Resuscitation最新文献

{"title":"Revisiting priorities in resuscitative hysterotomy","authors":"Justus Wolff, Janosch Dahmen","doi":"10.1016/j.resuscitation.2025.110538","DOIUrl":"10.1016/j.resuscitation.2025.110538","url":null,"abstract":"","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":"208 ","pages":"Article 110538"},"PeriodicalIF":6.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143426076","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 role of hospital performance on race and ethnicity outcome disparities for US non-traumatic out-of-hospital cardiac arrests","authors":"Ryan Huebinger ,&nbsp;Marina Del Rios ,&nbsp;Benjamin S. Abella ,&nbsp;Bryan McNally ,&nbsp;Carrie Bakunas ,&nbsp;Richard Witkov ,&nbsp;Joseph Gill ,&nbsp;Bentley Bobrow ,&nbsp;CARES Surveillance Group","doi":"10.1016/j.resuscitation.2025.110496","DOIUrl":"10.1016/j.resuscitation.2025.110496","url":null,"abstract":"<div><h3>Background</h3><div>Factors contributing to worse outcomes for out-of-hospital cardiac arrests (OHCA) from minoritized communities are poorly understood. We sought to evaluate the impact of receiving hospital performance on OHCA outcome disparities.</div></div><div><h3>Methods</h3><div>We performed a retrospective cohort study of non-traumatic OHCAs from the National Cardiac Arrest Registry to Enhance Survival from 2013 to 2022 that survived hospital admission<strong>.</strong> We created cohorts based on census-tract race/ethnicity: &gt;50% White, &gt;50% Black, and &gt;50% Hispanic/Latino. We stratified hospitals into performance quartiles based on hospital good neurologic outcome rates. We evaluated the association between race/ethnicity and care at better-performing hospitals. Using hierarchical modeling, we compared models evaluating the association between community race/ethnicity and outcomes, ignoring and adjusting for receiving hospital.</div></div><div><h3>Results</h3><div>We included 202,117 OHCAs. Compared to White, OHCAs from Black (OR 0.12[0.12–0.13]) and Hispanic/Latino (OR 0.21[0.20–0.21]) communities had lower odds of care at higher-performing hospitals, but care at higher-performing hospitals improved outcomes for all groups: White – OR 1.43[1.41–1.44]), Black – OR 1.54[1.50–1.59]), Hispanic/Latino − 1.51[1.46–1.56]. Ignoring receiving hospital, outcomes were worse for OHCAs from Black (aOR 0.56[0.54–0.58]) and Hispanic/Latino (aOR 0.63[0.61–0.66]) communities. Although adjusting for bystander cardiopulmonary resuscitation did not change results, adjusting for hospital performance quartile improved outcome odds (Black – aOR 0.80[0.76–0.84]; Hispanic/Latino – aOR 0.82[0.78–0.86]). Adjusting for receiving hospital random effect also improved outcome odds (Black – aOR 0.84[0.81–0.87]; Hispanic Latino – aOR 0.86[0.83–0.90]).</div></div><div><h3>Conclusions</h3><div>OHCAs from Black and Hispanic/Latino communities received care at high-performing hospitals less often, and adjusting for receiving hospital significantly diminished OHCA outcome disparities.</div></div>","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":"208 ","pages":"Article 110496"},"PeriodicalIF":6.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143010695","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 vs lidocaine in adult out-of-hospital cardiac arrest, is there a clear winner?","authors":"Petter Overton-Harris,&nbsp;Joshua R. Lupton","doi":"10.1016/j.resuscitation.2025.110547","DOIUrl":"10.1016/j.resuscitation.2025.110547","url":null,"abstract":"","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":"208 ","pages":"Article 110547"},"PeriodicalIF":6.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143458978","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":"Pharmacological interventions for the acute treatment of hyperkalaemia: A systematic review and meta-analysis","authors":"Marie Kristine Jessen ,&nbsp;Lars Wiuff Andersen ,&nbsp;Jana Djakow ,&nbsp;Ng Kee Chong ,&nbsp;Nikola Stankovic ,&nbsp;Christian Staehr ,&nbsp;Lauge Vammen ,&nbsp;Alberthe Hjort Petersen ,&nbsp;Cecilie Munch Johannsen ,&nbsp;Mark Andreas Eggertsen ,&nbsp;Signe Østergaard Mortensen ,&nbsp;Maria Høybye ,&nbsp;Casper Nørholt ,&nbsp;Mathias Johan Holmberg ,&nbsp;Asger Granfeldt ,&nbsp;International Liaison Committee on Resuscitation (ILCOR) Advanced Paediatric Life Support Task Forces","doi":"10.1016/j.resuscitation.2025.110489","DOIUrl":"10.1016/j.resuscitation.2025.110489","url":null,"abstract":"<div><h3>Background</h3><div>Hyperkalaemia is a life-threatening electrolyte disturbance and also a potential cause of cardiac arrest. The objective was to assess the effects of acute pharmacological interventions for the treatment of hyperkalaemia in patients with and without cardiac arrest.