Resuscitation最新文献

{"title":"A new Era in CPR: Are you … Ready For it?","authors":"Kara Hetherington , Eliza Cobb , Stephen J Nicholls , Hui-Chen Han","doi":"10.1016/j.resuscitation.2024.110442","DOIUrl":"10.1016/j.resuscitation.2024.110442","url":null,"abstract":"","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":"205 ","pages":"Article 110442"},"PeriodicalIF":6.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142710918","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":"Potassium disorders at intensive care unit admission and functional outcomes after cardiac arrest","authors":"Holm Aki ,&nbsp;Lascarrou Jean Baptiste ,&nbsp;Cariou Alain ,&nbsp;Reinikainen Matti ,&nbsp;Laitio Timo ,&nbsp;Kirkegaard Hans ,&nbsp;Søreide Eldar ,&nbsp;Taccone Fabio Silvio ,&nbsp;Lääperi Mitja ,&nbsp;B. Skrifvars Markus","doi":"10.1016/j.resuscitation.2024.110439","DOIUrl":"10.1016/j.resuscitation.2024.110439","url":null,"abstract":"<div><h3>Background</h3><div>Abnormal serum potassium levels are commonly found in the intensive care unit (ICU) population. We aimed to determine the prevalence of potassium disorders at ICU admission and its association with functional outcomes in comatose patients resuscitated from cardiac arrest.</div></div><div><h3>Methods</h3><div>We performed a post hoc analysis of pooled data from four randomised clinical trials involving comatose post-cardiac arrest patients admitted to ICU after return of spontaneous circulation (ROSC). Reference serum potassium levels were defined as between 3.0 and 4.9  mmol/L. An unfavourable functional outcome was defined as a cerebral performance category of 3 to 5 at 180 days. We compared potassium disturbances categorically in a mixed effects logistic regression model including initial rhythm, delay from collapse to return of spontaneous circulation, bystander cardiopulmonary resuscitation, lactate and urea at ICU admission, with normokalaemia set as the reference group.</div></div><div><h3>Results</h3><div>We included 1133 patients (557 from the HYPERION, 346 from the TTH48, 120 from the COMACARE, and 110 from the Xe-HYPOTHECA trials) with a median age of 64 years (interquartile range 55–72) and a predominance of males (72 %); a total of 712 (64 %) patients had unfavourable functional outcomes. On admission, 221 patients (19.5 %) experienced hyperkalaemia and 35 (3.1 %) patients experienced hypokalaemia. Fewer patients in the normokalaemia group (513/877, 58.5 %) had an unfavourable functional outcome compared to the hypokalaemia (24/35, 68.6 %) and hyperkalaemia groups (180/221, 81.4 %; p &lt; 0.001). Hyperkalaemia was associated with higher odds for an unfavourable functional outcome (adjusted odds ratio (OR) 1.85, 95 % confidence interval (CI) 1.10–3.12, p = 0.02), while hypokalaemia was not (OR 1.36 95 % CI 0.51–3.60, p = 0.53). The associations were not significant in a subgroup analysis adjusted for the modified cardiac arrest hospital prognosis score in 833 patients (OR 1.74, 95 % CI 0.91–3.34, p = 0.10 for hyperkalaemia and OR 1.48, 95 % CI 0.40–5.44, p = 0.55 for hypokalaemia).</div></div><div><h3>Conclusions</h3><div>Of the comatose patients admitted to ICU after cardiac arrest, one in five experienced a potassium disorder on ICU admission. Hyperkalaemia was associated with unfavourable functional outcomes at 180 days, while hypokalaemia was not.</div></div>","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":"205 ","pages":"Article 110439"},"PeriodicalIF":6.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142692951","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":"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,&nbsp;Carolina Sanchez Martinez,&nbsp;John Adel,&nbsp;Tobias J. Pfeffer,&nbsp;Muharrem Akin,&nbsp;Johann Bauersachs,&nbsp;Andreas Schäfer","doi":"10.1016/j.resuscitation.2024.110416","DOIUrl":"10.1016/j.resuscitation.2024.110416","url":null,"abstract":"<div><h3>Background</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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&amp;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 &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>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.</div></div>","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":"205 ","pages":"Article 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":"OA","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 ,&nbsp;Mehmet Semih Demirtaş ,&nbsp;Ekrem T. Sert ,&nbsp;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":"205 ","pages":"Article 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 ,&nbsp;Emily Nehme ,&nbsp;David Anderson ,&nbsp;Ashanti Dantanarayana ,&nbsp;Belinda Delardes ,&nbsp;Ziad Nehme","doi":"10.1016/j.resuscitation.2024.110419","DOIUrl":"10.1016/j.resuscitation.2024.110419","url":null,"abstract":"<div><h3>Aim</h3><div>The impact of personal protective equipment (PPE) on resuscitation quality is largely unknown<strong>.</strong> We sought to examine the effect of PPE requirements on CPR quality and resuscitation interventions during the COVID-19 pandemic in Victoria, Australia.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusion</h3><div>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.</div></div>","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":"205 ","pages":"Article 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,&nbsp;Ken Inoue,&nbsp;Taichi Kato,&nbsp;Kazuhiro Sugiyama","doi":"10.1016/j.resuscitation.2024.110448","DOIUrl":"10.1016/j.resuscitation.2024.110448","url":null,"abstract":"<div><h3>Aim</h3><div>To investigate the characteristics, outcomes, and prognostic factors of patients with hanging-induced out-of-hospital cardiac arrest (OHCA).</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusions</h3><div>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.</div></div>","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":"205 ","pages":"Article 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,&nbsp;Giuseppe Ristagno,&nbsp;Federico Semeraro,&nbsp;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":"205 ","pages":"Article 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 EIT Chair,&nbsp;Janet E. Bray BLS Chair,&nbsp;Therese Djärv FA Chair,&nbsp;Ian R. Drennan ALS Chair,&nbsp;Helen G. Liley NLS Chair,&nbsp;Kee-Chong Ng PLS Chair,&nbsp;Adam Cheng EIT Vice Chair,&nbsp;Matthew J. Douma FA Vice Chair,&nbsp;Barnaby R. Scholefield PLS Vice Chair,&nbsp;Michael Smyth BLS Vice Chair,&nbsp;Gary Weiner NLS Vice Chair,&nbsp;Cristian Abelairas-Gómez,&nbsp;Jason Acworth,&nbsp;Natalie Anderson,&nbsp;Dianne L. Atkins,&nbsp;David C. Berry,&nbsp;Farhan Bhanji,&nbsp;Bernd W. Böttiger,&nbsp;Richard N. Bradley,&nbsp;Jan Breckwoldt,&nbsp;Katherine M. Berg Sr Editor","doi":"10.1016/j.resuscitation.2024.110414","DOIUrl":"10.1016/j.resuscitation.2024.110414","url":null,"abstract":"<div><div>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.</div></div>","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":"205 ","pages":"Article 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":"Shaping the future of simulator interactions: The role of ChatGPT’s Advanced Voice Mode","authors":"Federico Lorenzo Barra ,&nbsp;Alessandro Costa ,&nbsp;Giovanna Rodella ,&nbsp;Federico Semeraro ,&nbsp;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":"205 ","pages":"Article 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":"Enhancing cardiac arrest response: Evaluating GPT-4o’s advanced voice interaction system","authors":"Federico Semeraro ,&nbsp;Elena Giovanna Bignami ,&nbsp;Jonathan Montomoli ,&nbsp;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":"205 ","pages":"Article 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}