Resuscitation最新文献

{"title":"Remote versus in-person pre-service neonatal resuscitation training: A noninferiority randomized controlled trial in Ethiopia","authors":"Rishi P. Mediratta ,&nbsp;Max K. Clary ,&nbsp;Jane W. Liang ,&nbsp;Kay Daniels ,&nbsp;Lulu M. Muhe ,&nbsp;Henry C. Lee ,&nbsp;Beza Eshetu ,&nbsp;Melkamu Berhane","doi":"10.1016/j.resuscitation.2025.110556","DOIUrl":"10.1016/j.resuscitation.2025.110556","url":null,"abstract":"<div><h3>Background</h3><div>In-person neonatal resuscitation training in resource-limited settings faces barriers of geographic access, facilitator and participant availability, and high costs. Remote training could overcome these challenges while maintaining effectiveness. We hypothesized that remote neonatal resuscitation training was noninferior to in-person training for acquiring and retaining knowledge and skills for pre-service education in Ethiopia.</div></div><div><h3>Methods</h3><div>We conducted a randomized, controlled, noninferiority trial comparing remote versus in-person neonatal resuscitation training in Jimma, Ethiopia. Medical students without prior resuscitation training were randomized (1:1) to Zoom or in-person delivery of the Helping Babies Breathe curriculum supplemented with videos. Outcome assessors were unmasked, but investigators not involved in participant recruitment remained masked. The primary outcome was neonatal resuscitation skills assessed by the Objective Structured Clinical Examination B (OSCE B) two months after training. The noninferiority margin was 13%. Group differences were assessed by intention-to-treat analysis using one-sided <em>t</em>-tests. A <em>p</em>-value &lt; 0.05 suggests noninferiority. The trial was registered at <span><span>Clinicaltrials.gov</span><svg><path></path></svg></span>, NCT05854745, and is complete.</div></div><div><h3>Results</h3><div>Between May 1-June 4, 2023, 354 medical students were randomized to remote or in-person training (177 per group). 262 attended the training and completed assessments (remote <em>n</em> = 123, in-person <em>n</em> = 139; 51% male overall). Two months after training, 199 participants completed assessments (remote <em>n</em> = 94, in-person <em>n</em> = 105). Mean OSCE B scores were 19.8 (SD 3.24) in the remote group and 20.5 (SD 2.24) in the in-person group (difference −0.76 [95% CI −1.53 to 0.01]; <em>p</em> &lt; 0.001 for noninferiority), with similar passing rates (remote 62.8%, in-person 60.0%). No adverse events occurred.</div></div><div><h3>Conclusion</h3><div>Remote training achieved noninferiority to in-person training in resuscitation skill retention at two months among medical students with minimal resuscitation experience, suggesting an effective and promising approach to expanding essential clinical training access globally in resource-limited settings.</div></div>","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":"209 ","pages":"Article 110556"},"PeriodicalIF":6.5,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143476067","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":"Women are profoundly underrepresented in educational depictions of bystander cardiopulmonary resuscitation","authors":"David Purkarthofer ,&nbsp;Valentina Bachner ,&nbsp;Fiona Schlacher ,&nbsp;Simon Orlob","doi":"10.1016/j.resuscitation.2025.110546","DOIUrl":"10.1016/j.resuscitation.2025.110546","url":null,"abstract":"","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":"208 ","pages":"Article 110546"},"PeriodicalIF":6.5,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143459125","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 survivors' self-reported cognitive function, and its association with self-reported health status, psychological distress, and life satisfaction-a Swedish nationwide registry study.","authors":"Karin Larsson, Carina Hjelm, Anna Strömberg, Johan Israelsson, Anders Bremer, Jens Agerström, Nina Carlsson, Dionysia Tsoukala, Erik Blennow Nordström, Kristofer Årestedt","doi":"10.1016/j.resuscitation.2025.110550","DOIUrl":"10.1016/j.resuscitation.2025.110550","url":null,"abstract":"<p><strong>Aim: </strong>Self-reported cognitive function has been described as an important complement to performance-based measurements but has seldom been investigated in cardiac arrest (CA) survivors. Therefore, the aim was to describe self-reported cognitive function and its association with health status, psychological distress, and life satisfaction.