</div></div><div><h3>Methods</h3><div>The review was reported according to PRISMA guidelines and registered on PROSPERO (CRD42023440553). We searched OVID Medline, EMBASE, and CENTRAL on September 9, 2024 for randomized trials, non-randomized trials, observational studies, and experimental animal studies. Two investigators performed abstract screening, full-text review, data extraction, and bias assessment. Outcomes included potassium levels, ECG findings, and clinical outcomes. Certainty of evidence was evaluated using GRADE.</div></div><div><h3>Results</h3><div>A total of 101 studies were included, with two studies including patients with cardiac arrest. In meta-analyses including adult patients without cardiac arrest, treated with insulin in combination with glucose, inhaled salbutamol, intravenous salbutamol dissolved in glucose, or a combination, the average reduction in potassium was between 0.7 and 1.2 mmol/l (very low to low certainty of evidence). The use of bicarbonate had no effect on potassium levels (very low certainty of evidence). In neonatal and paediatric populations, inhaled salbutamol and intravenous salbutamol reduced the average potassium between 0.9 and 1.0 mmol/l (very low to low certainty of evidence). There was no evidence to support a clinical beneficial effect of calcium for treatment of hyperkalemia.</div></div><div><h3>Conclusions</h3><div>Evidence supports treatment with insulin in combination with glucose, inhaled or intravenous sal-butamol, or the combination. No evidence supporting a clinical effect of calcium or bicarbonate for hyperkalaemia was identified.</div></div>","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":"208 ","pages":"Article 110489"},"PeriodicalIF":6.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142988668","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":"Pre-hospital ECPR cost analysis and cost effectiveness modelling study","authors":"Fredrick Zmudzki ,&nbsp;Brian Burns ,&nbsp;Natalie Kruit ,&nbsp;Changle Song ,&nbsp;Emily Moylan ,&nbsp;Hemal Vachharajani ,&nbsp;Hergen Buscher ,&nbsp;Timothy J. Southwood ,&nbsp;Paul Forrest ,&nbsp;Mark Dennis","doi":"10.1016/j.resuscitation.2024.110488","DOIUrl":"10.1016/j.resuscitation.2024.110488","url":null,"abstract":"<div><h3>Background</h3><div>The use of extracorporeal membrane oxygenation (ECMO) during cardiopulmonary resuscitation (ECPR) is increasing. Prehospital ECPR (PH-ECPR) for out-of-hospital cardiac arrest (OHCA) may improve both equity of access and outcomes but its cost effectiveness has yet to be determined.</div></div><div><h3>Methods</h3><div>Cost analyses of PH-ECPR was performed utilizing current PH-ECPR trial, NSW Ambulance Cardiac Arrest Registry (CAR), geospatial modelling and in-hospital costings data. Markov modelling was completed to combine the PH-ECPR cost analysis with reported patient outcomes across multiple ECPR strategies. Bridging formulae from ECPR survivor cerebral performance category (CPC) scores were used to estimate cost per quality adjusted life years (QALY) and Incremental Cost Effectiveness Ratios (ICERs). Probabilistic Sensitivity Analysis was completed to assess the probability of cost effectiveness for base case and PH-ECPR strategy variations.</div></div><div><h3>Results</h3><div>Assuming a base case of 100 patients per year, with a 25% team allocation to ECPR, the average pre-hospital ECPR cost per patient was $12,741 and total of $88,656 AUD equating to approximately $44,000 per QALY. Addition of a conservative 10% kidney organ donation rate reduces the cost per QALY to $22,000. Patient survival rate, the proportion of time the pre-hospital ECPR team are allocated to ECPR and organ donation significantly impact PH-ECPR cost effectiveness.</div></div><div><h3>Conclusion</h3><div>Initial cost analysis and modelling indicate PH-ECPR service strategies are likely to be cost effective and comparable to other medical interventions. Survival rate and service integration into non ECPR clinical tasks are key aspects contributing to cost effectiveness.