Resuscitation最新文献

{"title":"Where there’s smoke, is there fire? Spontaneous echo contrast and prognosis after cardiac arrest","authors":"Jocelyn Chai, Christopher B. Fordyce","doi":"10.1016/j.resuscitation.2025.110765","DOIUrl":"10.1016/j.resuscitation.2025.110765","url":null,"abstract":"","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":"215 ","pages":"Article 110765"},"PeriodicalIF":4.6,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144848536","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":"Assessing both early and late EEG patterns improves prediction of outcome after cardiac arrest","authors":"Marjolein Admiraal ,&nbsp;Sofia Backman ,&nbsp;Martin Annborn ,&nbsp;Ola Borgquist ,&nbsp;Josef Dankiewicz ,&nbsp;Joachim Düring ,&nbsp;Marion Moseby-Knappe ,&nbsp;Stéphane Legriel ,&nbsp;Hans Lindehammar ,&nbsp;Anna Lybeck ,&nbsp;Niklas Nielsen ,&nbsp;Andrea O. Rossetti ,&nbsp;Johan Undén ,&nbsp;Tobias Cronberg ,&nbsp;Erik Westhall","doi":"10.1016/j.resuscitation.2025.110762","DOIUrl":"10.1016/j.resuscitation.2025.110762","url":null,"abstract":"<div><h3>Objective</h3><div>Previously proposed “synchronous EEG patterns” predict poor outcome within 24 h after cardiac arrest (CA). We investigate the prognostic performance of these early EEG predictors in addition to the late EEG predictors (&gt;24 h) recommended in the European post-resuscitation guidelines.</div></div><div><h3>Methods</h3><div>Observational substudy of the TTM2-trial including consecutive comatose resuscitated patients. Continuous EEG-monitoring (cEEG) was blindly assessed using the American Clinical Neurophysiology Societýs standardised EEG terminology and categorised into early EEG predictors (burst-suppression with identical or highly epileptiform bursts, or suppression with generalised periodic discharges) and late EEG predictors (heterogenous burst-suppression or suppression). Poor outcome was defined as modified Rankin Scale 4–6 at six months.</div></div><div><h3>Results</h3><div>Of 191 included patients, 53 % had poor outcome. Early EEG predictors had 100 %[CI 96–100] specificity at all time-points and maximal sensitivity 30 %[CI 21–40] <em>before</em> 24 h. Late EEG predictors had 100 %[CI 96–100] specificity <em>beyond</em> 24 h with maximal sensitivity 32 %[CI 21–43]. Using both early and late EEG predictors, and gradually adding cEEG-information from consecutive time-epochs, sensitivity increased to 49 %[CI 39–59] up to 36 h after CA (p = 0.001). A continuous background within 12 h predicted good outcome (sensitivity 61 %[CI 50–71]; specificity 87 %[CI 79–93]).</div></div><div><h3>Conclusion</h3><div>Searching for both early EEG predictors (e.g. identical burst-suppression) and late EEG predictors (e.g. heterogenous burst-suppression &gt; 24 h) significantly improved sensitivity of poor outcome prediction without false positive survivors in this cohort. A self-fulfilling prophecy may have affected our results. cEEG during the first two days after CA identified half of the patients with a long-term poor outcome and half of the patients with a good outcome.</div></div>","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":"215 ","pages":"Article 110762"},"PeriodicalIF":4.6,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144812241","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":"Association of healthy sleep patterns with incident sudden cardiac arrest: a prospective study of 414,625 UK biobank participants","authors":"Fan Yang ,&nbsp;Tongtong Zhang ,&nbsp;Rui Mao ,&nbsp;Qingbian Ma","doi":"10.1016/j.resuscitation.2025.110756","DOIUrl":"10.1016/j.resuscitation.2025.110756","url":null,"abstract":"<div><h3>Background and Objective</h3><div>The relationship between healthy sleep patterns and the risk of incident sudden cardiac arrest (SCA) remains underexplored.