Resuscitation最新文献

{"title":"Volatile sedation for cardiac arrest patients. The question is still unanswered.","authors":"Sara Alcántara Carmona, Miguel Ángel Romera Ortega, Carlos Chamorro Jambrina","doi":"10.1016/j.resuscitation.2025.110576","DOIUrl":"10.1016/j.resuscitation.2025.110576","url":null,"abstract":"","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":" ","pages":"110576"},"PeriodicalIF":6.5,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143617019","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":"Response to \"Shot in the thigh or stab in the dark? Challenging the evidence for IM adrenaline in OHCA\".","authors":"Helen N Palatinus, Scott T Youngquist","doi":"10.1016/j.resuscitation.2025.110573","DOIUrl":"10.1016/j.resuscitation.2025.110573","url":null,"abstract":"","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":" ","pages":"110573"},"PeriodicalIF":6.5,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143617017","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":"Hesitate to resuscitate? A cohort study of hesitation to initiate resuscitation for in-hospital cardiac arrests","authors":"Lovisa Alarik ,&nbsp;Maja Nelson ,&nbsp;Lovisa Terling ,&nbsp;Anna Thoren ,&nbsp;Therese Djärv","doi":"10.1016/j.resuscitation.2025.110572","DOIUrl":"10.1016/j.resuscitation.2025.110572","url":null,"abstract":"<div><h3>Background</h3><div>In the event of an in-hospital cardiac arrest (IHCA), the fundamental principle is to initiate Cardiopulmonary Resuscitation (CPR). Lately, decisions on Do-not-attempt CPR (DNACPR) have received increasing attention which might affect the perception of medical staff in initiation of resuscitation.</div></div><div><h3>Aim</h3><div>To investigate to which extent medical staff hesitate to initiate CPR when arriving at an IHCA and to explore the factors influencing their hesitation.</div></div><div><h3>Methods</h3><div>Nationwide cohort study based on data from the Swedish Registry of Cardiopulmonary Resuscitation between the years 2007–2023 including all IHCAs aged 18 and over. Hesitation was defined based on answers on the variable “Expression of hesitation to start CPR”, it was categorized into either Hesitation (Yes) or Non-hesitation (no/unknown/left blank). Additional free text comments regarding the grounds for the hesitation was evaluated with an inductive qualitative content analysis. Hesitation ratio was calculated as the quote per variable.</div></div><div><h3>Results</h3><div>Among 36 471 patients with IHCA, the hesitation ratio was 8% (<em>n</em> = 2757). The patients mean age was 79 years in the hesitation group compared to 72 in the non-hesitation group (p-value &lt; 0.01). Hesitation ratio was higher in patients admitted to general wards than in patients admitted to intensive care units (11% vs. 3%, p-value &lt; 0.01). A hesitation ratio over 10% was found for; age, ongoing myocardial infarction, general ward, non-ECG-surveillance and unwitnessed. Grounds for the hesitations were most commonly due to a prior DNACPR order or a wish from the staff to have such, some related to age or comorbidity but none related to frailty.</div></div><div><h3>Conclusion</h3><div>Hesitation to initiate CPR in IHCA occur, particularly among older patients admitted in general wards. Hesitation relates to lack of resuscitation decisions or staff expressing an opinion that a DNACPR decision should have been made prior to the IHCA. This suggests that the routine around discussions and decisions of DNACPR orders could be improved.</div></div>","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":"210 ","pages":"Article 110572"},"PeriodicalIF":6.5,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143586756","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations with resolution of ST-segment elevation myocardial infarction criteria on out-of-hospital 12-lead electrocardiograms following resuscitation from cardiac arrest","authors":"Christopher J. Naas ,&nbsp;Hadi O. Saleh ,&nbsp;Thomas W. Engel II ,&nbsp;David D. Gutterman ,&nbsp;Aniko Szabo ,&nbsp;Thomas Grawey ,&nbsp;Benjamin W. Weston ,&nbsp;Christopher E. Monti ,&nbsp;John E. Baker ,&nbsp;Jacob Labinski ,&nbsp;Lujia Tang ,&nbsp;Jamie Jasti ,&nbsp;Jason A. Bartos ,&nbsp;Rajat Kalra ,&nbsp;Demetris Yannopoulos ,&nbsp;M. Riccardo Colella ,&nbsp;Tom P. Aufderheide","doi":"10.1016/j.resuscitation.2025.110567","DOIUrl":"10.1016/j.resuscitation.2025.110567","url":null,"abstract":"<div><h3>Introduction</h3><div>A previous study found that following out-of-hospital cardiac arrest (OHCA), 67% of out-of-hospital 12-lead electrocardiograms (ECGs) diagnostic for ST-segment elevation myocardial infarction (STEMI) changed to non-STEMI on repeat emergency department (ED) ECG. Here we evaluated associations with resolution of STEMI on ED ECG.