</div></div>","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":"208 ","pages":"Article 110488"},"PeriodicalIF":6.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142932068","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":"LIFEFORCE: An essential European Union funded project training schoolchildren in CPR using a targeted BLS algorithm","authors":"N. Rott,&nbsp;LIFEFORCE Collaborators","doi":"10.1016/j.resuscitation.2025.110553","DOIUrl":"10.1016/j.resuscitation.2025.110553","url":null,"abstract":"","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":"208 ","pages":"Article 110553"},"PeriodicalIF":6.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143468987","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":"Semi-autonomous drone delivering automated external defibrillators for real out-of-hospital cardiac arrest: A Danish feasibility study","authors":"Louise Kollander Jakobsen ,&nbsp;Jannie Kristine Bang Gram ,&nbsp;Anne Juul Grabmayr ,&nbsp;Anders Højen ,&nbsp;Carolina Malta Hansen ,&nbsp;Martin Rostgaard-Knudsen ,&nbsp;Andreas Claesson ,&nbsp;Fredrik Folke","doi":"10.1016/j.resuscitation.2025.110544","DOIUrl":"10.1016/j.resuscitation.2025.110544","url":null,"abstract":"<div><h3>Aim</h3><div>To assess the feasibility and safety of drone-delivered automated external defibrillators (AEDs) in real out-of-hospital cardiac arrests (OHCAs) in Denmark, addressing the critical need for timely defibrillation in OHCAs.</div></div><div><h3>Methods</h3><div>In this prospective clinical study in Aalborg, Denmark, an AED-carrying drone was dispatched for suspected OHCAs, from June 2022 to April 2023. The drone was stationed in an urban area (maximum flight-radius 6 km, covering 110,000 inhabitants) within designated airspace not requiring preflight approval from air-traffic control. Upon OHCA-suspicion, the emergency medical dispatcher activated the drone, which autonomously took off and flew beyond-visual-line-of-sight to the OHCA-location. On-site, a remote drone pilot (stationed cross-border) winched down the AED near the patient’s location. Flights were restricted to dry weather, mean windspeeds &lt; 8 m/s, and 8 am to 10 pm.</div></div><div><h3>Results</h3><div>Of 76 suspected OHCAs, 27 occurred during non-operating hours (nighttime). Of the remaining 49 OHCAs, 16 (33%) were eligible for drone take-off, all of which resulted in successful AED-delivery, without any adverse events. Weather caused 14 cancellations (29%), technical issues (dispatch centre, drone, or hangar problems) 13 (27%), and closed airspace 6 (12%). The median drone response time from activation to AED-delivery was 04:47 min (IQR 03:45–05:27), and the corresponding ambulance response time was 03:25 min (IQR 02:43–04:14). No drone-delivered AEDs were attached.</div></div><div><h3>Conclusion</h3><div>This study demonstrates the safety and feasibility of drone-delivered AEDs to real OHCAs. Improved time to AED delivery was limited due to swift ambulance service, highlighting the importance of strategic AED drone placement.</div></div>","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":"208 ","pages":"Article 110544"},"PeriodicalIF":6.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143442009","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":"Use of machine learning models to identify National Institutes of Health-funded cardiac arrest research","authors":"Ryan A. Coute ,&nbsp;Kameshwari Soundararajan ,&nbsp;Michael C. Kurz ,&nbsp;Ryan L. Melvin ,&nbsp;Ryan C. Godwin","doi":"10.1016/j.resuscitation.2025.110545","DOIUrl":"10.1016/j.resuscitation.2025.110545","url":null,"abstract":"<div><h3>Objective</h3><div>To compare the performance of three artificial intelligence (AI) classification strategies against manually classified National Institutes of Health (NIH) cardiac arrest (CA) grants, with the goal of developing a publicly available tool to track CA research funding in the United States.</div></div><div><h3>Methods</h3><div>Three AI strategies—traditional machine learning (ML), large language model (LLM) zero-shot learning, and LLM few-shot learning—were compared to manually categorized CA grant abstracts from NIH RePORTER (2007–2021). Traditional ML used a regularized logistic regression model trained on embedding vectors generated by OpenAI’s text-embedding-3-small model. Zero-shot learning, using GPT-4o-mini, classified grants based on task descriptions without labeled examples. Few-shot learning included six example grants. Models were evaluated on a balanced 20% holdout test set using accuracy, precision (positive predictive value), recall (sensitivity), and F1 score (harmonic mean of precision and recall).