Resuscitation最新文献

{"title":"Real-time cerebral oximetry and outcomes during out-of-hospital resuscitation.","authors":"Julia King, Jenny Shin, Robert Walker, Thomas Rea","doi":"10.1016/j.resuscitation.2025.110811","DOIUrl":"10.1016/j.resuscitation.2025.110811","url":null,"abstract":"","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":" ","pages":"110811"},"PeriodicalIF":4.6,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145065534","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 the AIRWAYS-2 randomised controlled trial on clinical practice in out-of-hospital cardiac arrest in England: a registry-based cohort study.","authors":"Mohammed Aljanoubi, Terry P Brown, Scott Booth, Charles D Deakin, Rachael Fothergill, Jerry P Nolan, Jasmeet Soar, Gavin D Perkins, Keith Couper","doi":"10.1016/j.resuscitation.2025.110820","DOIUrl":"https://doi.org/10.1016/j.resuscitation.2025.110820","url":null,"abstract":"<p><strong>Introduction: </strong>The AIRWAYS-2 randomised control trial, published in August 2018, showed that the use of a supraglottic airway was not superior to tracheal intubation in adult out-of-hospital cardiac arrest. We aimed to explore the impact of the AIRWAYS-2 trial and its findings on clinical practice in adult out-of-hospital cardiac arrest in England.</p><p><strong>Methods: </strong>We used data from the English Out-of-Hospital Cardiac Arrest Outcomes registry. We included adult out-of-hospital cardiac arrest patients treated between 2014 and 2020 and who received treatment from an English emergency medical service that submitted advanced airway management data to the registry. In our primary analysis, we used segmented regression to explore the association between the publication of the AIRWAYS-2 trial and the use of tracheal intubation.</p><p><strong>Results: </strong>We included 73,764 patients treated by seven emergency medical service systems between January 2014 and December 2020. The median age was 71.8 years; 64% were male, and 23% presented in a shockable rhythm. Between 2014 and 2020, the proportion of patients receiving tracheal intubation decreased from 44% in 2014 to 14% in 2020. The odds of receiving tracheal intubation decreased per quarter over the 7-year study period (adjusted odds ratio 0.93, 95% confidence interval 0 .93-0.94). In our segmented regression model, the estimated percentage decrease in the use of tracheal intubation per quarter was lower before the publication of AIRWAYS-2 (-0.02, 95% CI -0.02 to -0.01) than following the publication of AIRWAYS-2 (-2.01, 95% CI -2.04 to -1.99).</p><p><strong>Conclusion: </strong>In England, the proportion of adult OHCA patients receiving tracheal intubation decreased between 2014 and 2020. This decrease accelerated following August 2018, which may be partly attributable to the AIRWAYS-2 trial results.</p>","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":" ","pages":"110820"},"PeriodicalIF":4.6,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145058679","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":"In-hospital cardiac arrest in neonates in the United States: a study of epidemiology, outcomes, and trends from 2003 to 2022.","authors":"Prithvi Sendi, Rachana Domudala, Balagangadhar R Totapally","doi":"10.1016/j.resuscitation.2025.110817","DOIUrl":"10.1016/j.resuscitation.2025.110817","url":null,"abstract":"<p><strong>Background: </strong>The incidence of in-hospital cardiac arrest (IHCA) in neonates varies with gestational age (GA) and carries high morbidity and mortality. The study aimed to explore incidence of and mortality after IHCA from time of birth to 28 days of life.</p><p><strong>Methods: </strong>We retrospectively analyzed 7 one-year epochs from the Kids' Inpatient Database from 2003 to 2022. GA was divided into extremely preterm (EP; GA < 28 weeks), very preterm (VP; GA 28-31 weeks), moderately preterm (MP; GA 32-33 weeks), late preterm (LP; GA 34-36 weeks), and term (T; GA > 36 weeks). We analyzed the incidence and trend of IHCA per 1000 hospital discharges and 1000 US live births, including IHCA at birth or during hospitalization.</p><p><strong>Results: </strong>Among 24,877,754 discharges, 30,117 neonates had IHCA with an incidence of 1.21 per 1000 discharges and 1.08 per 1000 US births. The incidence of IHCA increased (0.8-1.58 per 1000 discharges; p < 0.001), and the mortality during index admission decreased (46.3-40.8 %; p = 0.005). Odds of IHCA were higher in Black neonates and those at lower socioeconomic status.</p><p><strong>Conclusion: </strong>The incidence of IHCA in neonates in the US has increased from 2003 to 2022, with a decrease in mortality during index admission. While the odds of IHCA is highest among EP and VP neonates, the majority of IHCA occurred in MP, LP, and T neonates. Mortality for EP, VP, and LP neonates has remained unchanged. These findings highlight the importance of GA-specific interventions and prevention strategies and addressing disparities related to race and socioeconomic status.