</div></div><div><h3>Methods</h3><div>In this secondary analysis of a previous retrospective study, adults (≥18 years) with return of spontaneous circulation (ROSC) following OHCA, at least 1 out-of-hospital and ED ECG and transport to the study hospital were entered. We analyzed variables suspected of influencing ischemic changes on ECG including arrest characteristics, treatment interventions, resuscitation duration, and out-of-hospital and ED ECG acquisition times.</div></div><div><h3>Results</h3><div>Forty-nine of 176 patients entered had out-of-hospital ECGs diagnostic for STEMI, and 33/49 (67%) had resolved STEMI upon ED evaluation. Shorter resuscitation time (13 [interquartile range 5–18] vs 21 [14–28] minutes), <em>p</em> = 0.007), less epinephrine (3 [1–4] vs 5 [2–10] milligrams, <em>p</em> = 0.018), lower incidence of norepinephrine (5/33 (15%) vs 11/16 (69%), <em>p</em> ≤ 0.001), less time from ROSC to out-of-hospital ECG acquisition (5.5 [1–8] vs 8.5 [7–14] minutes, <em>p</em> = 0.044), and more time between out-of-hospital and ED ECG acquisition (34 [25–52] vs 21 [14–27] minutes, <em>p</em> = 0.001) were associated with resolution of out-of-hospital STEMI on ED evaluation. More defibrillations were associated with increased ischemia on ED ECG for patients with non-STEMI out-of-hospital ECGs.</div></div><div><h3>Conclusion</h3><div>ROSC patients with STEMI on out-of-hospital ECG commonly resolve in the ED (67%). These identified associations may better inform clinical decision making. Post-ROSC out-of-hospital 12-lead ECGs should be repeated on arrival in the ED.</div></div>","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":"209 ","pages":"Article 110567"},"PeriodicalIF":6.5,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143586742","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":"Amiodarone in shockable cardiac arrest: lights and shadows","authors":"Alessia Currao,&nbsp;Simone Savastano","doi":"10.1016/j.resuscitation.2025.110568","DOIUrl":"10.1016/j.resuscitation.2025.110568","url":null,"abstract":"","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":"209 ","pages":"Article 110568"},"PeriodicalIF":6.5,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143586740","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":"From first aid to BLS certification: Addressing the distinction in training standards","authors":"Federico Semeraro,&nbsp;Lorenzo Gamberini,&nbsp;Sebastian Schnaubelt,&nbsp;Manuel Picardi,&nbsp;Koenraad G. Monsieurs","doi":"10.1016/j.resuscitation.2025.110571","DOIUrl":"10.1016/j.resuscitation.2025.110571","url":null,"abstract":"","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":"209 ","pages":"Article 110571"},"PeriodicalIF":6.5,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143586754","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":"Double or nothing: Alternative defibrillation strategies reduces downtime in ventricular fibrillation","authors":"D. Stub ,&nbsp;R. Batchelor ,&nbsp;J. Ball","doi":"10.1016/j.resuscitation.2025.110570","DOIUrl":"10.1016/j.resuscitation.2025.110570","url":null,"abstract":"","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":"209 ","pages":"Article 110570"},"PeriodicalIF":6.5,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143586750","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":"Evaluating the accuracy of surrogate markers for identifying opioid-associated out-of-hospital cardiac arrests","authors":"Jamie Jasti,&nbsp;Kristopher Kennedy,&nbsp;M. Riccardo Colella,&nbsp;Tom P. Aufderheide","doi":"10.1016/j.resuscitation.2025.110569","DOIUrl":"10.1016/j.resuscitation.2025.110569","url":null,"abstract":"<div><h3>Background</h3><div>Previous studies have used emergency medical services (EMS) naloxone administration and EMS overdose impression as surrogate markers to identify opioid-associated (OA) out-of-hospital cardiac arrests (OA-OHCA). We evaluated the accuracy of these two surrogate markers using medical examiner post-mortem toxicology data in OHCA patients who died.</div></div><div><h3>Methods</h3><div>We conducted a retrospective cohort study of all adult (≥18) non-traumatic OHCA patients treated by Milwaukee County EMS between January 1st, 2015 to December 31st, 2016. EMS naloxone administration and EMS impression of cardiac arrest etiology were used to classify expired patients into 2 groups: (1a) Received ≥1 Naloxone (1b) No Naloxone, and (2a) EMS-impression overdose, (2b) Not EMS-impression overdose. Milwaukee County Medical Examiner (MCME) opioid toxicology data was used as the reference standard and matched to EMS-treated OHCA patients that expired to determine the sensitivity (SN), specificity (SP), positive predictive value (PPV), and the negative predictive value (NPV) of both surrogate markers.