Resuscitation最新文献

{"title":"Is it tau-tological to add novel biomarkers to post-arrest prognostication.","authors":"Laura Faiver, Jonathan Elmer","doi":"10.1016/j.resuscitation.2024.110472","DOIUrl":"10.1016/j.resuscitation.2024.110472","url":null,"abstract":"","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":" ","pages":"110472"},"PeriodicalIF":6.5,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142872372","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":"Prognostic accuracy of early head computed tomography after cardiac arrest - Zooming into the first hours.","authors":"Christoph Leithner, Martin Kenda","doi":"10.1016/j.resuscitation.2024.110473","DOIUrl":"10.1016/j.resuscitation.2024.110473","url":null,"abstract":"","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":" ","pages":"110473"},"PeriodicalIF":6.5,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142872598","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":"Visual detection of pulselessness by carotid artery sonography - A prospective observational study among medical students.","authors":"B Vojnar, A Holl, H C Dinges, T Keller, H Wulf, C Gaik","doi":"10.1016/j.resuscitation.2024.110461","DOIUrl":"10.1016/j.resuscitation.2024.110461","url":null,"abstract":"<p><strong>Aim: </strong>This cross-sectional study aimed to determine whether medical students with little to no ultrasound experience could correctly distinguish between 'pulsation present' and 'no pulsation present' after a short introductory video on the subject using ultrasound videos of the common carotid artery (CCA).</p><p><strong>Methods: </strong>Ultrasound videos (B-mode, M-mode, and Color Doppler) of pulsatile (systolic blood pressure 70-80 mmHg) and non-pulsatile (cardiopulmonary bypass surgery, clamped aorta) CCA were created. These were demonstrated to the medical students for a period of ten seconds - corresponding to the duration of the manual pulse palpation during cardiopulmonary resuscitation (CPR). All participants viewed twenty of these videos in random order on a tablet and were asked to decide whether or not a CCA pulse was present.</p><p><strong>Results: </strong>432 participants completed the study in full on 20 cases, enabling a total of 8640 decisions on CCA pulse 'present' or 'not present' to be evaluated. M-mode: in 96 % (1244/1296) of the cases, the participants correctly identified the presence of pulsatile CCA. In the videos without pulsatile CCA, the correct decision 'no pulsation present' was made in 95 % (1231/1296) of the cases. B-mode: the decision 'pulsation present' was made correctly in 69 % (889/1296) of the cases, and in the remaining 31 % (407/1296) the option 'no pulsation present' was incorrectly chosen, although a video with CCA pulsation was shown. In contrast, the correct decision 'no pulsation present' was selected in 99 % of the cases (2142/2160). Color Doppler: CCA pulsation was correctly detected in 99.5 % (1290/1296) of the cases. In the videos without CCA pulsation, 99 % (1281/1296) of the videos were correctly evaluated as 'no pulsation present'.</p><p><strong>Conclusion: </strong>Medical students seem to be able to detect the absence of a pulse with a high degree of accuracy using 2D ultrasound of the CCA in a controlled study setting, using different ultrasound modes. The results of this study suggest that a combination of Color Doppler and B-mode may be useful when evaluating the CCA during CPR to answer the question 'pulsation present' or 'no pulsation present'.</p>","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":" ","pages":"110461"},"PeriodicalIF":6.5,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142865423","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":"Selective or routine face mask application for breathing support of preterm infants at birth: a randomised trial.","authors":"Caitríona M Ní Chathasaigh, Emma A Dunne, Lucy E Geraghty, Madeleine C Murphy, Eoin O'Currain, Lisa K McCarthy, Colm P F O'Donnell","doi":"10.1016/j.resuscitation.2024.110467","DOIUrl":"10.1016/j.resuscitation.2024.110467","url":null,"abstract":"<p><strong>Background: </strong>Most preterm infants breathe spontaneously at birth. Despite this, the majority have a face mask immediately applied for breathing support. Face mask application may inhibit spontaneous breathing in newborn infants. We wished to determine whether selectively applying a mask to give positive pressure ventilation (PPV) for apnoea or bradycardia only compared to routinely applying a mask for continuous positive airway pressure (CPAP) resulted in fewer preterm infants receiving PPV in the delivery room (DR).