</div></div><div><h3>Methods</h3><div>In this prospective cohort study, data from 414,625 participants in the UK Biobank (UKB) were analyzed. Sleep patterns were assessed using a composite sleep score incorporating five sleep behaviors: sleep chronotype, sleep duration, insomnia, snoring, and daytime sleepiness. The association between sleep patterns and incident SCA was evaluated using Cox proportional hazards models.</div></div><div><h3>Results</h3><div>Over a median follow-up of 13.93 years, 2545 incident SCA cases were identified. In the fully adjusted Model 3, participants with sleep scores of 4 or 5 had a 19 % [Hard ratio (HR) = 0.81; 95 % Confidence interval (CI): 0.65–1.00] lower risk of SCA compared to those with sleep scores of 0–1, and each one-point increase in sleep score was associated with a 5 % reduction in SCA risk. Restricted cubic spline analysis demonstrated a dose–response relationship between sleep scores and SCA risk, with no evidence of nonlinearity. If all individuals adhered to an optimal sleep score of 5, the incidence of SCA may potentially be reduced by 17.11 %. Notably, the association between sleep scores and SCA risk was more pronounced in individuals younger than 60 years at baseline and those without chronic conditions such as coronary heart disease, hypertension, stroke, or cancer. Additionally, sleep duration, insomnia, and snoring showed significant genetic correlations with SCA.</div></div><div><h3>Conclusion</h3><div>Healthy sleep patterns are associated with a significantly reduced risk of SCA, particularly among individuals younger than 60 years without cardiovascular disease, cerebrovascular disease, or cancer.</div></div>","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":"215 ","pages":"Article 110756"},"PeriodicalIF":4.6,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144812263","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":"Beyond STEMI: High-risk ECG patterns as predictors of occlusive myocardial infarction in out-of-hospital cardiac arrest patients","authors":"Claudio Silwanis ,&nbsp;Julian Maier ,&nbsp;Johannes Eder ,&nbsp;Max Groche ,&nbsp;Alexander Nahler ,&nbsp;Alexander Fellner ,&nbsp;Hermann Blessberger ,&nbsp;Jörg Kellermair ,&nbsp;Clemens Steinwender ,&nbsp;Thomas Lambert","doi":"10.1016/j.resuscitation.2025.110763","DOIUrl":"10.1016/j.resuscitation.2025.110763","url":null,"abstract":"<div><h3>Background/Aim</h3><div>Immediate coronary angiography (CAG) is recommended for patients with ST-elevation myocardial infarction (STEMI) after out-of-hospital cardiac arrest (OHCA). However, some occlusive myocardial infarctions (OMI) do not meet STEMI criteria. This study investigated whether additional ECG patterns beyond STEMI could more accurately identify OMI in OHCA patients, compared to using STEMI criteria alone.</div></div><div><h3>Methods</h3><div>This retrospective study categorised patients based on their first post-resuscitation ECG into two groups: STEMI and non-STEMI with high-risk ECG criteria and compared them for OMI by CAG.</div></div><div><h3>Results</h3><div>Among 97 patients OMI was identified in 55 % (53/97) of patients, specifically in 25 of 31 with STEMI (81 %), 24 of 29 with high-risk ECG (83 %), and 4 of 37 patients with neither (11 %). Combining STEMI and high-risk ECG criteria would have predicted OMI in 92 % (49/53) of cases. Patients with high-risk ECG experienced significantly longer median delays until CAG (101.5 [IQR 63–336.75] vs. 47.5 [25.75–71.25] minutes; p = 0.004) compared to those with STEMI on the ECG. Although 30-day mortality did not differ between STEMI and high-risk ECG patients (p = 0.973), survival-differences could be observed between groups. Syntax-I-Score was significantly higher in the high-risk ECG group (29 [IQR 19–38] vs. 15 [IQR 3–24.5]; p = 0.002).</div></div><div><h3>Conclusion</h3><div>Combining STEMI and high-risk ECG criteria improves OMI prediction compared to STEMI criteria alone, potentially enabling faster treatment and better OHCA survival.