Resuscitation最新文献

{"title":"Ultra-early short- and middle-latency SSEP accurately predict good and poor outcome after cardiac arrest","authors":"Maenia Scarpino ,&nbsp;Andrea Nencioni ,&nbsp;Pasquale Bernardo ,&nbsp;Manuela Bonizzoli ,&nbsp;Peiman Nazerian ,&nbsp;Benedetta Piccardi ,&nbsp;Riccardo Carrai ,&nbsp;Claudio Sandroni ,&nbsp;Antonello Grippo","doi":"10.1016/j.resuscitation.2025.110801","DOIUrl":"10.1016/j.resuscitation.2025.110801","url":null,"abstract":"<div><h3>Background</h3><div>Accurate prognostication following cardiac arrest (CA) is crucial for informing clinical decisions. Current guidelines do not recommend a specific time point for recording somatosensory evoked potentials (SSEPs) after CA. We evaluated the ability of ultra-early short- and middle-latency SSEPs to predict good an poor neurological outcome and compared its accuracy with that of other predictors recorded early after CA.</div></div><div><h3>Methods</h3><div>Prospective single-centre study. Sixty-five comatose adults underwent a multimodal prognostic assessment, including neurophysiological (SSEPs and electroencephalogram [EEG]), clinical (pupillary reflexes and myoclonus), and imaging indices (brain computed tomography [CT]) within 6 h post-CA. Serum neuron-specific enolase (NSE) was sampled 12 h post-CA. We analysed the SSEPs N20 wave amplitude and duration, and the presence of the middle-latency N70 wave. Poor outcome was defined as a Cerebral Performance Category (CPC) of 3–5 at hospital discharge.</div></div><div><h3>Results</h3><div>A bilaterally absent N20 wave predicted poor outcome with 100[89–100]% specificity and 67[48–82]% sensitivity. Adding low-amplitude (&lt;1.2 µV), prolonged (&gt;10 ms) N20 waves without N70 increased sensitivity to 93[79–99]% without compromising specificity. Conversely, a high-amplitude (&gt;3 µV) N20 wave with normal duration with preserved N70 predicted good outcome with 94[79–99]% sensitivity and 100[89–100]% specificity. SSEPs outperformed all other early prognostic indices for both good and poor outcome prediction. All poor outcome patients had at least two concordant unfavourable predictors.</div></div><div><h3>Conclusions</h3><div>Ultra-early quantitative assessment of short- and middle-latency SSEPs provides highly accurate prediction of both good and poor neurological outcomes after CA. This approach may enhance early clinical decision-making and warrants validation in larger cohorts.</div></div>","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":"216 ","pages":"Article 110801"},"PeriodicalIF":4.6,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145008441","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":"Efficacy of supraglottic airway devices in chest compression synchronized ventilation during continuous resuscitation: a prospective randomized cross-over cadaver study.","authors":"Tamar Gelashvili, Beate Brand-Saberi, Mahsa Darvishali, Annika Hoyer, Lydia Johnson Kolaparambil Varghese, Vanessa Kuehn, Jonas Lohmann, Christian Neuhaus, Claudia Schneider, Justin Trenkel, Jochen Hinkelbein, Gerrit Jansen","doi":"10.1016/j.resuscitation.2025.110795","DOIUrl":"10.1016/j.resuscitation.2025.110795","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to evaluate the efficacy of Chest-Compression-Synchronized-Ventilation (CCSV) using supraglottic airway devices (SGA) compared to tracheal intubation (TI) for ventilation during continuous resuscitation.</p><p><strong>Methods: </strong>In this cross-over study, the lungs of adult Thiel-embalmed cadavers were initially recruited using TI. Subsequently, various SGA (Laryngeal-Mask = Ambu®AuraGain™, Laryngeal-Tube = LTS-D®, i-gel-Laryngeal-Mask = I-GEL®) and TI were applied in randomized order during continuous chest compressions. CCSV was delivered with a CCSV-Pressure (pCCSV) = 40 mbar, PEEP = 3 mbar, respiratory-rate (RR) synchronized with the chest compression rate. The primary endpoint was achieving a pCCSV = 40 ± 3 mbar. Secondary endpoints included pCCSV, expiratory tidal (V_te) 1 ml/kgBW and leakage volumes (V_leak). Logistic regression models with random intercepts were used for the primary outcome, and linear mixed models were applied for secondary outcomes.