</div></div><div><h3>Results</h3><div>1,654 OHCA cases were included; 112 (6.8%) received ≥1 Naloxone and 1,542 (93.2%) received No Naloxone; 60 (3.6%) were EMS-impression overdose and 1,594 (96.4%) were not EMS-impression overdose. Of the 525 opioid-associated deaths in the MCME Drug-related Death Database, 150 (28.6%) were OA-OHCA cases treated by EMS. The SN, SP, PPV, and NPV for EMS naloxone administration was 39%, 96%, 52%, and 94% respectively. The SN, SP, PPV, and NPV for EMS-impression overdose was 27%, 99%, 68%, and 93% respectively.</div></div><div><h3>Conclusion</h3><div>EMS naloxone administration and EMS- impression overdose had limited sensitivity for identifying OA-OHCA in expired patients in this large urban EMS system. Prehospital and public health researchers should identify improved methods for accurately classifying this OHCA subpopulation.</div></div>","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":"209 ","pages":"Article 110569"},"PeriodicalIF":6.5,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143586752","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":"Corrigendum to “The “invisible ceiling” of bystander CPR in three Asian countries: Descriptive study of national OHCA registry” [Resuscitation 206 (2025) 110445]","authors":"Yohei Okada ,&nbsp;Ki Jeong Hong ,&nbsp;Shir Lynn Lim ,&nbsp;Dehan Hong ,&nbsp;Yih Yng Ng ,&nbsp;Benjamin S.H. Leong ,&nbsp;Kyoung Jun Song ,&nbsp;Jeong Ho Park ,&nbsp;Young Sun Ro ,&nbsp;Tetsuhisa Kitamura ,&nbsp;Chika Nishiyama ,&nbsp;Tasuku Matsuyama ,&nbsp;Takeyuki Kiguchi ,&nbsp;Norihiro Nishioka ,&nbsp;Taku Iwami ,&nbsp;Sang Do Shin ,&nbsp;Marcus Eng Hock Ong ,&nbsp;Fahad Javaid Siddiqui","doi":"10.1016/j.resuscitation.2025.110555","DOIUrl":"10.1016/j.resuscitation.2025.110555","url":null,"abstract":"","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":"209 ","pages":"Article 110555"},"PeriodicalIF":6.5,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143552367","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The association between initial defibrillation dose and outcomes following adult out-of-hospital cardiac arrest resuscitation: A retrospective, multi-agency study","authors":"Tanner Smida ,&nbsp;Sheldon Cheskes ,&nbsp;Remle Crowe ,&nbsp;Bradley S. Price ,&nbsp;James Scheidler ,&nbsp;Michael Shukis ,&nbsp;P.S. Martin ,&nbsp;James Bardes","doi":"10.1016/j.resuscitation.2025.110507","DOIUrl":"10.1016/j.resuscitation.2025.110507","url":null,"abstract":"<div><h3>Introduction</h3><div>Effective defibrillation is essential to out-of-hospital cardiac arrest (OHCA) survival. International guidelines recommend initial defibrillation energies between 120 and 360 Joules, which has led to widespread practice variation. Leveraging this natural experiment, we aimed to explore the association between initial defibrillation dose and outcome following OHCA.</div></div><div><h3>Methods</h3><div>The ESO Data Collaborative (2018–2022) was used for this nationwide, retrospective study of adult (18–80 years of age) non-traumatic OHCA patients who presented with an initially shockable ECG rhythm. We excluded patients if they had ROSC prior to initial defibrillation, a resuscitation-limiting advanced directive, or were residents in a healthcare institution. The primary exposure was initial defibrillation dose, defined as Joules per kilogram of body weight, and the primary outcome was return of spontaneous circulation (ROSC). We included survival to discharge as a secondary outcome. We used multivariable logistic regression modeling to assess the relationship between defibrillation dose and outcome.</div></div><div><h3>Results</h3><div>We analyzed data from 21,121 patients. Of the 12,160 patients linked to a defibrillator manufacturer, 7,240 (59.5%) were treated using a biphasic truncated exponential (BTE) waveform and 4,920 (40.5%) were treated using a rectilinear biphasic (RLB) waveform. Defibrillation dose (per 1 J/kg increase) was not associated with ROSC (BTE aOR: 0.97 [0.92, 1.01], <em>n</em> = 7,240; RLB aOR: 1.00 [0.92, 1.09], <em>n</em> = 4,920; all aOR: 1.01 [0.98, 1.04], 21,121) or survival (BTE aOR: 0.98 [0.87, 1.10], <em>n</em> = 1,245; RLB aOR: 0.89 [0.70, 1.12], <em>n</em> = 775; all aOR: 1.00 [0.92, 1.08], <em>n</em> = 2,981).</div></div><div><h3>Conclusions</h3><div>Initial defibrillation dose was not associated with outcome in this nationwide cohort.</div></div>","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":"208 ","pages":"Article 110507"},"PeriodicalIF":6.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143041667","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}