Resuscitation最新文献

{"title":"Translating the R-EDByUS score into clinical decisions after cardiac arrest.","authors":"Cheng-Yi Fan, Chih-Wei Sung","doi":"10.1016/j.resuscitation.2026.111353","DOIUrl":"10.1016/j.resuscitation.2026.111353","url":null,"abstract":"","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":" ","pages":"111353"},"PeriodicalIF":6.0,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149196087","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":"Early post-ROSC laboratory phenotypes and clinical outcomes after out-of-hospital cardiac arrest: a 10-year national cohort study.","authors":"Xinyi Liu, Kwone Wai Chong, Yee How Lau, Chester Lee Drum, Arthur Mark Richards, Gregory Y H Lip, Khung Keong Yeo, Marcus E H Ong, Shir Lynn Lim","doi":"10.1016/j.resuscitation.2026.111351","DOIUrl":"10.1016/j.resuscitation.2026.111351","url":null,"abstract":"<p><strong>Background: </strong>Prior phenotyping in out-of-hospital cardiac arrest (OHCA) relied predominantly on prehospital indicators, which neither describe nor grade the underlying ischemia-reperfusion injury. We aimed to derive laboratory-based phenotypes and describe their clinical characteristics and outcome associations.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study of adult resuscitated OHCA patients of presumed cardiac etiology between 01/02/2011 and 01/01/2022, linking Singapore's national OHCA and cardiovascular databases. Unsupervised latent class analysis (LCA) was applied to 14 laboratory variables within six hours post-return of spontaneous circulation (ROSC). Stability was confirmed through split-sample validation. Logistic regression and Cox proportional hazards model, adjusted for age, sex and initial cardiac rhythm, assessed poor neurological recovery at hospital discharge, 30-day and 3-year mortality.</p><p><strong>Results: </strong>Among 1514 eligible patients (median age 65.0 years, 73.6% males), LCA identified three distinct phenotypes: multi-organ dysfunction (MOD, N = 286), homeostatic (HOM, N = 967), and immune-dysregulated (IMD, N = 261), independently reproduced in derivation (entropy = 0.817) and replication (entropy = 0.892) subsamples. The most discriminative variables were creatinine, eosinophil and lymphocyte. Compared to MOD, both HOM (aOR: 0.50, 95% CI 0.30-0.78, p = 0.004) and IMD (aOR: 0.46, 95% CI 0.26-0.78, p = 0.005) phenotypes had significantly lower odds of poor neurological recovery. This pattern was consistent for 30-day mortality (HOM aHR: 0.71, 95% CI 0.61-0.83; IMD aHR: 0.78, 95% CI 0.64-0.94) and 3-year mortality (HOM aHR: 0.70, 95% CI 0.60-0.82; IMD aHR: 0.74, 95% CI 0.62-0.90), all p ≤ 0.01.</p><p><strong>Conclusion: </strong>Early post-ROSC laboratory data identified three prognostically distinct phenotypes among resuscitated OHCA patients. These exploratory findings support external validation and investigation of phenotype-guided therapies.</p>","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":" ","pages":"111351"},"PeriodicalIF":6.0,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149148016","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 epidemiology of paediatric out-of-hospital cardiac arrest in Australia and New Zealand: a report from the Australasian resuscitation outcomes Consortium Epistry (Aus-ROC).","authors":"Amrita Saha, Stuart Howell, Ziad Nehme, Jason Acworth, Judith Finn, Stephen Ball, Jason Belcher, Emma Bosley, Tan Doan, Bridget Dicker, Heather Hutchinson, Sarah Maessen, Andy Swain, Steven Faddy, Kimberley Davis, Jake Mayhew, Amy Keir, Damien Norsworthy, Matt Green, Mike McDermott, Ashanti Dantanarayana, Sam Perillo, Curtis Cooper, Peter Cameron, Janet E Bray","doi":"10.1016/j.resuscitation.2026.111347","DOIUrl":"10.1016/j.resuscitation.2026.111347","url":null,"abstract":"<p><strong>Background: </strong>This first epidemiological study of paediatric out-of-hospital cardiac arrest (pOHCA) across Australia and New Zealand explores the incidence, patient and event characteristics, both overall and by developmental age groups, and examines factors associated with outcomes.</p><p><strong>Methods: </strong>All pOHCAs (aged <18 years) attended by emergency medical services (EMS) in Australia and New Zealand from 2017 to 2023 were included. Crude incidence rates (per 100,000 person-years) were calculated for EMS-attended and EMS-treated cases. Logistic regression models were used to identify associations between patient and arrest characteristics and survival (event and 30-day/hospital discharge).