</p><p><strong>Results: </strong>Eleven cadavers were included. While two(18 %) were successfully ventilated with all airway types, three(27 %) could only be ventilated with an TI. Two cadavers(18 %) could not be sufficiently ventilated with any of the airway devices including TI. When comparing TI and SGA, for TI a greater chance of reaching the target corridor of pCCSV (Odds Ratio(OR) = 1.87; 95 %-Confidence-Interval(95 %CI) = [0.91-3.83]; P = 0.0864) and a higher pCCSV was observed (regression-coefficient(RC) = 2.99 mbar; 95 %CI = [1.63-4.35]; p < 0.0001), along with a higher V_te (RC = 42.42 ml; 95 %CI = [32.07-52.27]; p < 0.0001), and a lower V_leak (RC = -55.03 %; 95 %CI = [-62.92-47.15]; p < 0.0001). In comparisons among the individual SGA, lower pCCSV-values were observed for Ambu®AuraGain™ versus I-GEL® (RC = -2.58 mbar; 95 %CI = [-4.04--1.13]; p = 0.0006), Ambu®AuraGain™ versus LTS-D® (RC = -1.73 mbar; 95 %CI = [-3.18--0.27]; p = 0.0204), and LTS-D® versus I-GEL® (RC = -0.86 mbar; 95 %CI = [-2.30-0.59]; p = 0.2434).</p><p><strong>Conclusion: </strong>SGA were associated with a lower likelihood of reaching the target range of pCCSV, lower V_te, and higher V_leak. Regardless the airway device, CCSV-failure is possible emphasizing the need for vigilant respiratory monitoring.</p><p><strong>Registration: </strong>URL: https://www.</p><p><strong>Clinicaltrials: </strong>gov. Unique identifier number: NCT06306898.</p>","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":" ","pages":"110795"},"PeriodicalIF":4.6,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145001472","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":"Question on the occurrence of lung injury in patients receiving chest compression synchronized ventilation in the SYMEVECA study.","authors":"Jukka Kopra, Robert Östman, Erik Litonius, Markus B Skrifvars, Pirkka T Pekkarinen","doi":"10.1016/j.resuscitation.2025.110800","DOIUrl":"10.1016/j.resuscitation.2025.110800","url":null,"abstract":"","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":" ","pages":"110800"},"PeriodicalIF":4.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144993261","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":"Evaluating measurement quality and feasibility of neurocognitive screening instruments for adult survivors of out-of-hospital cardiac arrest: A systematic review.","authors":"Theresa Aves, Katherine S Allan, Sajeevan Sujanthan, Damyen Henderson-Lee Wah, Mahbod Rahimi, Sara Shalca, Teruko Kishibe, Steve Lin, Richard H Swartz, Katie N Dainty, Kirstie L Haywood","doi":"10.1016/j.resuscitation.2025.110793","DOIUrl":"10.1016/j.resuscitation.2025.110793","url":null,"abstract":"<p><strong>Aim: </strong>To systematically review and appraise the measurement properties, interpretability, and feasibility of outcome measurement instruments (OMIs) for screening neurocognitive function among adult survivors of out-of hospital cardiac arrest (OHCA).</p><p><strong>Methods: </strong>Online databases were searched (MEDLINE, EMBASE, CENTRAL, CINAHL, PsychINFO) from inception - August 23, 2024. Included articles evaluated measurement properties, interpretability (assigning meaning to scores), and/or feasibility (ease of application) of multidomain instruments for screening neurocognitive function among OHCA survivors. Evidence was reviewed according to the Consensus-based Standards for the selection of health status Measurement Instruments (COSMIN) guidelines: Risk of Bias determined study quality; COSMIN criteria for good measurement properties was applied; data were pooled where possible, finally, the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) criteria rated the certainty of evidence.</p><p><strong>Results: </strong>Of 2336 titles and abstracts, 27 articles provided evidence for 13 instruments (MoCA, T-MoCA, Mini MoCA, MMSE, MMSE-ALFI, 3MS, TICS, TICS-m, WASI, IQCODE, IQCODE-CA, SF-16 IQCODE-CA, and CFQ). Only three reported measurement properties for two OMIs: the MoCA and the IQCODE-CA. The MoCA demonstrated high quality evidence of criterion validity across two studies (pooled AUC: 0.80; 95% CI: 0.67 to 0.93). There were inconsistent results for the IQCODE-CA. There was limited evidence of score interpretability and feasibility across all 13 OMIs.