</div></div>","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":"215 ","pages":"Article 110763"},"PeriodicalIF":4.6,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144812264","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":"Influence of different ventilation strategies during cardiopulmonary resuscitation on the return of spontaneous circulation in out-of-hospital cardiac arrest: a retrospective study from the German resuscitation registry","authors":"Pia Turowski ,&nbsp;Katharina Fetz ,&nbsp;Jan-Thorsten Gräsner ,&nbsp;Stephan Seewald ,&nbsp;Jan Wnent","doi":"10.1016/j.resuscitation.2025.110764","DOIUrl":"10.1016/j.resuscitation.2025.110764","url":null,"abstract":"<div><h3>Aim</h3><div>To evaluate the association of different intra-arrest ventilation strategies with return of spontaneous circulation (ROSC), hospital admission, and 24-h survival among adult OHCA patients.</div></div><div><h3>Methods</h3><div>This retrospective cross-sectional study analyzed data from the German Resuscitation Registry. Adult patients (≥18 years) with non-traumatic out-of-hospital cardiac arrest (OHCA) between March 2016 and March 2023 were included if they received CPR, endotracheal intubation during CPR, and had a documented ventilation strategy. Four ventilation modes were compared: Intermittent Positive Pressure Ventilation (IPPV), Chest Compression Synchronized Ventilation (CCSV), biphasic positive airway pressure (BIPAP), and manual bag-valve ventilation (Manually). ROSC observed (ROSC_obs) was compared with expected ROSC (ROSC_exp) based on the ROSC after cardiac arrest score (RACA). Secondary outcomes were hospital admission status and 24-hour survival.</div></div><div><h3>Results</h3><div>Among 3,195 patients (IPPV: 1,865; CCSV: 194; BIPAP: 81; Manually: 1,055), ROSC occurred in 44 % (IPPV), 40 % (CCSV), 49 % (BIPAP), and 39 % (Manually). IPPV showed a significant positive deviation from ROSC_exp (+2.7 %, <em>p</em> = 0.0005). No other strategy reached statistical significance. Patients ventilated with CCSV had a lower rate of admission with ROSC (24 %) and higher rates of admission under ongoing CPR (34 %). In the manual bag-valve ventilated group more patients died on scene (59 %).</div></div><div><h3>Conclusion</h3><div>Respirator controlled ventilation with IPPV modestly but significantly exceeded expected ROSC rates in patients with non-traumatic OHCA. CCSV, the mode designed specifically for ventilation during CPR, does not seem to be superior to manual bag-valve ventilation. Randomized controlled trials are needed to refine mechanical ventilation strategies in CPR.</div></div>","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":"215 ","pages":"Article 110764"},"PeriodicalIF":4.6,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144812267","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":"Intramuscular adrenaline to improve outcomes following cardiac arrest – An experimental porcine study","authors":"Lykke Kjærsgaard ,&nbsp;Casper Nørholt ,&nbsp;Katrine Fogh Møller ,&nbsp;Malthe Randel Nyengaard ,&nbsp;Margrete Hjuler Lund ,&nbsp;Signe Vilain ,&nbsp;Ditte Bonde Bojsen ,&nbsp;Lauge Vammen ,&nbsp;Lars W. Andersen ,&nbsp;Asger Granfeldt","doi":"10.1016/j.resuscitation.2025.110754","DOIUrl":"10.1016/j.resuscitation.2025.110754","url":null,"abstract":"<div><h3>Aim</h3><div>To investigate early intramuscular adrenaline as an add-on treatment for cardiac arrest in a clinically relevant porcine model. We hypothesized that intramuscular adrenaline would improve return of spontaneous circulation (ROSC) compared to placebo.</div></div><div><h3>Methods</h3><div>36 pigs (38–42 kg) were subjected to hypoxia induced cardiac arrest for 3.5 min. During resuscitation, the pigs were randomized to either 0.125 mg/kg (0.125 mL/kg) intramuscular adrenaline or placebo 0.125 mL/kg normal saline. Both groups underwent basic life support followed by advanced life support including intravenous adrenaline 5 min after intramuscular adrenaline. Pigs achieving ROSC underwent one hour of intensive care. The primary outcome was ROSC.