Resuscitation最新文献_第5页

Resuscitative hysterotomy in out-of-hospital cardiac arrest: Time to deliver for mothers and babies 院外心脏骤停的复苏子宫切开术：母亲和婴儿的分娩时间。

IF 6.5 1区医学

Resuscitation Pub Date : 2025-02-01 DOI: 10.1016/j.resuscitation.2025.110493

Peter J. McGuigan, Glenn M. Eastwood

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IO or not IO, is that the question?

IF 6.5 1区医学

Resuscitation Pub Date : 2025-02-01 DOI: 10.1016/j.resuscitation.2025.110521

Peter T. Morley

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Effects of very early hyperoxemia on neurologic outcome after out-of-hospital cardiac arrest: A secondary analysis of the TTM-2 trial 院外心脏骤停后早期高氧血症对神经系统预后的影响：TTM-2试验的二次分析

IF 6.5 1区医学

Resuscitation Pub Date : 2025-02-01 DOI: 10.1016/j.resuscitation.2024.110460

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 , Chiara Robba

{"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 , Chiara Robba","doi":"10.1016/j.resuscitation.2024.110460","DOIUrl":"10.1016/j.resuscitation.2024.110460","url":null,"abstract":"<div><h3>Purpose</h3><div>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.</div></div><div><h3>Methods</h3><div>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 (PaO<sub>2</sub>) 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 PaO<sub>2</sub> recorded during each period. Poor functional outcome was defined as a 6 months modified Rankin Score (mRS) of 4 to 6.</div></div><div><h3>Results</h3><div>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 PaO<sub>2</sub> 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.</div></div><div><h3>Conclusions</h3><div>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.</div></div>","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":"207 ","pages":"Article 110460"},"PeriodicalIF":6.5,"publicationDate":"2025-02-01","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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Apple iOS Update Enables Dispatchers to Stream Live Video and Record Media During Emergency Calls Apple iOS更新使调度员能够在紧急呼叫期间流式传输实时视频和录制媒体。

IF 6.5 1区医学

Resuscitation Pub Date : 2025-02-01 DOI: 10.1016/j.resuscitation.2025.110494

Nino Fijačko, Robert Greif

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Public access defibrillators: The stark reality 公共除颤器：残酷的现实。

IF 6.5 1区医学

Resuscitation Pub Date : 2025-02-01 DOI: 10.1016/j.resuscitation.2025.110502

Bruno Thomas-Lamotte, Nordine Benameur, Louis Soulat, Tomislav Petrovic, Frédéric Lapostolle

引用次数: 0

Unraveling some of the myth about drowning, out-of-hospital cardiac arrest and outcomes: Many critical factors and processes, most of them disappointingly difficult to manage 揭开有关溺水、院外心脏骤停和结果的一些迷思：许多关键因素和过程，其中大多数都难以管理，令人失望。

IF 6.5 1区医学

Resuscitation Pub Date : 2025-02-01 DOI: 10.1016/j.resuscitation.2025.110518

Gerrit J. Noordergraaf, Alyssa Venema

引用次数: 0

Extracorporeal cardiopulmonary resuscitation outcomes in pre-Glenn single ventricle infants: Analysis of a ten-year dataset glenn前单心室婴儿体外心肺复苏结果：十年数据集分析。

IF 6.5 1区医学

Resuscitation Pub Date : 2025-02-01 DOI: 10.1016/j.resuscitation.2025.110490

Ivie Esangbedo , Thomas Brogan , Titus Chan , Yuen Lie Tjoeng , Marshall Brown , D. Michael McMullan