</p><p><strong>Methods: </strong>Infants born before 32 weeks of gestation were randomly assigned to either SELECTIVE or ROUTINE groups, stratified by gestational age (GA) [<28 and 28-31 weeks]. Infants in the SELECTIVE group were placed supine to breathe spontaneously and were not to receive mask CPAP before five minutes of life. Infants in the ROUTINE group received face mask CPAP as soon as possible after birth. Infants in both groups received mask PPV for apnoea or bradycardia. The primary outcome was face mask PPV in the DR.</p><p><strong>Results: </strong>Of the 201 who were randomly assigned, we analysed data for 200 infants: 98 in the SELECTIVE group [mean (SD) GA: 28 (3) weeks; birth weight (BW): 1120 (439)g] and 102 in the ROUTINE group [mean (SD) GA: 28 (2) weeks; BW: 1150 (425)g]. PPV rates in the DR were similar between groups [SELECTIVE 63/98 (64 %) versus ROUTINE 53/102 (52 %); RR 1.24, 95 %CI 0.98-1.57, p = 0.08].</p><p><strong>Conclusion: </strong>Selectively applying a face mask for PPV only did not result in fewer preterm infants receiving PPV in the DR.</p>","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":" ","pages":"110467"},"PeriodicalIF":6.5,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142865370","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 impact of gasping versus apnea on initial heart rate and response to positive pressure ventilation in the delivery room following interruption of placental blood flow.","authors":"Jørgen E Linde, Jeffrey Perlman, Robert Moshiro, Ladislaus Blacy, Esto Mduma, Hege Langli Ersdal","doi":"10.1016/j.resuscitation.2024.110462","DOIUrl":"10.1016/j.resuscitation.2024.110462","url":null,"abstract":"<p><strong>Background: </strong>The impact and/or significance of gasping or apnea on cardio-respiratory status at birth remains unclear.</p><p><strong>Objectives: </strong>The study objectives were to determine in infants presenting with gasping or apnea in the delivery room, initial heart rate (HR), responses to positive pressure ventilation (PPV), time to onset of spontaneous respirations, and the relationship of these responses to 24-hour outcome (death/survival) METHODS: Observation study undertaken in a rural setting involving late preterm and term newborns who gasped (n=126) or were apneic (n=105) at birth and received PPV had HR and respiratory parameters continuously measured and were video recorded.</p><p><strong>Results: </strong>Apneic (12.3 %) versus gasping infants (5.7 %) were 7.2-fold more likely to die in the first 24 h (p = 0.01) and 2.8-fold more likely to die (p = 0.047) by 7 days. Initial HR was higher in gasping versus apneic infants (122 vs 105 bpm) (p = 0.01). Time to initiate breathing after starting PPV was significantly shorter in gasping versus apneic infants. No differences in applied peak inflation pressure, tidal volume, end tidal CO2, or resuscitation duration were noted. Of infants who died versus survivors, a HR < 100 bpm was observed more often in both gasping and apneic infants (p = 0.01) CONCLUSIONS: Infants who present with gasping versus apnea are less likely to die; apneic infants are more likely to die within the initial 24 h. Gasping versus apneic infants had a higher initial HR, were less likely to have a HR < 100 bmp and initiated spontaneous respiratory effort sooner after PPV. These findings are consistent with experimental and adult observations that suggest gasping appears critical to survival if PPV is initiated in a timely manner.