</div></div><div><h3>Results</h3><div>The ROSC rate was 4/18 (22 %) in the placebo group and 4/18 (22 %) in the intervention group (OR = 1.00 95 %CI [0.15;6.55], <em>p</em> = 1.00). There was no difference in coronary perfusion pressure or cerebral oxygen tension (difference: 0.71 mmHg [95 %CI: −7.25; 8.67], <em>p</em> = 0.86 difference: 3.0 mmHg [95 %CI: −7.68; 13.69], <em>p</em> = 0.57). Adrenaline blood concentrations were significantly higher in the intervention group 30 min (difference: 9.44 nmol/L [95 %CI: 3.42; 15.5] <em>p</em> = 0.009) and 60 min after ROSC (difference: 15.9 nmol/L [95 %CI: 8.51; 23.4] <em>p</em> = 0.002). There was a significantly higher cardiac output in the intervention group 60 min after ROSC (difference: 2.58 L/min [95 %CI: 0.78; 4.37] <em>p</em> = 0.013).</div></div><div><h3>Conclusion</h3><div>Early intramuscular injection of adrenaline 5 min prior to intravenous adrenaline did not increase the ROSC rate but resulted in a prolonged absorption with higher adrenaline levels at 30 and 60 min after ROSC.</div></div>","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":"215 ","pages":"Article 110754"},"PeriodicalIF":4.6,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144812268","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 UEFA EURO 2024 Get Trained Save Lives campaign – Promoting public health during mega sport events","authors":"Lorenzo Gamberini ,&nbsp;Federico Semeraro ,&nbsp;Sander Van Goor ,&nbsp;Zoran Bahtijarevic ,&nbsp;Peter Klomp ,&nbsp;Evert Verhagen ,&nbsp;Robert Greif ,&nbsp;Jan Van Dooren ,&nbsp;Koenraad G. Monsieurs ,&nbsp;Carsten Lott","doi":"10.1016/j.resuscitation.2025.110759","DOIUrl":"10.1016/j.resuscitation.2025.110759","url":null,"abstract":"<div><h3>Aim</h3><div>This report describes the organisation, implementation, and outcomes of the ‘Get Trained Save Lives’ (GTSL) campaign, held from 15 May to 31 July 2024, with peak activity during Union of European Football Associations (UEFA) EURO 2024 (14 June–14 July). Jointly led by the European Resuscitation Council (ERC) and UEFA, the campaign aimed to raise awareness of sudden cardiac arrest (SCA) and promote cardiopulmonary resuscitation (CPR) skills among football fans during this Mega Sport Event (MSE).</div></div><div><h3>Methods</h3><div>The campaign was built on four key elements: (1) self-directed online training; (2) gamified 45-min CPR sessions for football professionals; (3) media campaigns featuring prominent footballers; and (4) live, gamified CPR training booths in Fan Zones across ten German host cities, offering hands-on practice with real-time feedback. Performance metrics were collected during these activities.</div></div><div><h3>Results</h3><div>By December 2024, GTSL had engaged 183,887 individuals: 77,387 completed the full online course; 9100 from elite football teams joined in-person training; over 40,000 engaged in Fan Zone CPR experiences; and 57,400 participated via brief interactions, satellite events, or social media. Online content reached 5 million users, with 4.7 million engagements. Gamified CPR sessions recorded a median performance score of 88/100, comparable to instructor-led outcomes.</div></div><div><h3>Conclusion</h3><div>GTSL effectively merged CPR training with edutainment and gamification, empowering football professionals and fans with lifesaving skills. Though confidence levels were not directly assessed, performance scores and participation levels showed learned CPR competences. Future MSEs can replicate this model to expand CPR awareness and improve bystander response.