</p><p><strong>Conclusions: </strong>Insufficient evidence of essential measurement properties limits instrument choice. Whilst the MoCA had acceptable criterion validity, evidence of content validity was inadequate, and reliability and responsiveness lacking. Establishing robust evidence to inform screening of neurocognitive function in this population should be prioritized.</p>","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":" ","pages":"110793"},"PeriodicalIF":4.6,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144966801","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":"Comparative accuracy of a wireless heart rate monitor (NeoBeat) versus standard EKG during resuscitation of very premature neonates.","authors":"Kasim Hassen, Kaitlyn Fitzgerald, Felix Ines, Anup C Katheria","doi":"10.1016/j.resuscitation.2025.110792","DOIUrl":"10.1016/j.resuscitation.2025.110792","url":null,"abstract":"<p><strong>Background: </strong>Rapid and accurate heart rate assessment is essential in neonatal resuscitation, particularly for very premature infants where delays can impact timely intervention. A wireless heart rate monitor (NeoBeat) device has been validated in term babies but not in smaller preterm infants. We sought to validate the use of the Neobeat device compared to standard EKG in extremely preterm neonates during resuscitation.</p><p><strong>Methods: </strong>A prospective observational study of very premature neonates undergoing routine resuscitation was conducted at a tertiary care center. Heart rate data were simultaneously recorded using the NeoBeat wireless monitor and a standard three-lead EKG.</p><p><strong>Results: </strong>Thirty very preterm infants (gestational age, (GA) 26.6 ± 1.9 weeks and birth weight range (250-1310 g)) were enrolled. A total of 1690 heart rate pairs were analyzed. A strong correlation and tracking observed between NeoBeat and EKG-derived heart rates (Pearson r = 0.96, Spearman ρ = 0.95), with a mean absolute difference of 3.76 beats per minute (bpm). Correlation remained robust across different resuscitation interventions (Intubation: r = 0.93 vs. No Intubation: r = 0.90, p = 0.207, PPV: r = 0.93 vs. No PPV: r = 0.87, p = 0.726).</p><p><strong>Conclusion: </strong>In very preterm infants, NeoBeat wireless monitor achieved 96 % precision (r = 0.96) and maintained a mean absolute difference of 3.76 bpm compared to EKG, supporting its reliability and accuracy for real time neonatal monitoring, including infants weighing as little as 250 g, though statistical power in this range was limited. Randomized studies comparing NeoBeat to standard EKG are warranted to confirm these findings in extremely preterm infants and explore whether NeoBeat improves clinical outcomes.</p>","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":" ","pages":"110792"},"PeriodicalIF":4.6,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12439110/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144966782","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":"Outcomes in pediatric ECPR for in-hospital cardiac arrest: an ELSO registry analysis.","authors":"Raysa Morales-Demori, Taylor L Olson, Alexander Alali, Ryan P Barbaro, Peter Rycus, Peta M A Alexander, Erika R O'Neil, Duy D Dinh, Sukru Aras, Matthew Friedman, Marc Anders","doi":"10.1016/j.resuscitation.2025.110794","DOIUrl":"10.1016/j.resuscitation.2025.110794","url":null,"abstract":"<p><strong>Background: </strong>Utilization of in-hospital extracorporeal cardiopulmonary resuscitation (ECPR) in pediatrics has increased significantly, with concurrent improvements in survival. Despite these advances, there remains considerable variability in the criteria for pediatric ECPR candidacy. This study aims to identify the patient demographics as well as pre-, peri-, and post-arrest characteristics associated with ECPR outcome.