Resuscitation最新文献

{"title":"Increased rate of anoxic brain damage with laryngeal tube compared to endotracheal intubation in patients with shockable out-of-hospital cardiac arrest - Experience from the HAnnover COoling REgistry (HACORE).","authors":"Vera Garcheva, Carolina Sanchez Martinez, John Adel, Tobias J Pfeffer, Muharrem Akin, Johann Bauersachs, Andreas Schäfer","doi":"10.1016/j.resuscitation.2024.110416","DOIUrl":"10.1016/j.resuscitation.2024.110416","url":null,"abstract":"<p><strong>Background: </strong>Supraglottic airway devices such as the laryngeal tube (LT) are recommended in current guidelines for simplified airway management in patients during and immediately after out-of-hospital cardiac arrest (OHCA). Trials evaluating LTs included predominantly OHCA patients with non-shockable rhythms and low survival rates. Hence, LTs are widely used, but their impact on preventing hypoxic brain damage during resuscitation has not been evaluated yet.</p><p><strong>Methods: </strong>We analysed 452 OHCA-patients with shockable-rhythms from the HAnnover COoling REgistry (HACORE) who had return of spontaneous circulation prior to transport. Of those, 405 patients received primary airway management by endotracheal intubation (ETI) and 47 by LT. Patients were afterwards treated according to the Hannover Cardiac Resuscitation Algorithm (HaCRA) applying a strict post-resuscitation management including therapeutic hypothermia and avoiding routine prognostication.</p><p><strong>Results: </strong>While mortality in this group was moderate with both airway strategies (ETI 29 % vs LT 34 %, p = 0.487), the rate of anoxic brain damage was much higher in the LT compared to the ETI group (38 % vs 21 %, p = 0.011). Survivors in the ETI group were more likely to have good neurological outcome (cerebral performance category 1&2) compared to the LT group (35 % vs 17 %, p = 0.013). Pneumonia was more common in the LT vs ETI group (81 % vs 53 %, p < 0.001).</p><p><strong>Conclusions: </strong>While the original prehospital pragmatic trials comparing LT to ETI mostly included patients with non-shockable rhythm in settings with high mortality, our analysis is based on a real-world registry and focuses on successfully resuscitated patients, whose cause of arrest was most probably not due to hypoxia. In this cohort, use of LT was associated with a higher rate of anoxic brain damage and worse functional neurological outcome compared to use of ETI.</p>","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":" ","pages":"110416"},"PeriodicalIF":6.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142506868","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":"ChatGPT and pediatric advanced life support: A performance evaluation.","authors":"Kamil Kokulu, Mehmet Semih Demirtaş, Ekrem T Sert, Hüseyin Mutlu","doi":"10.1016/j.resuscitation.2024.110451","DOIUrl":"10.1016/j.resuscitation.2024.110451","url":null,"abstract":"","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":" ","pages":"110451"},"PeriodicalIF":6.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142780844","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":"Changes in out-of-hospital cardiac arrest resuscitation quality during and after the COVID-19 pandemic.","authors":"Charlotte Kennedy, Emily Nehme, David Anderson, Ashanti Dantanarayana, Belinda Delardes, Ziad Nehme","doi":"10.1016/j.resuscitation.2024.110419","DOIUrl":"10.1016/j.resuscitation.2024.110419","url":null,"abstract":"<p><strong>Aim: </strong>The impact of personal protective equipment (PPE) on resuscitation quality is largely unknown. We sought to examine the effect of PPE requirements on CPR quality and resuscitation interventions during the COVID-19 pandemic in Victoria, Australia.</p><p><strong>Methods: </strong>We performed a retrospective cohort study of adult OHCA patients of medical aetiology who received attempted resuscitation. The study consisted of three periods; a pre-COVID-19 period (1st March 2019 to 15th March 2020), the COVID-19 period (16th March 2020 to 12th October 2022) and a post-COVID-19 period (13th October 2022 to 30th June 2023). Multivariable quantile and logistic regression were used to examine changes in CPR metrics and time to resuscitation interventions across the three periods.