</p><p><strong>Methods: </strong>This study utilised data from the Swedish Register of Cardiopulmonary Resuscitation (2018-2021), registered 3-6 months post-CA. Cognitive function was assessed by a single question: \"How do you experience your memory, concentration, and/or planning abilities today compared to before the cardiac arrest?\". Health status was measured using the EQ VAS, psychological distress with the Hospital Anxiety and Depression Scale, and overall life satisfaction with the Life Satisfaction checklist. Data were analysed using binary logistic regression.</p><p><strong>Results: </strong>Among 4026 identified survivors, 1254 fulfilled the inclusion criteria. The mean age was 65.9 years (SD = 13.4) and 31.7% were female. Self-reported cognitive function among survivors was reported as: 'Much worse' by 3.1%, 'Worse' by 23.8%, 'Unchanged' by 68.3%, 'Better' by 3.3%, and 'Much better' by 1.5%. Declined cognitive function was associated with lower health status (OR = 2.76, 95% CI = 2.09-3.64), symptoms of anxiety (OR = 3.84, 95% CI = 2.80-5.24) and depression (OR = 4.52, 95% CI = 3.22-6.32), and being dissatisfied with overall life (OR = 2.74, 95% CI = 2.11-3.54). These associations remained significant after age, sex, place of CA, aetiology, initial rhythm, initial witnessed status, and cerebral performance were controlled.</p><p><strong>Conclusions: </strong>Survivors experiencing declined cognitive function post-CA are at a higher risk of poorer health status, increased psychological distress, and reduced life satisfaction, and these risks should be acknowledged by healthcare professionals.</p>","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":" ","pages":"110550"},"PeriodicalIF":6.5,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143458982","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":"Cost-effectiveness of drone-delivered automated external defibrillators for cardiac arrest","authors":"Muhammad Maaz ,&nbsp;K.H. Benjamin Leung ,&nbsp;Justin J. Boutilier ,&nbsp;Sze-chuan Suen ,&nbsp;Paul Dorian ,&nbsp;Laurie J. Morrison ,&nbsp;Damon C. Scales ,&nbsp;Sheldon Cheskes ,&nbsp;Timothy C.Y. Chan","doi":"10.1016/j.resuscitation.2025.110552","DOIUrl":"10.1016/j.resuscitation.2025.110552","url":null,"abstract":"<div><h3>Background</h3><div>Out-of-hospital cardiac arrest (OHCA) is a significant cause of mortality and morbidity in North America, for which timely defibrillation of shockable rhythms is essential. Drones have been proposed as an intervention to improve response time and are being implemented in practice.</div></div><div><h3>Aim</h3><div>To determine the cost-effectiveness of drone-delivered automated external defibrillators (AEDs) for OHCAs.</div></div><div><h3>Methods</h3><div>Using data from 22,017 OHCAs in Ontario, Canada over 10 years, we developed a comprehensive computational framework combining machine learning, optimization and a Markov microsimulation model to provide an economic evaluation of 964 different drone networks across a wide range of sizes and configurations. We simulated response times, survival outcomes, lifetime quality-adjusted life-years (QALYs), lifetime healthcare costs, and 10-year operational costs for each network.</div></div><div><h3>Results</h3><div>All 964 drone networks were cost-effective. We identified 20 networks on the cost-QALY efficient frontier, each with shorter response times, more survivors across all categories, and higher costs per survivor. Historical ambulance response (i.e., standard care) had mean response time of 6 min 21 s. On the efficient frontier, average drone response times were 32% to 71% shorter than standard care. There were 1,855 (8.4%) survivors to hospital discharge in standard care, which increased by 21% to 46% across the 20 drone networks. The smallest non-dominated drone network, with 20 drones, cost $20,912 per QALY gained. All drone networks had higher net monetary benefit than standard care. Cost-effectiveness was even greater for shockable and witnessed populations. Extensive sensitivity analyses showed that our results were robust to changes in modelling assumptions.</div></div><div><h3>Conclusions</h3><div>Drone-delivered AEDs were associated with reductions in response time, mortality and morbidity, and were found to be highly cost-effective relative to standard ambulance response with no drones.