</p><p><strong>Methods: </strong>This is a retrospective study of patients up to 18 years old with witnessed in-hospital cardiac arrest and ECPR from January 2020 until October 2024 reported to the Extracorporeal Life Support Organization (ELSO) Registry. The primary outcome was a composite measure including survival to hospital discharge, heart transplantation, or placement of permanent ventricular assist device. Univariate and multivariate logistic regression, as well as Kaplan Meier and Joint-Model analysis were performed.</p><p><strong>Results: </strong>A total of 1,903 patients were analyzed in the study, with 1,410 (74.1 %) presenting with cardiac precipitating events, 358 (18.8 %) with non-cardiac events, and 135 (7.1 %) with unknown causes. Overall, 788 patients (41.4 %) achieved a favorable composite outcome, including 641 (45.5 %) in the cardiac group, 100 (27.9 %) in the non-cardiac group and 47 (34.8 %) in the unknown group. On univariate analysis, non-cardiac event (OR 0.46 [0.36-0.60]), longer cardiopulmonary resuscitation (CPR) duration (OR 0.98 [0.98-0.99]), non-shockable rhythm (OR 0.62 [0.49-0.79]), and higher lactate (OR 0.95 [0.93-0.97]) were associated with decreased odds of favorable outcome, whereas signs of life (OR 1.52 [1.22-1.89]) and higher pH (OR 3.26 [2.03-5.27]) were associated with increased odds of favorable outcome. Independent predictors of increased odds of favorable outcome on multivariate analysis included higher pH at 24 h (OR 10.69 [1.46-78.36]), whereas variables associated with decreased odds of favorable outcome included history of prior ECMO run (OR 0.37 [0.22-0.62]), lung disease (OR 0.37 [0.16-0.85]), renal replacement therapy (OR 0.39 [0.16-0.94]), higher PaCO₂ prior to ECMO (OR 0.99 [0.99-0.99]), higher lactate at 24 h (OR 0.80 [0.75-0.85]), and longer CPR time (OR (0.99 [0.99-0.99]). Elevated lactate tertiles at all points (pre-ECPR, 6 h, and 24 h) were associated with lower rates of favorable outcome by Kaplan-Meier (p log-rank < 0.0001) and Joint model analyses (p = 0.018).</p><p><strong>Conclusion: </strong>Pediatric ECPR is a complex, resource-intensive intervention impacted by institutional expertise, patient selection, arrest characteristics, and post-ECPR management. We highlight several prognostic variables that may be useful in determining ECPR candidacy.</p>","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":" ","pages":"110794"},"PeriodicalIF":4.6,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144966822","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":"Cardiac arrest and pandemic: learn from the past to anticipate the future","authors":"Alexis Descatha ,&nbsp;Dominique Savary","doi":"10.1016/j.resuscitation.2025.110797","DOIUrl":"10.1016/j.resuscitation.2025.110797","url":null,"abstract":"","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":"215 ","pages":"Article 110797"},"PeriodicalIF":4.6,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144966763","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":"Neonatal resuscitation - Finding the pathway to effective implementation.","authors":"Helen G Liley","doi":"10.1016/j.resuscitation.2025.110798","DOIUrl":"https://doi.org/10.1016/j.resuscitation.2025.110798","url":null,"abstract":"","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":" ","pages":"110798"},"PeriodicalIF":4.6,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144966770","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":"Perioperative cardiac arrest: more data, more questions","authors":"Richard A. Armstrong ,&nbsp;Andrew D. Kane","doi":"10.1016/j.resuscitation.2025.110799","DOIUrl":"10.1016/j.resuscitation.2025.110799","url":null,"abstract":"","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":"215 ","pages":"Article 110799"},"PeriodicalIF":4.6,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144966839","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":"Personalizing resuscitation: the promise and challenge of multimodal physiology-directed CPR","authors":"Jeremy R. Herrmann,&nbsp;Ryan W. Morgan","doi":"10.1016/j.resuscitation.2025.110796","DOIUrl":"10.1016/j.resuscitation.2025.110796","url":null,"abstract":"","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":"216 ","pages":"Article 110796"},"PeriodicalIF":4.6,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144966797","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}