</p>","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":" ","pages":"110462"},"PeriodicalIF":6.5,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142824472","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 of sternum compressions are associated with higher systolic blood pressure than lower half of sternum compressions in cardiac arrest.","authors":"Daniel M Rolston, Daniel Jafari, Ghania Haddad, Xueqi Huang, Alaina Berruti, Kevin Frank, Nicholas Bielawa, Timmy Li, Lance B Becker, Allison L Cohen","doi":"10.1016/j.resuscitation.2024.110466","DOIUrl":"10.1016/j.resuscitation.2024.110466","url":null,"abstract":"<p><strong>Introduction: </strong>Limited evidence supports guidelines to perform chest compressions at the lower half of the sternum. Imaging studies suggest this location may obstruct blood flow. Our primary aim was to compare the highest arterial line systolic blood pressure (SBP) during lower-half-of-sternum chest compressions (CC) versus those left-of-sternum, where the left ventricle is more likely located. Secondarily, we compared the highest end-tidal CO₂ (ETCO₂).</p><p><strong>Methods: </strong>We conducted a retrospective cohort study of video-recorded, adult Emergency Department (ED) cardiac arrest resuscitations where changes in CC location were attempted to improve physiologic parameters (SBP, ETCO₂). We excluded epigastric and right-of-sternum compressions. Four CC zones were analyzed: recommended lower-half-of-sternum; left of lower-half-of-sternum; high left lateral; low left lateral. We combined all left-of-sternum compressions for analysis using linear mixed-effects models and multivariable mixed-effects controlling for manual vs. mechanical CCs.</p><p><strong>Results: </strong>Among 24 patients analyzed, 20 (83.3 %) had initial compressions at the lower-half-of-sternum. 11 patients had 28 lower-half-of-sternum and 32 left-of-sternum CC intervals with available SBPs. In the mixed-effects model, least squares mean (LSMean) SBP was higher with left-of-sternum CCs (108.5 mmHg [95 % CI 88.3-128.8 mmHg]) versus lower-half-of-sternum CCs (66.7 mmHg [95 % CI 46.5-86.9 mmHg], p < 0.001). 18 patients had 44 lower-half-of-sternum and 32 left-of-sternum CC intervals with available ETCO₂. In the mixed-effects model, LSMean ETCO₂ was similar at the lower-half-of-sternum (20.4 mmHg [95 % CI 16.0-24.9 mmHg]) and left-of-sternum (22.6 mmHg [95 % CI 17.6-27.6 mmHg], p = 0.300). Results were similar when controlling for manual vs. mechanical CCs.</p><p><strong>Conclusions: </strong>In our pilot, retrospective, observational study of select ED cardiac arrest patients, left-of-sternum chest compressions are associated with higher SBP than lower-half-of-sternum compressions, while ETCO₂ was similar.</p>","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":" ","pages":"110466"},"PeriodicalIF":6.5,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142822534","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":"Will simultaneous intra-aortic ballon pump and mechanical chest compressions become the new way of treating cardiac arrests?","authors":"L Wik","doi":"10.1016/j.resuscitation.2024.110463","DOIUrl":"10.1016/j.resuscitation.2024.110463","url":null,"abstract":"","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":" ","pages":"110463"},"PeriodicalIF":6.5,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142824473","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":"Fritz Sterz.","authors":"Michael Baubin, Wolfgang Schreiber","doi":"10.1016/j.resuscitation.2024.110465","DOIUrl":"10.1016/j.resuscitation.2024.110465","url":null,"abstract":"","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":" ","pages":"110465"},"PeriodicalIF":6.5,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142818999","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":"Breaking down barriers: Call-taker strategies to address caller perception of inappropriateness of cardiopulmonary resuscitation during the emergency ambulance call.","authors":"Emogene S Aldridge, Nirukshi Perera, Stephen Ball, Austin Whiteside, Janet Bray, Judith Finn","doi":"10.1016/j.resuscitation.2024.110459","DOIUrl":"10.1016/j.resuscitation.2024.110459","url":null,"abstract":"<p><strong>Background: </strong>Ambulance call-takers perform the critical role of prompting callers to initiate and continue cardiopulmonary resuscitation (CPR) for patients with suspected out-of-hospital cardiac arrest (OHCA). This study aimed to identify call-taker strategies to address callers' perceptions of CPR 'inappropriateness' (perceiving the patient as dead and beyond help, or as showing signs of life).