</div></div><div><h3>Results</h3><div>Out of 1,505 grants categorized, 378 (25%) were identified as CA research, yielding 302 grants in the holdout test set, 76 of which were CA research. The few-shot approach performed best, achieving the highest accuracy (0.90) and the best balance of precision and recall (F1 score 0.82). In contrast, traditional ML had the lowest accuracy (0.87) and the highest precision (0.89) but suffered from poor recall, with approximately 2.5 times more false negatives than either generative approach. The zero-shot approach outperformed traditional ML in accuracy (0.88) and recall (0.86) but had lower precision (0.72).</div></div><div><h3>Conclusion</h3><div>AI can rapidly identify CA grants with excellent accuracy and very good precision and recall, making it a promising tool for tracking research funding.</div></div>","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":"208 ","pages":"Article 110545"},"PeriodicalIF":6.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143442011","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":"Reply to “Revisiting priorities in resuscitative hysterotomy”","authors":"Caroline Leech,&nbsp;Tim Nutbeam,&nbsp;Keith Couper,&nbsp;Joyce Yeung","doi":"10.1016/j.resuscitation.2025.110548","DOIUrl":"10.1016/j.resuscitation.2025.110548","url":null,"abstract":"","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":"208 ","pages":"Article 110548"},"PeriodicalIF":6.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143459085","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":"A retrospective ‘target trial emulation’ comparing amiodarone and lidocaine for adult out-of-hospital cardiac arrest resuscitation","authors":"Tanner Smida ,&nbsp;Remle Crowe ,&nbsp;Bradley S. Price ,&nbsp;James Scheidler ,&nbsp;P.S. Martin ,&nbsp;Michael Shukis ,&nbsp;James Bardes","doi":"10.1016/j.resuscitation.2025.110515","DOIUrl":"10.1016/j.resuscitation.2025.110515","url":null,"abstract":"<div><h3>Objective</h3><div>The administration of amiodarone or lidocaine is recommended during the resuscitation of out-of-hospital cardiac arrest (OHCA) patients presenting with defibrillation-refractory or recurrent ventricular fibrillation or ventricular tachycardia. Our objective was to use ‘target trial emulation’ methodology to compare the outcomes of patients who received amiodarone or lidocaine during resuscitation.</div></div><div><h3>Methods</h3><div>Adult, non-traumatic OHCA patients in the ESO Data Collaborative 2018–2023 datasets who experienced OHCA prior to EMS arrival, presented with a shockable rhythm, and received amiodarone or lidocaine during resuscitation were evaluated for inclusion. We used propensity score matching (PSM) to investigate the association between antiarrhythmic and outcomes. Return of spontaneous circulation (ROSC) was the primary outcome. Secondary outcomes included the number of post-drug defibrillations and survival to hospital discharge.</div></div><div><h3>Results</h3><div>After application of exclusion criteria, 23,263 patients from 1,707 EMS agencies were eligible for analysis. Prior to PSM, 6,010/20,284 (29.6%) of the patients who received amiodarone and 1,071/2,979 (35.9%) of the patients who received lidocaine achieved prehospital ROSC. Following PSM, lidocaine administration was associated with greater odds of prehospital ROSC (36.0 vs. 30.4%; aOR: 1.29 [1.16, 1.44], <em>n</em> = 2,976 matched pairs). Lidocaine administration was also associated with fewer post-drug defibrillations (median: 2 [0–4] vs. 2 [0–6], mean: 3.3 vs. 3.9, <em>p</em> &lt; 0.01, <em>n</em> = 2,976 pairs), and greater odds of survival to discharge (35.1 vs. 25.7%; OR: 1.54 [1.19, 2.00], <em>n</em> = 538 pairs).</div></div><div><h3>Conclusion</h3><div>Our ‘target trial emulation’ suggested that lidocaine was associated with greater odds of prehospital ROSC in comparison to amiodarone when administered during resuscitation from shock refractory or recurrent VF/VT.</div></div>","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":"208 ","pages":"Article 110515"},"PeriodicalIF":6.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143041589","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}