</p><p><strong>Results: </strong>EMS attended 4779 cases and treated 3139 (65.7%). Incidence rates for EMS-attended and EMS-treated cases were 10.1 and 6.6, respectively; with a bimodal age distribution peaking in infants (65.4) and adolescents (11.4). Most EMS-attended cases were unwitnessed (66.9%), of medical origin (60.1%), had initial non-shockable rhythms (91.1%), occurred in private residences (74.3%), and received bystander cardiopulmonary resuscitation (62.7%). Few (1.6%) received bystander defibrillation. Arrest characteristics varied widely between age groups. Survival to 30-days/hospital discharge in EMS-treated cases was 10.0% (highest in late childhood [15.4%] and lowest in infants [7.9%]). Multivariable analysis identified that increasing age was positively associated with event survival, whilst bystander-witnessed arrest, initial shockable rhythm, arrest aetiology, and EMS response time were significant predictors of short and long-term survival.</p><p><strong>Conclusion: </strong>The incidence, patient characteristics, and survival outcomes of pOHCA in our region differ significantly by age groups. Age- and context-specific prevention and resuscitation strategies are essential for reducing the burden and improving survival outcomes.</p>","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":" ","pages":"111347"},"PeriodicalIF":6.0,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149149322","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":"Outcomes following impedance threshold device use during out-of-hospital cardiac arrest.","authors":"Aaron C Weidman, Remle P Crowe, Ali Treichel, James J Menegazzi","doi":"10.1016/j.resuscitation.2026.111340","DOIUrl":"10.1016/j.resuscitation.2026.111340","url":null,"abstract":"<p><strong>Background: </strong>Existing work is equivocal regarding the benefit of impedance threshold device (ITD) use among patients experiencing out-of-hospital cardiac arrest (OHCA). We examined the association of ITD use with prehospital outcomes and longer-term dispositions in a nationally representative sample of OHCA patients.</p><p><strong>Methods: </strong>We included adult, non-traumatic, OHCA scene runs from the 2024 ESO Data Collaborative. We compared patients treated with (a) ITD only; (b) ITD and active compression-decompression device (ITD + ACD); and (c) neither device (no ITD). Prehospital outcomes included return of spontaneous circulation (ROSC) and survival to hospital arrival (SHA); disposition outcomes included survival to hospital discharge and favorable neurologic outcome (i.e., discharge to home). We used multivariate logistic regression to examine the association of treatment group with outcomes, adjusting for demographics and several potential confounders.</p><p><strong>Results: </strong>We included 97,439 patient records (85.3% no ITD; 13.1% ITD only; 1.6% ITD + ACD). Disposition outcomes were available for 13,026 patients (13.4%). ROSC was higher for patients treated with ITD only (26.7%) than those treated with no ITD (23.8%; aOR = 1.09 [1.04, 1.14]); a similar pattern emerged for SHA. Conversely, survival to discharge was lower for patients treated with ITD only (23.9%) than those treated with no ITD (32.0%; aOR = 0.68, [0.61, 0.76]); a similar pattern emerged for favorable neurologic outcome. The ITD + ACD group showed more extreme versions of the trends observed for ITD only.</p><p><strong>Conclusions: </strong>ITD use was associated with improved prehospital outcomes but worsened dispositional outcomes among patients experiencing OHCA, suggesting this device may prove beneficial early in resuscitation of OHCA patients.</p>","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":" ","pages":"111340"},"PeriodicalIF":6.0,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149138138","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":"Automated external defibrillators for in-hospital cardiac arrest: a systematic review.","authors":"Farzan Ansari, Melanie Walker, Raquel Oleksin, Angélique Roy, Alex Taylor, Steven C Brooks","doi":"10.1016/j.resuscitation.2026.111350","DOIUrl":"10.1016/j.resuscitation.2026.111350","url":null,"abstract":"<p><strong>Background: </strong>Automated external defibrillators (AEDs) improve survival after out-of-hospital cardiac arrest, but their role in in-hospital cardiac arrest (IHCA) remains uncertain. This systematic review evaluates whether ward-accessible AED capability prior to code blue team arrival improves survival and neurologic outcomes compared with standard resuscitation systems.</p><p><strong>Methods: </strong>Six databases were searched. Eligible studies compared AED use to manual defibrillation in IHCA outside specialized areas. Primary outcome was survival with favorable neurological status (CPC 1-2, mRS 0-3, or no deterioration from baseline). Secondary outcomes included ROSC, survival at 24 h, survival to discharge, 30-day survival, CPR quality, and timing metrics. Three independent reviewers performed study selection, data extraction, and risk-of-bias assessment. Due to substantial heterogeneity, results were synthesized descriptively.