.1016/j.resuscitation.2025.110633","url":null,"abstract":"","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":"212 ","pages":"Article 110633"},"PeriodicalIF":6.5,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144036381","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}