</div></div>","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":"215 ","pages":"Article 110759"},"PeriodicalIF":4.6,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144812270","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 the COVID-19 pandemic on favourable neurological outcome after EMS-witnessed out-of-hospital cardiac arrest: a prospective nationwide observational study","authors":"Takefumi Tsunemitsu ,&nbsp;Norihiro Nishioka ,&nbsp;Tomohiko Imamura ,&nbsp;Tomonari Shimamoto ,&nbsp;Tasuku Matsuyama ,&nbsp;Takeyuki Kiguchi ,&nbsp;Kosuke Kiyohara ,&nbsp;Chika Nishiyama ,&nbsp;Tetsuhisa Kitamura ,&nbsp;Yoshimitsu Takahashi ,&nbsp;Taku iwami","doi":"10.1016/j.resuscitation.2025.110758","DOIUrl":"10.1016/j.resuscitation.2025.110758","url":null,"abstract":"<div><h3>Aim</h3><div>To evaluate the impact of the COVID-19 pandemic on favourable neurological outcome after out-of-cardiac arrest (OHCA) witnessed by emergency medical services (EMS) personnels in Japan.</div></div><div><h3>Methods</h3><div>We conducted an interrupted time series analysis (ITSA) using a prospective, nationwide, population-based registry in Japan to assess 30-day favourable neurological outcome (Cerebral Performance Category 1 or 2), prehospital return of spontaneous circulation (ROSC), and 30-day survival among adult patients with EMS-witnessed OHCA during the pre-pandemic (January 2016–March 2020) and pandemic (April 2020–December 2021) periods. Subgroup analyses were performed by stratifying regions based on state of emergency declaration status. A controlled ITSA was conducted to compare outcome trends between areas with and without significant COVID-19 spread.</div></div><div><h3>Results</h3><div>In total, 58,315 adult patients with EMS-witnessed OHCA were identified. Favourable neurological outcome significantly declined during the pandemic (relative risk [RR], 0.80; 95 % CI, 0.71–0.91; <em>p</em> &lt; 0.001). Prehospital ROSC and 30-day survival also decreased significantly (<em>p</em> &lt; 0.05). In subgroup analyses, favourable neurological outcome declined in areas affected by COVID-19 spread (<em>p</em> &lt; 0.001), while no significant change was observed in unaffected areas (<em>p</em> = 0.243). The controlled ITSA revealed a significantly greater decline in favourable neurological outcome in areas with COVID-19 spread compared with unaffected areas (RR, 0.77; 95 % CI, 0.60–0.98; <em>p</em> = 0.035).</div></div><div><h3>Conclusion</h3><div>Favourable neurological outcomes among patients with EMS-witnessed OHCA in Japan were lower during the COVID-19 pandemic, particularly in regions affected by COVID-19 spread.</div></div>","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":"215 ","pages":"Article 110758"},"PeriodicalIF":4.6,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144812266","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":"Does the effectiveness of advanced airway management depend on initial cardiac arrest rhythm? A secondary analysis of the pragmatic airway resuscitation trial","authors":"Kianna Eurick-Bering ,&nbsp;David A. Berger ,&nbsp;Robert Swor ,&nbsp;Graham Nichol ,&nbsp;Ahamed Idris ,&nbsp;Mohamud R. Daya ,&nbsp;Jestin Carlson ,&nbsp;Henry E. Wang","doi":"10.1016/j.resuscitation.2025.110760","DOIUrl":"10.1016/j.resuscitation.2025.110760","url":null,"abstract":"<div><h3>Background</h3><div>Over 70% of patients with out-of-hospital cardiac arrest (OHCA) present with a non-shockable initial rhythm, asystole or pulseless electrical activity (PEA), which is associated with lower survival than a shockable initial rhythm. Advanced airway management and oxygen delivery are important OHCA interventions, but their impact based on different presenting rhythm groups are incompletely defined. Our objective was to determine if advanced airway strategy is associated with outcomes in shockable, PEA and asystolic OHCA.</div></div><div><h3>Methods</h3><div>We performed a secondary analysis of data collected from the Pragmatic Airway Resuscitation Trial (PART), which assigned adults with OHCA to a strategy of either endotracheal intubation (ETI) or laryngeal tube (LT) for initial advanced airway management. We stratified patients by initial cardiac rhythm: shockable (ventricular fibrillation/pulseless ventricular tachycardia (pVT), AED shock), PEA or asystole. We excluded AED non-shockable and unknown rhythms. The primary outcome was 72-h survival. Secondary outcomes included return of spontaneous circulation (ROSC) at emergency department arrival, survival to hospital discharge, and survival with good neurological function (modified Rankin score ≤3). We used general estimating equations to determine the associations between airway strategy initial arrest rhythm and outcomes, adjusted for age, sex, witnessed status, and bystander CPR.