</p><p><strong>Results: </strong>Six reports from five unique study cohorts met inclusion criteria (total screened = 5510). Neurologically favorable survival was inconsistent. One study reported improved outcomes following a combined AED-and-training intervention, whereas the largest multicentre cohort found no significant difference in neurological disability among survivors (adjusted relative risk 1.01, 95% CI 0.93-1.09). ROSC and survival to discharge were not consistently improved. Only one study directly quantified AED-associated compression pauses, and effects on time to defibrillation varied by setting.</p><p><strong>Conclusion: </strong>Available evidence is insufficient to determine whether routine ward-level AED deployment improves IHCA outcomes. Included studies were observational and heterogeneous and CPR quality and training were incompletely characterized. Potential benefit from earlier defibrillation in shockable rhythms must be weighed against possible compression interruptions. Contemporary comparative studies are needed.</p>","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":" ","pages":"111350"},"PeriodicalIF":6.0,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149114111","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":"Prehospital prognostication after out-of-hospital cardiac arrest in tertiary care centers: the R-EDByUS score in the JAAM-OHCA registry.","authors":"Takenobu Shimada, Ryota Kawai, Ayumi Shintani, Satoshi Kodera, Naoki Fujisawa, Wataru Saitoh, Yoshihiro Iwasaki, Takefumi Kishimori, Sakae Matsuzuka, Yusuke Hayashi, Atsushi Shibata, Asahiro Ito, Kenichiro Otsuka, Yasutomi Higashikuni, Norihiko Takeda, Tetsuro Nishimura, Yasumitsu Mizobata, Daiju Fukuda","doi":"10.1016/j.resuscitation.2026.111341","DOIUrl":"10.1016/j.resuscitation.2026.111341","url":null,"abstract":"<p><strong>Aim: </strong>The R-EDByUS score predicts unfavorable neurological outcomes after out-of-hospital cardiac arrest (OHCA) using prehospital variables alone, with separate models based on return of spontaneous circulation (ROSC) status at hospital arrival. However, whether the score remains valid in patients transported to tertiary care centers is uncertain. We therefore aimed to validate it externally in this setting.</p><p><strong>Methods: </strong>Using the JAAM-OHCA Registry, we analyzed adult patients with presumed cardiogenic OHCA transported to tertiary care centers. The regression-based R-EDByUS score was applied to predict unfavorable neurological outcome (Cerebral Performance Category 3-5) at 1 month in the prehospital ROSC and ongoing cardiopulmonary resuscitation (CPR) cohorts. Discrimination and calibration were assessed, and score performance was examined across in-hospital intervention subgroups (percutaneous coronary intervention, targeted temperature management, and extracorporeal membrane oxygenation). We also assessed the proportion of patients with unfavorable outcomes among those with a predicted probability ≥99%.</p><p><strong>Results: </strong>Of 29,345 patients, 3305 were classified into the prehospital ROSC cohort and 26,040 into the ongoing CPR cohort. The score showed good discrimination, with areas under the curve of 0.906 and 0.913, and good calibration in the prehospital ROSC cohort. Discrimination was lower among patients who received PCI, TTM, or ECMO in the ongoing CPR cohort. Among patients with a predicted probability ≥99%, 100% (112/112; prehospital ROSC) and 99.9% (20,560/20,588; ongoing CPR) had unfavorable outcomes.</p><p><strong>Conclusion: </strong>The R-EDByUS score showed good discrimination in the JAAM-OHCA Registry, supporting its use for early risk stratification in cardiogenic OHCA even in tertiary care centers.</p>","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":" ","pages":"111341"},"PeriodicalIF":6.0,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149114140","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":"Hypoxia: the acid test for the neonatal heart!?","authors":"Mathijs Binkhorst, Marije Hogeveen","doi":"10.1016/j.resuscitation.2026.111255","DOIUrl":"10.1016/j.resuscitation.2026.111255","url":null,"abstract":"","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":" ","pages":"111255"},"PeriodicalIF":6.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148762121","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 to measure first responders' arrival time in a smartphone alerting system? An observational study.","authors":"Annalena G U Heisel, Hans-Jörg Busch, Georg Trummer, Sebastian Heinrich, Michael Patrick Müller, Julian Ganter","doi":"10.1016/j.resuscitation.2026.111329","DOIUrl":"10.1016/j.resuscitation.2026.111329","url":null,"abstract":"<p><strong>Background: </strong>Out-of-hospital cardiac arrest remains a time-critical emergency in which early cardiopulmonary resuscitation and defibrillation are key to survival. Smartphone Alerting Systems (SAS) mobilize community first responders (CFR) rapidly, but accurate measurement of their arrival times remains challenging for system evaluation and optimization.