</p><p><strong>Results: </strong>We included 8,956 patients (2,389 pre-COVID-19, 4,935 during COVID-19 and 1,632 post-COVID-19). A number of CPR quality metrics deteriorated during the COVID-19 period compared to the pre-COVID-19 period, including: chest compression fraction (median difference [MD] -0.81 percentage points; 95% CI -1.07,-0.56), release velocity (MD -5.26 mm per second; 95% CI -9.79, -0.72) and resuscitation duration (MD -2.2 min; 95% CI -3.39, -1.05). The COVID-19 period was also associated with longer post-shock pauses (MD 0.22 s; 95% CI 0.05, 0.38), and a reduction in the risk-adjusted odds of receiving adrenaline administration within 5 mins (AOR 0.72, 95% CI 0.63 - 0.82) and laryngeal mask insertion within 10 mins of arrival (AOR 0.83, 95% CI 0.74 - 0.94). These factors, with the exception of resuscitation duration and time to larygeal mask insertion, remained significantly different from baseline for the post-COVID-19 period.</p><p><strong>Conclusion: </strong>Several CPR quality metrics declined during the COVID-19 period and some remain below pre-pandemic levels. Further research is needed to understand these impacts on OHCA outcomes.</p>","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":" ","pages":"110419"},"PeriodicalIF":6.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142506867","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":"Characteristics, outcomes, and prognostic factors in patients with hanging-induced out-of-hospital cardiac arrest: An analysis of a nationwide registry in Japan.","authors":"Keita Shibahashi, Ken Inoue, Taichi Kato, Kazuhiro Sugiyama","doi":"10.1016/j.resuscitation.2024.110448","DOIUrl":"10.1016/j.resuscitation.2024.110448","url":null,"abstract":"<p><strong>Aim: </strong>To investigate the characteristics, outcomes, and prognostic factors of patients with hanging-induced out-of-hospital cardiac arrest (OHCA).</p><p><strong>Methods: </strong>We analysed data from a population-based Japanese nationwide OHCA registry (2021-2022), comparing patients aged ≥18 years with hanging-induced OHCA to those with other OHCA causes. The primary outcome was 1-month favourable neurological outcomes. Prognostic factors for hanging-induced OHCA were identified using multivariable logistic regression analysis.</p><p><strong>Results: </strong>Of 263,426 OHCAs, 7,878 (3.0 %) were hanging-induced, with an incidence of 3.1 per 100,000 person-years. Patients with hanging-induced OHCA were younger (median age; 58 vs. 81 years), more frequently males (60.2 % vs. 57.5 %), and less likely to have a witness (1.7 % vs. 42.1 %) and initial shockable rhythm (0.4 % vs. 5.9 %). The chance of 1-month favourable neurological outcomes was significantly lower in patients with hanging-induced OHCA than those with other OHCA causes (0.4 % vs. 2.5 %). Factors associated with favourable neurological outcomes included younger age, witnessed arrest, initial non-asystole cardiac rhythm, and prehospital return of spontaneous circulation (ROSC). Patients with initial non-asystole rhythm and prehospital ROSC had an 11.1 % probability of favourable neurological outcomes, whereas 97.1 % of patients lacking these characteristics had only a 0.1 % probability.</p><p><strong>Conclusions: </strong>Prognosis following hanging-induced OHCAs was significantly worse compared to OHCAs of other causes. While some patients with initial non-asystole rhythm and prehospital ROSC may benefit from cardiopulmonary resuscitation, most lack these favourable features and have an exceedingly low chance of achieving favourable neurological outcomes at 1-month post-arrest.</p>","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":" ","pages":"110448"},"PeriodicalIF":6.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142771474","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":"Perspective on cardiac arrest survivorship: Findings from an Italian landmark survey.","authors":"Erga Cerchiari, Giuseppe Ristagno, Federico Semeraro, Andrea Scapigliati","doi":"10.1016/j.resuscitation.2024.110458","DOIUrl":"10.1016/j.resuscitation.2024.110458","url":null,"abstract":"","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":" ","pages":"110458"},"PeriodicalIF":6.