</div></div><div><h3>Results</h3><div>There were 3004 patients in the parent trial of which 2847 were included in this analysis. Of these 575 (20.2 %) were shockable, 671 (23.6 %) were PEA, and 1601 (56.2 %) were asystole. Compared with ETI, LT airway use was not associated with improved 72-h survival in shockable rhythms (adjusted [AOR] 1.30 (0.91, 1.67)), PEA (AOR 0.97 (0.65, 1.45)), or asystole (AOR 1.13 (0.79, 1.64)). Similarly, we noted no significant interaction between airway strategy and initial rhythm for the secondary outcomes of ROSC, survival to discharge, and survival to discharge with good neurological function.</div></div><div><h3>Conclusion</h3><div>Prehospital advanced airway management strategy (ETI vs. LT) was not significantly associated with outcomes regardless of initial cardiac rhythm.</div></div>","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":"215 ","pages":"Article 110760"},"PeriodicalIF":4.6,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144812265","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":"Real-time cerebral oximetry and outcomes during out-of-hospital resuscitation","authors":"Jenny Shin ,&nbsp;Julia King ,&nbsp;Robert Walker ,&nbsp;Dana Yost ,&nbsp;Jennifer Blackwood ,&nbsp;Jason Coult ,&nbsp;Fred Chapman ,&nbsp;Robert W. Neumar ,&nbsp;Peter Kudenchuk ,&nbsp;Thomas Rea","doi":"10.1016/j.resuscitation.2025.110761","DOIUrl":"10.1016/j.resuscitation.2025.110761","url":null,"abstract":"<div><h3>Background</h3><div>Anoxic brain injury is a common mode of death following out-of-hospital cardiac arrest (OHCA). We assessed the course of regional cerebral oxygen saturation (rSO₂) during resuscitation to understand its association with return of spontaneous circulation (ROSC) and functional survival.</div></div><div><h3>Methods</h3><div>We conducted a prospective observational investigation of OHCA patients treated by Emergency Medical Services (EMS) in a suburban community. Real-time rSO₂ was characterized overall and according to ROSC and favorable survival defined by Cerebral Performance Category (CPC) 1–2. We also calculated ΔrSO₂, defined as the change in rSO₂ from pre- to post-ROSC among those who achieved ROSC, and compared to a time-matched rSO₂ difference among those receiving CPR who did not achieve ROSC.</div></div><div><h3>Results</h3><div>Of 140 eligible cases, 93 were enrolled. Of these, 55 % (<em>n</em> = 51) achieved ROSC and 10 % (<em>n</em> = 9) survived with CPC 1–2. Upon cerebral oximeter application, the median rSO₂ was 33 % (interquartile range = 22.45 %). Initial rSO₂ did not predict subsequent ROSC (38 % ROSC vs 27 % no ROSC, AUC = 0.61, <em>p</em> = 0.13) or subsequent favorable survival (45 % CPC 1–2 vs 32 % no survival with CPC 1–2, AUC = 0.77, <em>p</em> = 0.17). However, real-time rSO₂ and ΔrSO₂ were greater upon ROSC versus time-matched ongoing pulselessness (rSO₂ = 60 % vs. 33 %, AUC = 0.84, <em>p</em> &lt; 0.001; ΔrSO₂ = 11 % vs. 1 %, AUC = 0.85, <em>p</em> &lt; 0.001). Among those who achieved ROSC, rSO₂ and ΔrSO₂ during the <em>peri</em>-ROSC period was greater among those with subsequent favorable survival (rSO₂ = 63 % vs. 46 %, AUC = 0.74, <em>p</em> = 0.06; ΔrSO₂ = 29 % vs. 10 %, AUC = 0.77, <em>p</em> = 0.04)</div></div><div><h3>Conclusion</h3><div>Greater values of rSO₂ and ΔrSO₂ identified instantaneous ROSC and predicted favorable neurological survival among those who achieved ROSC.</div></div>","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":"215 ","pages":"Article 110761"},"PeriodicalIF":4.6,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144812269","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}