</p><p><strong>Methods: </strong>In this observational study, all activations of the SAS \"Region of Lifesavers\" in Freiburg, Germany, were analyzed over a 12-month period (1/12/2023-30/11/2024). Response time was defined as the interval from system activation by the dispatch center to one of three arrival indicators: GPS entry into a 100-m radius (GPS100m), GPS entry into a 50-m radius (GPS50m), or manual confirmation via the app. Descriptive statistics, the Friedman test, Wilcoxon signed-rank test, and Bland-Altman plots were used to compare the response time measurement methods.</p><p><strong>Results: </strong>Of 1498 alerts, 2480 CFR accepted, the median arrival times were GPS100m = 04:21 [02:58, 06:00] min, GPS50m = 04:40 [03:19, 06:25] min, and manual confirmation 05:50 [04:03, 08:04] min (1577 complete data cases). Significant differences were observed between all methods (p < 0.001 for all pairwise comparisons). Manual confirmation was documented in only 69.2% of cases. Bland-Altman analysis showed a smaller bias for GPS50m than for GPS100m, with comparable limits of agreement.</p><p><strong>Conclusion: </strong>GPS-based tracking provides a reliable, objective measure of CFR arrival times. The 50 m geofence offers the highest practical applicability and consistency. Manual confirmation was often delayed or missing, limiting its reliability. GPS50m could be considered a standardized metric for arrival measurement in SAS for further evaluation and optimization. (DRKS00032957, 30/10/2023).</p>","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":" ","pages":"111329"},"PeriodicalIF":6.0,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149064300","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 impact of bystander-patient relationship and age in patients with out-of-hospital cardiac arrest.","authors":"Hiroaki Yaginuma, Yuichi Saito, Kazuya Tateishi, Hideki Kitahara, Naohiro Yonemoto, Tetsuya Matoba, Yoshio Tahara, Yoshio Kobayashi","doi":"10.1016/j.resuscitation.2026.111330","DOIUrl":"10.1016/j.resuscitation.2026.111330","url":null,"abstract":"<p><strong>Aim of the study: </strong>Bystander presence improves outcomes after out-of-hospital cardiac arrest (OHCA). Although bystander type is reportedly associated with neurological outcomes, the potential modifying effect of age on this association remains uncertain.</p><p><strong>Methods: </strong>Using the All-Japan Utstein Registry, we included adults with witnessed OHCA between 2005 and 2023. Patients were categorized into 3 groups according to the bystander-patient relationship (family members, friends and colleagues, and passersby) and further divided into 4 age categories (18-69, 70-79, 80-89, and ≥90 years). The primary endpoint was 1-month neurologically favorable survival.</p><p><strong>Results: </strong>Of the 554,923 patients included, 459,841 (82.9%) were witnessed by family members, 55,112 (9.9%) were witnessed by friends or colleagues, and 39,970 (7.2%) were witnessed by passersby. With advancing age, the proportion of patients witnessed by family members increased (P < 0.001). The probability of neurologically favorable survival at 1 month was lowest in the family members group, followed by the passersby and the friends and colleagues group (4.2% vs. 10.1% vs. 15.3%, P < 0.001). This trend overall remained consistent across age groups. Multivariable analysis showed that OHCA witnessed by family members was associated with poorer neurological outcomes. Among younger patients (aged 20-40 years), however, OHCA witnessed by family members was related to better neurological outcomes.</p><p><strong>Conclusions: </strong>Patients with OHCA witnessed by family members had worse neurological outcomes than those witnessed by friends, colleagues, and passersby. This association differed by patient age, with family-member-witnessed OHCA associated with more favorable outcomes in younger patients but poorer outcomes in the elderly.</p>","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":" ","pages":"111330"},"PeriodicalIF":6.0,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149064306","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":"575 - Four-year Follow-up of two Teaching Strategies (Sequential vs. Global) Integrated into the School Curriculum: a Quasi-Experimental Study","authors":"Santiago Martínez-Isasi, Maria García Martínez, Antonio Rodriguez-Núñez, Maria García-Silva, Pedro Pascual-Martínez","doi":"10.1016/s0300-9572(26)01855-1","DOIUrl":"https://doi.org/10.1016/s0300-9572(26)01855-1","url":null,"abstract":"","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":"142 1","pages":""},"PeriodicalIF":6.5,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148979870","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}