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142792099","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":"2024 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations: Summary From the Basic Life Support; Advanced Life Support; Pediatric Life Support; Neonatal Life Support; Education, Implementation, and Teams; and First Aid Task Forces.","authors":"Robert Greif, Janet E Bray, Therese Djärv, Ian R Drennan, Helen G Liley, Kee-Chong Ng, Adam Cheng, Matthew J Douma, Barnaby R Scholefield, Michael Smyth, Gary Weiner, Cristian Abelairas-Gómez, Jason Acworth, Natalie Anderson, Dianne L Atkins, David C Berry, Farhan Bhanji, Bernd W Böttiger, Richard N Bradley, Jan Breckwoldt, Jestin N Carlson, Pascal Cassan, Wei-Tien Chang, Nathan P Charlton, Sung Phil Chung, Julie Considine, Andrea Cortegiani, Daniela T Costa-Nobre, Keith Couper, Thomaz Bittencourt Couto, Katie N Dainty, Vihara Dassanayake, Peter G Davis, Jennifer A Dawson, Allan R de Caen, Charles D Deakin, Guillaume Debaty, Jimena Del Castillo, Maya Dewan, Bridget Dicker, Jana Djakow, Aaron J Donoghue, Kathryn Eastwood, Walid El-Naggar, Raffo Escalante-Kanashiro, Jorge Fabres, Barbara Farquharson, Joe Fawke, Maria Fernanda de Almeida, Shannon M Fernando, Emer Finan, Judith Finn, Gustavo E Flores, Elizabeth E Foglia, Fredrik Folke, Craig A Goolsby, Asger Granfeldt, Anne-Marie Guerguerian, Ruth Guinsburg, Carolina Malta Hansen, Tetsuo Hatanaka, Karen G Hirsch, Mathias J Holmberg, Stuart Hooper, Amber V Hoover, Ming-Ju Hsieh, Takanari Ikeyama, Tetsuya Isayama, Nicholas J Johnson, Justin Josephsen, Anup Katheria, Mandira D Kawakami, Monica Kleinman, David Kloeck, Ying-Chih Ko, Peter Kudenchuk, Amy Kule, Hiroshi Kurosawa, Jorien Laermans, Anthony Lagina, Kasper G Lauridsen, Eric J Lavonas, Henry C Lee, Swee Han Lim, Yiqun Lin, Andrew S Lockey, Jesus Lopez-Herce, George Lukas, Finlay Macneil, Ian K Maconochie, John Madar, Abel Martinez-Mejas, Siobhan Masterson, Tasuku Matsuyama, Richard Mausling, Christopher J D McKinlay, Daniel Meyran, William Montgomery, Peter T Morley, Laurie J Morrison, Ari L Moskowitz, Michelle Myburgh, Sabine Nabecker, Vinay Nadkarni, Firdose Nakwa, Kevin J Nation, Ziad Nehme, Tonia Nicholson, Nikolaos Nikolaou, Chika Nishiyama, Tatsuya Norii, Gabrielle Nuthall, Shinichiro Ohshimo, Theresa Olasveengen, Alexander Olaussen, Gene Ong, Aaron Orkin, Michael J Parr, Gavin D Perkins, Helen Pocock, Yacov Rabi, Violetta Raffay, James Raitt, Tia Raymond, Giuseppe Ristagno, Antonio Rodriguez-Nunez, Joseph Rossano, Mario Rüdiger, Claudio Sandroni, Taylor L Sawyer, Stephen M Schexnayder, Georg Schmölzer, Sebastian Schnaubelt, Anna Lene Seidler, Federico Semeraro, Eunice M Singletary, Markus B Skrifvars, Christopher M Smith, Jasmeet Soar, Anne Lee Solevåg, Roger Soll, Willem Stassen, Takahiro Sugiura, Kaushila Thilakasiri, Janice Tijssen, Lokesh Kumar Tiwari, Alexis Topjian, Daniele Trevisanuto, Christian Vaillancourt, Michelle Welsford, Myra H Wyckoff, Chih-Wei Yang, Joyce Yeung, Carolyn M Zelop, David A Zideman, Jerry P Nolan, Katherine M Berg","doi":"10.1016/j.resuscitation.2024.110414","DOIUrl":"10.1016/j.resuscitation.2024.110414","url":null,"abstract":"<p><p>This is the eighth annual summary of the International Liaison Committee on Resuscitation International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations; a more comprehensive review was done in 2020. This latest summary addresses the most recent published resuscitation evidence reviewed by the International Liaison Committee on Resuscitation task force science experts. Members from 6 International Liaison Committee on Resuscitation task forces have assessed, discussed, and debated the quality of the evidence, using Grading of Recommendations Assessment, Development, and Evaluation criteria, and their statements include consensus treatment recommendations. Insights into the deliberations of the task forces are provided in the Justification and Evidence-to-Decision Framework Highlights sections. In addition, the task forces list priority knowledge gaps for further research.</p>","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":" ","pages":"110414"},"PeriodicalIF":6.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142644689","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":"Enhancing cardiac arrest response: Evaluating GPT-4o's advanced voice interaction system.","authors":"Federico Semeraro, Elena Giovanna Bignami, Jonathan Montomoli, Koenraad G Monsieurs","doi":"10.1016/j.resuscitation.2024.110447","DOIUrl":"10.1016/j.resuscitation.2024.110447","url":null,"abstract":"","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":" ","pages":"110447"},"PeriodicalIF":6.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142755363","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":"Shaping the future of simulator interactions: The role of ChatGPT's Advanced Voice Mode.","authors":"Federico Lorenzo Barra, Alessandro Costa, Giovanna Rodella, Federico Semeraro, Luca Carenzo","doi":"10.1016/j.resuscitation.2024.110452","DOIUrl":"10.1016/j.resuscitation.2024.110452","url":null,"abstract":"","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":" ","pages":"110452"},"PeriodicalIF":6.