</div></div>","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":"209 ","pages":"Article 110552"},"PeriodicalIF":6.5,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143458993","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":"Intraventricular pressure and volume during conventional and automated head-up CPR.","authors":"Pouria Pourzand, Johanna Moore, Anja Metzger, Mithun Suresh, Bayert Salverda, Hamza Hai, Sue Duval, Kerry Bachista, Guillaume Debaty, Keith Lurie","doi":"10.1016/j.resuscitation.2025.110551","DOIUrl":"10.1016/j.resuscitation.2025.110551","url":null,"abstract":"<p><strong>Background: </strong>Active compression-decompression (ACD) CPR, an impedance threshold device (ITD) and automated head and thorax elevation, collectively termed AHUP-CPR, increases cerebral and coronary perfusion pressures, brain blood flow, end-tidal CO2 (ETCO2) and cerebral oximetry (rSO2) in animal models compared with conventional (C) CPR. We tested the hypothesis that cardiac stroke volume (SV) is higher with AHUP-CPR versus C-CPR or ACD + ITD in a porcine cardiac arrest model.</p><p><strong>Methods: </strong>Farm pigs (n = 14) were sedated, anesthetized, and ventilated. Hemodynamics, including biventricular pressure-volume loops, were continuously measured. Following 10 min of untreated ventricular fibrillation, C-CPR was performed for 2 min, then ACD + ITD for 2 min in the flat position, and then AHUP-CPR thereafter. Linear mixed-effects model and Pearson correlation comparisons were used for statistical analysis.</p><p><strong>Results: </strong>Coronary and cerebral perfusion pressures, ETCO2, rSO2, and right (RV) and left (LV) ventricular SV increased progressively and significantly with the implementation of AHUP-CPR (p < 0.05). RV SV with C-CPR was 24.8 ± 2.8 mL (∼48% of baseline) versus 45.2 ± 4.1 with AHUP-CPR (∼90% of baseline) (p < 0.01). LV SV with C-CPR was 17.6 ± 1.8 mL (∼35% of baseline) versus 38.7 ± 6.7 with AHUP-CPR (∼80% of baseline) (p < 0.01).</p><p><strong>Conclusion: </strong>A fundamental and inherent shortcoming of C-CPR, limited cardiac stroke volume, and resultant forward flow, can be overcome with AHUP-CPR. These findings may help explain the better outcomes associated with early use of AHUP-CPR.</p>","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":" ","pages":"110551"},"PeriodicalIF":6.5,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143459016","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 alternate defibrillation strategies on time in ventricular fibrillation.","authors":"Sheldon Cheskes, Ian R Drennan, Linda Turner, Sandeep V Pandit, Robert G Walker, Paul Dorian","doi":"10.1016/j.resuscitation.2025.110549","DOIUrl":"10.1016/j.resuscitation.2025.110549","url":null,"abstract":"<p><strong>Background: </strong>Time in ventricular fibrillation (VF) is associated with survival after out-of-hospital cardiac arrest (OHCA). The impact of vector change defibrillation (VC) and double sequential external defibrillation (DSED) on VF duration has not been explored.</p><p><strong>Objective: </strong>To compare the effects of VC and DSED on VF duration and defibrillation outcomes.</p><p><strong>Methods: </strong>We conducted a secondary analysis of patients enrolled in the Double Sequential External Defibrillation for Refractory VF RCT. We assessed the ECG after each shock, calculating VF time (median, IQR) and shock outcomes. The Kruskal-Wallis test was used to compare VF duration across groups, with post-hoc pairwise comparisons using Dunn's test and Bonferroni correction. Chi-square tests compared shock outcomes.</p><p><strong>Results: </strong>Among 342 patients, 1842 shocks were analyzed (834 after three failed standard shocks: 429 standard, 218 VC, 187 DSED). Median VF time was significantly shorter for DSED (83 [0, 120] s) and VC (98 [0, 120] s) compared to standard shocks (108 [38, 120] s) (P = 0.003). The proportion of shocks leading to return of spontaneous circulation (ROSC) and survival to hospital discharge respectively was higher for DSED (17.6%, 10.2% p < 0.001 ROSC, p = 0.002 survival) and VC (14.2%, 7.3% p < 0.002 ROSC, p = 0.049 survival) than for standard shocks (5.3%, 3.5%) The proportion of shocks in which VF was not terminated was significantly lower for DSED shocks (29.9%) than standard shocks (40.6%) (P = 0.013).