{"title":"Extracorporeal cardiopulmonary resuscitation outcomes in pre-Glenn single ventricle infants: Analysis of a ten-year dataset","authors":"Ivie Esangbedo , Thomas Brogan , Titus Chan , Yuen Lie Tjoeng , Marshall Brown , D. Michael McMullan","doi":"10.1016/j.resuscitation.2025.110490","DOIUrl":"10.1016/j.resuscitation.2025.110490","url":null,"abstract":"<div><h3>Background</h3><div>While several studies have reported on outcomes of extracorporeal membrane oxygenation (ECMO) in patients with single ventricle physiology, few studies have described outcomes of extracorporeal cardiopulmonary resuscitation (ECPR) in this unique population. The objective of this study was to determine survival and risk factors for mortality after ECPR in single ventricle patients prior to superior cavopulmonary anastomosis, using a large sample from the Extracorporeal Life Support Organization (ELSO) Registry.</div></div><div><h3>Methods</h3><div>We included single ventricle patients who underwent ECPR for in-hospital cardiac arrest (IHCA) between January 2012 and December 2021. We excluded patients who had undergone a superior cavopulmonary anastomosis, inferior cavopulmonary anastomosis, or who were older than 180 days at the time of ECPR. We collected data on mortality, ECMO course and ECMO complications. Subjects who survived to hospital discharge after ECPR were compared to subjects who did not survive to hospital discharge. We then performed univariate logistic regression followed by multivariable logistic regression analysis for associations with survival to hospital discharge.</div></div><div><h3>Results</h3><div>There were 420 subjects included who had index ECPR events. Median age was 14 (IQR 7,44) days and median weight was 3.14 (IQR 2.8, 3.8) kg.. Hypoplastic left heart syndrome was the most common diagnosis (354/420; 84.2%), and 47.4% of the cohort (199/420) had undergone a Norwood operation. Survival to hospital discharge occurred in 159/420 (37.9%) of subjects. Median number of hours on ECMO (122 vs. 93 h; <em>p</em> < 0.001), presence of seizures by electroencephalography (24% vs. 15%; <em>p</em> = 0.033), and need for renal replacement therapy (45% vs. 34%; <em>p</em> = 0.023) were significantly higher among non-survivors compared to survivors. In the subgroup of Norwood patients, survival was 43.2% after ECPR. Presence of Norwood variable was 54% among ECPR survivors in the overall cohort, compared to 43% among non-survivors (<em>p</em> = 0.032). In a multivariable logistic regression model to test association with survival to discharge, number of ECMO hours and presence of seizures were associated with decreased odds of survival to hospital discharge [adjusted odds ratio 0.95 (95% C.I. 0.92–0.98) and 0.57 (95% C.I. 0.33–0.97) respectively]. The odds ratio for ECMO hours demonstrated a decrease in odds of survival by 5% for every 12 h on ECMO. Presence of Norwood operation pre-arrest was associated with increased odds of survival [adjusted odds ratio 1.53 (95% C.I. 1.01–2.32)].</div></div><div><h3>Conclusion</h3><div>In our cohort of pre-Glenn single ventricle infants, survival after ECPR for in-hospital cardiac arrest was 37.9%. Number of hours on ECMO and seizures post-ECMO cannulation were associated with decreased odds of survival. Single ventricle infants who had undergone Norwood palliation ","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":"207 ","pages":"Article 110490"},"PeriodicalIF":6.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142954145","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}

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Sub30: Feasibility study of a pre-hospital extracorporeal membrane oxygenation (ECMO) in patients with refractory out-of-hospital cardiac arrest in London, United Kingdom Sub30：英国伦敦院前体外膜氧合（ECMO）治疗难治性院外心脏骤停患者的可行性研究。

IF 6.5 1区医学

Resuscitation Pub Date : 2025-02-01 DOI: 10.1016/j.resuscitation.2024.110455

Ben Singer , Teddy Tun Win HLA , Mamoun Abu-Habsa , Gareth Davies , Fenella Wrigley , Mark Faulkner , Simon J Finney