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142771778","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":"Impact of coma duration on functional outcomes at discharge and long-term survival after cardiac arrest.","authors":"Jonathan Tam, Nicholas Case, Patrick Coppler, Clifton Callaway, Laura Faiver, Jonathan Elmer","doi":"10.1016/j.resuscitation.2024.110444","DOIUrl":"10.1016/j.resuscitation.2024.110444","url":null,"abstract":"<p><strong>Introduction: </strong>Awakening from coma is crucial for survivors of cardiac arrest, though coma duration is variable. We tested the association of coma duration with short-term functional recovery and long-term survival after cardiac arrest.</p><p><strong>Methods: </strong>In this retrospective cohort study, we identified post-arrest patients who were comatose on presentation but awakened during hospitalization. We recorded demographics, arrest characteristics, days from arrest to awakening, and modified Rankin Scale (mRS) at hospital discharge. We compared discharge mRS between patients with short and long coma duration dichotomized at its median, 3, and 6 days. We compared long-term survival between patients with short and long coma duration who survived to hospital discharge. Finally, we used Cox regression to quantify the independent association of coma duration with survival after adjusting for patient and arrest characteristics.</p><p><strong>Results: </strong>We included 979 subjects with median coma duration 2 [IQR 1-4] days. Shorter coma duration was associated with a higher proportion of patients with discharge mRS ≤ 3 (p < 0.001). We observed 742 subjects who survived to discharge for 3,136 person-years and found no difference in long-term survival between short and long coma durations (p = 0.86). Coma duration was not associated with hazard of death (HR 1.00, 95 %CI 0.97-1.03) after adjusting for age, location of arrest, Charlson Comorbidity Index, and discharge mRS.</p><p><strong>Conclusions: </strong>Shorter coma duration was associated with better functional outcome at discharge, but not with long-term survival.</p>","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":" ","pages":"110444"},"PeriodicalIF":6.5,"publicationDate":"2024-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142771437","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":"Long-term heart function in refractory out-of-hospital cardiac arrest treated with prehospital extracorporeal cardiopulmonary resuscitation.","authors":"Joelle Khoury, Tal Soumagnac, Damien Vimpere, Assia El Morabity, Alice Hutin, Jean-Herlé Raphalen, Lionel Lamhaut","doi":"10.1016/j.resuscitation.2024.110449","DOIUrl":"10.1016/j.resuscitation.2024.110449","url":null,"abstract":"<p><strong>Introduction: </strong>Extracorporeal cardiopulmonary resuscitation (ECPR) is a treatment for refractory out-of-hospital cardiac arrest (OHCA), often due to acute coronary syndrome (ACS). However, the long-term impact of prehospital ECPR on heart function in surviving patients remains unclear.</p><p><strong>Methods: </strong>We conducted a 9 year monocentric retrospective observational study in Paris, France (January 1, 2015, to December 31, 2023). Patients were included if they had a refractory OHCA caused by ACS and were treated with prehospital ECPR. The primary outcome was the New York Heart Association Functional Classification (NYHA-FC) at one year. We also evaluated survival with good neurological outcomes (CPC 1 or 2) and left ventricular ejection fraction (LVEF) at the same time interval. Finally we assessed the ability to work in patients who were still alive.</p><p><strong>Results: </strong>A total of 114 patients were included, 24/114 (21 %) survived at one year with good neurological outcomes (CPC 1 or 2). Among them, the median NYHA-FC at one year was 1 (1-1), and half had recovered an LVEF > 50 %. At the time of data collection, 21 patients were still alive, with a median follow-up time of 6.8 (3.6-8.0) years. Half of these patients were actively working, with a median time of 10 months (3-21) to regain the ability to work since the onset of OHCA.</p><p><strong>Conclusion: </strong>Most patients who were treated with prehospital ECPR for refractory OHCA due to ACS and survived with good neurological outcomes recovered a good heart function at one year, and half of them were working.</p>","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":" ","pages":"110449"},"PeriodicalIF":6.5,"publicationDate":"2024-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142771762","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}