</p><p><strong>Conclusions: </strong>DSED and VC reduced VF duration and increased the likelihood of ROSC and survival compared to standard shocks. These findings may contribute to the improved survival noted in the trial.</p>","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":" ","pages":"110549"},"PeriodicalIF":6.5,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143459179","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":"Artificial intelligence in cardiopulmonary resuscitation: Driving awareness and debunking myths","authors":"Federico Semeraro,&nbsp;Sebastian Schnaubelt,&nbsp;Jonathan Montomoli,&nbsp;Elena Giovanna Bignami,&nbsp;Koenraad G. Monsieurs","doi":"10.1016/j.resuscitation.2025.110539","DOIUrl":"10.1016/j.resuscitation.2025.110539","url":null,"abstract":"","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":"208 ","pages":"Article 110539"},"PeriodicalIF":6.5,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143426069","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":"Progress and challenges in implementing “Kids Save Lives” across Europe in 2025","authors":"Federico Semeraro,&nbsp;Kaushila Thilakasiri,&nbsp;Sebastian Schnaubelt,&nbsp;Bernd W. Böttiger","doi":"10.1016/j.resuscitation.2025.110541","DOIUrl":"10.1016/j.resuscitation.2025.110541","url":null,"abstract":"","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":"208 ","pages":"Article 110541"},"PeriodicalIF":6.5,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143426075","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":"Diastolic blood pressures and end tidal carbon dioxides during cardiopulmonary resuscitations and their association with outcomes in adult out-of-hospital cardiac arrest patients: A preplanned secondary analysis of the Augmented Medication CardioPulmonary resuscitation (AMCPR) trial","authors":"June-sung Kim,&nbsp;Youn-Jung Kim,&nbsp;Seok In Hong,&nbsp;Sang-Min Kim,&nbsp;Bora Chae,&nbsp;Seung Mok Ryoo,&nbsp;Won Young Kim","doi":"10.1016/j.resuscitation.2025.110537","DOIUrl":"10.1016/j.resuscitation.2025.110537","url":null,"abstract":"<div><h3>Background</h3><div>The optimal targets for diastolic blood pressure (DBP) and end-tidal carbon dioxide (ETCO2) during cardiopulmonary resuscitation (CPR) and their association with outcomes remain unclear. This study aimed to evaluate the association between DBP and ETCO2 and the return of spontaneous circulation (ROSC) during CPR.</div></div><div><h3>Methods</h3><div>This study was a preplanned sub-analysis of the Augmented Medication CardioPulmonary Resuscitation (AMCPR) trial. We extracted initial (within 5 min), follow-up (around 10 min), and delta (follow-up minus initial) values of DBP and ETCO2 from the registry. The primary outcome was sustained ROSC (≥20 min).</div></div><div><h3>Results</h3><div>The study included 264 patients, mostly male (69.3%) and with a median age of 74 years old. Of these patients, 101 (38.3%) achieved sustained ROSC. Patients with sustained ROSC had statistically higher initial, follow-up, and delta values of DBP compared to those without ROSC. However, the levels of ETCO2 were similar between the two groups, except for follow-up values. Follow-up DBP above 26.5 and delta DBP above 6.5 were independently associated with sustained ROSC (adjusted odds ratio, aOR = 10.03, 95% confidence interval, CI = 3.64–27.66, <em>p</em> &lt; 0.01, and aOR = 4.83, 95% CI = 1.90–12.26, <em>p</em> &lt; 0.01).</div></div><div><h3>Conclusion</h3><div>Monitoring DBP during resuscitation in patients with cardiac arrest may provide additional information about successful initial resuscitation. Improving certain levels of DBP may influence outcomes.</div></div>","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":"210 ","pages":"Article 110537"},"PeriodicalIF":6.5,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143426073","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 gap between promise and reality: Evaluating new AI’s role in CPR education","authors":"Federico Semeraro,&nbsp;Nino Fijačko,&nbsp;Lorenzo Gamberini,&nbsp;Elena Giovanna Bignami,&nbsp;Robert Greif","doi":"10.1016/j.resuscitation.2025.110540","DOIUrl":"10.1016/j.resuscitation.2025.110540","url":null,"abstract":"","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":"208 ","pages":"Article 110540"},"PeriodicalIF":6.5,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143426077","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}