</p>","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":" ","pages":"110817"},"PeriodicalIF":4.6,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145058592","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":"Delayed neurological recovery in patients after extracorporeal resuscitation compared to conventional resuscitation. Implications for outcome assessment after cardiac arrest","authors":"Ingrid Magnet ,&nbsp;Christian Clodi ,&nbsp;Florian Ettl ,&nbsp;Jürgen Grafeneder ,&nbsp;Michael Holzer ,&nbsp;Elisabeth Lobmeyr ,&nbsp;Heidrun Losert ,&nbsp;Matthias Mueller ,&nbsp;Alexander Nürnberger ,&nbsp;Alexandra-Maria Stommel ,&nbsp;Julia Riebandt ,&nbsp;Christoph Schriefl ,&nbsp;Peter Schellongowski ,&nbsp;Mathias Schneeweiss-Gleixner ,&nbsp;Christoph Testori ,&nbsp;Andrea Zeiner-Schatzl ,&nbsp;Robert Zilberszac ,&nbsp;Wilhelm Behringer ,&nbsp;Felix Eibensteiner ,&nbsp;Michael Poppe","doi":"10.1016/j.resuscitation.2025.110819","DOIUrl":"10.1016/j.resuscitation.2025.110819","url":null,"abstract":"<div><h3>Introduction</h3><div>Extracorporeal cardiopulmonary resuscitation (eCPR) is a rescue therapy for refractory cardiac arrest, with evidence suggesting improved outcomes when performed at experienced centres. Unlike conventional CPR (cCPR), eCPR patients often exhibit delayed recovery. Current guidelines recommend outcome assessment at 1 month or hospital discharge, potentially missing late neurological improvements. This study investigates longitudinal changes in neurological outcomes among eCPR and cCPR patients<strong>.</strong></div></div><div><h3>Methods</h3><div>We conducted a single-centre, retrospective cohort study at the Cardiac Arrest Centre Vienna, including adult patients treated with eCPR or cCPR between January 2020 and May 2024. Patients who survived at least 1 month were analysed. The primary endpoint was the difference in the temporal change in favourable neurological outcome (Cerebral performance category, CPC 1–2) between 1 and 6 months in eCPR versus cCPR patients. Secondary endpoints included CPC distribution, survival rates, and patterns of delayed recovery.</div></div><div><h3>Results</h3><div>Of 912 included patients (209 eCPR, 703 cCPR), 435 were alive at 1 month. In eCPR patients (<em>n</em> = 63), favourable neurological outcome increased from 59 % at 1 month to 87 % at 6 months (<em>p</em> &lt; 0.001), while in cCPR patients (<em>n</em> = 372), it increased from 81 % to 84 % (<em>p</em> = ns). This corresponded to a 29 % versus 3 % increase in patients with a favourable neurological outcome (<em>p</em> &lt; 0.001). There was no change in neurological outcome between 6 and 12 months in either group. Overall, recovery in eCPR patients was prolonged compared to patients after successful resuscitation with cCPR.</div></div><div><h3>Conclusion</h3><div>Neurological outcomes in eCPR patients frequently continue to improve after 1 month after cardiac arrest. Future eCPR trials should therefore use outcome assessments beyond 1 month to fully capture recovery potential and patient-centred outcomes.</div></div>","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":"216 ","pages":"Article 110819"},"PeriodicalIF":4.6,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145058597","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 relationship between cardiopulmonary resuscitation duration and prognosis in patients with out-of-hospital cardiac arrest due to asphyxiation.","authors":"Chisato Nakajima, Masahiro Kashiura, Yutaro Shinzato, Yuki Kishihara, Shunsuke Amagasa, Hideto Yasuda, Takashi Moriya","doi":"10.1016/j.resuscitation.2025.110818","DOIUrl":"10.1016/j.resuscitation.2025.110818","url":null,"abstract":"<p><strong>Aim: </strong>Asphyxial out-of-hospital cardiac arrest (OHCA) is associated with poor outcomes and may have a narrower time window for favourable outcomes compared to cardiac-origin OHCA. However, studies examining cardiopulmonary resuscitation (CPR) duration in OHCA due to asphyxiation are limited. Hence, this study aimed to investigate the relationship between CPR duration and prognosis in patients who experienced OHCA due to asphyxiation.</p><p><strong>Methods: </strong>This retrospective study used data from the Japanese Association for Acute Medicine's OHCA registry for June 2014 to December 2021. The study population comprised adult patients who received CPR by emergency medical service personnel and achieved return of spontaneous circulation. The primary outcome was one-month survival; the secondary outcome was favourable neurological outcome at one month (cerebral performance category 1 or 2). The influence of CPR duration was examined using logistic regression analysis after adjusting for multiple confounding factors.</p><p><strong>Results: </strong>The analysis included 2594 patients of asphyxiation-induced OHCA. The median CPR duration was 26 min (interquartile range, 17-35 min). At one month, 515 patients (19.9%) survived and 62 (2.4%) achieved favourable neurological outcomes. Increasing CPR duration was associated with lower chances of one-month survival and favorable neurological outcome (aOR per minute: 0.88 and 0.78, respectively; 95% CI: 0.86-0.90 and 0.71-0.85, respectively). The probability of favorable neurological outcome and survival dropped below 1% after 4 and 31 min of CPR, respectively.