</p><p><strong>Methods: </strong>Using a linguistic approach, we analysed 31 calls previously identified as having an inappropriateness barrier to CPR initiation or continuation. In Phase 1, we listened to call recordings and studied call transcripts to identify the strategies and linguistic features used by call-takers. Phase 2 was a discourse analysis of transcript extracts to describe how certain strategies, identified in Phase 1, were used in the caller-call-taker interactions.</p><p><strong>Results: </strong>Call-takers used various strategies when responding to callers who considered CPR inappropriate. Call-takers rarely used a single strategy or linguistic feature in isolation, tending to use combinations of minimal tokens of alignment (e.g. caller name or encouragements statements), with deontics (including directives/commands and statements of obligation e.g. \"do this for me\") and provision of either context (e.g. \"the ambulance is on its way\") or a rationale (\"he's not breathing effectively so we need to perform CPR to help him\"). Most call-taker attempts were successful, with callers overcoming 71% of initiation barriers and 88% of continuation barriers.</p><p><strong>Conclusions: </strong>Call-takers used a combination of linguistic features (minimal/symbolic tokens, deontics) and strategies (providing unscripted statements about the context or a rationale for CPR) to overcome barriers of perceived inappropriateness to CPR.</p>","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":" ","pages":"110459"},"PeriodicalIF":6.5,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142814134","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":"Effects of very early hyperoxemia on neurologic outcome after out-of-hospital cardiac arrest: A secondary analysis of the TTM-2 trial.","authors":"Filippo Sanfilippo, Agnieszka Uryga, Cristina Santonocito, Janus Christian Jakobsen, Gisela Lilja, Hans Friberg, Pedro David Wendel-Garcia, Paul J Young, Glenn Eastwood, Michelle S Chew, Johan Unden, Matthew Thomas, Anders M Grejs, Matt P Wise, Andreas Lundin, Jacob Hollenberg, Naomi Hammond, Manoj Saxena, Annborn Martin, Robert Bánszky, Fabio Silvio Taccone, Josef Dankiewicz, Niklas Nielsen, Florian Ebner, Jan BeloholaveK, Matthias Hanggi, Luca Montagnani, Nicolo' Patroniti, Chiara Robba","doi":"10.1016/j.resuscitation.2024.110460","DOIUrl":"10.1016/j.resuscitation.2024.110460","url":null,"abstract":"<p><strong>Purpose: </strong>Hyperoxemia is common in patients resuscitated after out-of-hospital cardiac arrest (OHCA) admitted to the intensive care unit (ICU) and may increase the risk of mortality. However, the effect of hyperoxemia on functional outcome, specifically related to the timing of exposure to hyperoxemia, remains unclear.</p><p><strong>Methods: </strong>The secondary analysis of the Target Temperature Management 2 (TTM-2) randomized trial. The primary aim was to identify the best cut-off of partial arterial pressure of oxygen (PaO₂) to predict poor functional outcome within the first 24 h from admission, with this period further separated into 'very early' (0-4 h), 'early' (8-24 h), and 'late' (28-72 h) periods. Hyperoxemia was defined as the highest PaO₂ recorded during each period. Poor functional outcome was defined as a 6 months modified Rankin Score (mRS) of 4 to 6.</p><p><strong>Results: </strong>A total of 1,631 patients were analysed for the 'very early' and 'early' periods, and 1,591 in the 'late period'. In a multivariate logistic regression model, a PaO₂ above 245 mmHg during the very early phase was independently associated with a higher probability of poor functional outcome (Odds Ratio, OR = 1.63, 95 % Confidence Interval, CI 1.08-2.44, p = 0.019). No significant associations were found for the later periods.</p><p><strong>Conclusions: </strong>Very early hyperoxemia after ICU admission is associated with higher risk of poor functional outcome after OHCA. Avoiding hyperoxia in the initial hours after resuscitation should be considered.</p>","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":" ","pages":"110460"},"PeriodicalIF":6.5,"publicationDate":"2024-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142802029","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}