{"title":"Sub30: Feasibility study of a pre-hospital extracorporeal membrane oxygenation (ECMO) in patients with refractory out-of-hospital cardiac arrest in London, United Kingdom","authors":"Ben Singer , Teddy Tun Win HLA , Mamoun Abu-Habsa , Gareth Davies , Fenella Wrigley , Mark Faulkner , Simon J Finney","doi":"10.1016/j.resuscitation.2024.110455","DOIUrl":"10.1016/j.resuscitation.2024.110455","url":null,"abstract":"<div><h3>Aim</h3><div>Sub30 study is an open-label, prospective, single-arm feasibility study with the primary objective of assessing the logistics, feasibility, and safety of ECPR delivery in a pre-hospital setting for refractory out-of-hospital cardiac arrest patients in London, United Kingdom.</div></div><div><h3>Results</h3><div>Forty-three eligible patients were identified by London Ambulance Service over 27 trial recruitment days during a 13-month study period resulting in the despatch of the pre-hospital ECPR team to 18 patients. Five patients met full criteria and were cannulated for ECPR. All patients were male with a median age of 61 years and received ECPR full flows at a mean of 47 min (range 37–59 min) from initial collapse after a median travel time to scene of 14 min (range 3–20 min). No patient met the primary outcome measure of being established on pre-hospital ECPR within 30 min of the call to the emergency services. Out of 5 patients, 3 patients had treatment withdrawn and 2 survived to hospital discharge (both CPC score 3 and modified Rankin Score (mRS) score 4 and 5 respectively).</div></div><div><h3>Methods</h3><div>Open-label, single-arm, feasibility, prospective study.</div></div><div><h3>Conclusions</h3><div>Whilst our study did not meet primary outcome of achieving full ECPR flow within 30-minute of collapse, it demonstrated safe, timely and effective delivery of ECPR with comparable survival rates by pre-hospital teams in a large metropolitan city and this has potential to improve outcomes in refractory out-of-hospital cardiac arrest patients.</div></div>","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":"207 ","pages":"Article 110455"},"PeriodicalIF":6.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142792103","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}

引用次数: 0

Expedited conveyance of out-of-hospital-cardiac arrest patients with STEMI and shockable rhythms to Cardiac Arrest Centres − A feasibility pilot study of the British Cardiovascular Intervention Society conveyance algorithm

IF 6.5 1区医学

Resuscitation Pub Date : 2025-02-01 DOI: 10.1016/j.resuscitation.2025.110491

Rupert F.G. Simpson , Thomas Johnson , Paul Rees , Guy Glover , Uzma Sajjad , Samer Fawaz , Sarosh Khan , Emma Beadle , Daryl Perilla , Maria Maccaroni , Christopher Cook , Marco Mion , Qiang Xue , Rohan Jagathesan , Gerald J. Clesham , Tom Quinn , Johannes Von Vopelius-Feldt , Sean Gallagher , Abdul Mozid , Ellie Gudde , Thomas R. Keeble

{"title":"Expedited conveyance of out-of-hospital-cardiac arrest patients with STEMI and shockable rhythms to Cardiac Arrest Centres − A feasibility pilot study of the British Cardiovascular Intervention Society conveyance algorithm","authors":"Rupert F.G. Simpson , Thomas Johnson , Paul Rees , Guy Glover , Uzma Sajjad , Samer Fawaz , Sarosh Khan , Emma Beadle , Daryl Perilla , Maria Maccaroni , Christopher Cook , Marco Mion , Qiang Xue , Rohan Jagathesan , Gerald J. Clesham , Tom Quinn , Johannes Von Vopelius-Feldt , Sean Gallagher , Abdul Mozid , Ellie Gudde , Thomas R. Keeble","doi":"10.1016/j.resuscitation.2025.110491","DOIUrl":"10.1016/j.resuscitation.2025.110491","url":null,"abstract":"<div><h3>Background and aims</h3><div>Guidelines suggest non-traumatic out-of-hospital cardiac arrest (OHCA) be conveyed to cardiac arrest centres (CAC). We hypothesised that (a) a pre-hospital conveyance algorithm based on initial presenting rhythm following OHCA is feasible and (b) that would demonstrate survival advantage.</div></div><div><h3>Methods</h3><div>This observational pilot study included all consecutive patients with OHCA from suspected cardiac aetiology from the county of Essex, United Kingdom from April 2022-April 2023. For the first 6 months, OHCA patients had conveyance as standard of care. For the next 6 months, consecutive OHCA patients with STEMI or initial shockable rhythm were directly conveyed to the CAC, initial non-shockable rhythm without STEMI continued to be taken to the nearest Emergency Department (BCIS protocol). Primary outcome was death from any cause at 30 days. Secondary outcome was survival with favourable neurological outcome.</div></div><div><h3>Results</h3><div>Of 330 patients (mean age 67.5 ± 13.1, 66% male), 162 patients were in the standard care group and 168 in the BCIS conveyance group. Algorithm implementation was associated with numerically lower all cause 30-day mortality [(81% vs 73%, RR 1.10 (95% CI 0.98–1.24) <em>p</em> = 0.10] and numerically higher 30-day survival with favourable neurological outcome [15% vs 19%, RR 1.05 (0.95–1.15), <em>p</em> = 0.38]. Post hoc analysis showed that the BCIS conveyance algorithm was associated with lower 30 day mortality in those with an initial shockable rhythm [(61% vs 41%, RR 1.5 (95% CI 1.05–2.13) <em>p</em> = 0.02 and in those with a MIRACLE<sub>2</sub> score ≤ 5 [(63%% vs 38%, RR 0.59 (95% CI 0.61–0.86) <em>p</em> = 0.005].</div></div><div><h3>Conclusions</h3><div>The BCIS algorithm is feasible and did not impact overall mortality, but there is signal that direct conveyance of OHCA patients with an initial shockable rhythm and low MIRACLE<sub>2</sub> score, to a dedicated CAC may improve survival.</div></div>","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":"207 ","pages":"Article 110491"},"PeriodicalIF":6.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143071273","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}