</p><p><strong>Conclusions: </strong>Prolonged CPR was associated with poor outcomes in patients with asphyxiation-related OHCA and may be futile in these cases.</p>","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":" ","pages":"110818"},"PeriodicalIF":4.6,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145058608","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":"Oximetry and neurological survival: defining the window of value.","authors":"Shenglong Li, Longfei You","doi":"10.1016/j.resuscitation.2025.110804","DOIUrl":"10.1016/j.resuscitation.2025.110804","url":null,"abstract":"","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":" ","pages":"110804"},"PeriodicalIF":4.6,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145041278","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 Letter: Question on the occurrence of lung injury in patients receiving chest compression synchronized ventilation in the SYMEVECA study.","authors":"Alberto Hernández-Tejedor, Vanesa Gónzález Puebla, Ervigio Corral Torres, Sara Isabel Montero Hernández","doi":"10.1016/j.resuscitation.2025.110810","DOIUrl":"10.1016/j.resuscitation.2025.110810","url":null,"abstract":"","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":" ","pages":"110810"},"PeriodicalIF":4.6,"publicationDate":"2025-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145024133","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 Community Alert to Provider Response: The Impact of Turnout Time on Community Responder Systems.","authors":"William Brady, Andrew Muck","doi":"10.1016/j.resuscitation.2025.110803","DOIUrl":"https://doi.org/10.1016/j.resuscitation.2025.110803","url":null,"abstract":"","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":" ","pages":"110803"},"PeriodicalIF":4.6,"publicationDate":"2025-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145024213","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":"Can Utstein help foxes reach the juicy aetiology grapes?","authors":"Therese Djarv (Tessa) ,&nbsp;Erik Ullemark","doi":"10.1016/j.resuscitation.2025.110812","DOIUrl":"10.1016/j.resuscitation.2025.110812","url":null,"abstract":"","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":"216 ","pages":"Article 110812"},"PeriodicalIF":4.6,"publicationDate":"2025-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145024152","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":"Flow disruptions during delivery room intubation of neonates with congenital diaphragmatic hernia","authors":"Heidi M. Herrick ,&nbsp;Charis Lim ,&nbsp;K. Taylor Wild ,&nbsp;Jesse Y. Hsu ,&nbsp;Ken Catchpole ,&nbsp;Holly L. Hedrick ,&nbsp;Natalie E. Rintoul ,&nbsp;Anne M. Ades ,&nbsp;Scott Lorch ,&nbsp;Elizabeth E. Foglia","doi":"10.1016/j.resuscitation.2025.110802","DOIUrl":"10.1016/j.resuscitation.2025.110802","url":null,"abstract":"<div><h3>Aim</h3><div>Flow disruptions (FDs) are deviations in the progression of care that compromise safety and efficiency of a specific process. Neonatal intubation is a life-saving high-risk procedure required for delivery room (DR) management of neonates with moderate to severe congenital diaphragmatic hernia (CDH). This study evaluated FDs during DR intubation of neonates with CDH and their association with process and outcome measures.</div></div><div><h3>Methods</h3><div>Single-center observational study of video-recorded DR intubations of neonates with CDH. FDs were measured from birth through commencement of invasive endotracheal tube ventilation and classified using a neonatal FD tool and impact score. The primary outcome was time to invasive ventilation. Secondary outcomes were time to oxygen saturation (SpO₂) ≥85 %, time to electrocardiogram signal, time to pulse oximetry signal, and time to secured endotracheal tube. Linear regression models evaluated the association of FD rate/minute before ventilation and outcomes.</div></div><div><h3>Results</h3><div>Between 11/2021 and 4/2023, 29 video-recorded resuscitations were included. A mean of 7.1 FDs/minute (±3.2) occurred before ventilation. Rate of high impact FDs was associated with a ventilation delay; a one FD/minute increase in rate of high impact FDs was associated with a 19.0 s (95 % confidence interval 4.6–33.4) ventilation delay and delay in pulse oximetry acquisition. Rate of medium impact FDs was associated with a delay in SpO₂ ≥85 %.</div></div><div><h3>Conclusion</h3><div>FDs occur frequently during DR intubation of neonates with CDH, and high impact FDs are associated with longer time to initiate invasive ventilation. FDs represent modifiable targets to improve CDH intubation and may generalize to other neonatal intubations.</div></div>","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":"216 ","pages":"Article 110802"},"PeriodicalIF":4.6,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145008489","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}