引用次数: 0

Left ventricular energetics in patients receiving veno-arterial extracorporeal membrane oxygenation for extracorporeal cardiopulmonary resuscitation 体外心肺复苏中接受静脉-动脉体外膜氧合患者的左心室能量。

IF 6.5 1区医学

Resuscitation Pub Date : 2025-02-01 DOI: 10.1016/j.resuscitation.2024.110475

Rajat Kalra , Christopher Gaisendrees , Tamas Alexy , Marinos Kosmopoulos , Sebastian Voicu , Jason A. Bartos , Sergey G. Gurevich , Ganesh Raveendran , Deborah Jaeger , Despoina Koukousaki , Andrea M. Elliott , Alejandra Gutierrez Bernal , Mark Dennis , Brian Burns , Demetris Yannopoulos

{"title":"Left ventricular energetics in patients receiving veno-arterial extracorporeal membrane oxygenation for extracorporeal cardiopulmonary resuscitation","authors":"Rajat Kalra , Christopher Gaisendrees , Tamas Alexy , Marinos Kosmopoulos , Sebastian Voicu , Jason A. Bartos , Sergey G. Gurevich , Ganesh Raveendran , Deborah Jaeger , Despoina Koukousaki , Andrea M. Elliott , Alejandra Gutierrez Bernal , Mark Dennis , Brian Burns , Demetris Yannopoulos","doi":"10.1016/j.resuscitation.2024.110475","DOIUrl":"10.1016/j.resuscitation.2024.110475","url":null,"abstract":"<div><h3>Introduction</h3><div>The haemodynamic effects veno-arterial extracorporeal membrane oxygenation (VA-ECMO) remain inadequately understood. We investigated invasive left ventricular (LV) haemodynamics in patients who underwent treatment with an intensive care strategy involving extracorporeal cardiopulmonary resuscitation (ECPR).</div></div><div><h3>Methods</h3><div>We conducted invasive haemodynamic assessments on 15 patients who underwent ECPR and achieved return of spontaneous circulation. Left ventricular end-diastolic pressure (LVEDP), ejection fraction (LVEF), end-diastolic volume (LVEDV), and stroke work (LVSW) were evaluated using simultaneous invasive left heart catheterization and 3D echocardiography. Paired comparisons between high and low VA-ECMO flow were performed.</div></div><div><h3>Results</h3><div>Invasive haemodynamic studies were performed in 15 patients aged 58 (43,65) years at 3.0 (2.0, 4.0) days after cannulation. Six patients survived the index hospitalization, and 9 expired during the index hospitalization. Among the total cohort, transitioning from the highest VA-ECMO flow (median 4.0 L/min) to the lowest VA-ECMO flow (median 2.0 L/min) led to increases in LVEDV from 85 (68,125) mL to 106 (70,153) mL (p = 0.005) and LVEDP from 14 (8,23) mmHg to 17 (12,30) mmHg (p = 0.001), respectively. Similarly, the LVSW increased from 2051 ± 1525 mL*mmHg at the highest level of VA-ECMO flow to 2627 ± 1559 at the lowest VA-ECMO flow (p = 0.01).</div></div><div><h3>Conclusion</h3><div>High VA-ECMO flow significantly reduced LVEDP, LVEDV, and LVSW compared to low VA-ECMO flow.</div></div>","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":"207 ","pages":"Article 110475"},"PeriodicalIF":6.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142872390","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}

引用次数: 0