Resuscitation最新文献

{"title":"Impact of smartphone activated first responders on provision of bystander CPR, bystander AED and outcomes for out-of-hospital cardiac arrest (OHCA)","authors":"Haruka Takahashi ,&nbsp;Nurul Ain ,&nbsp;Stephanie Fook-Chong ,&nbsp;Fan Qiao ,&nbsp;Nur Shahidah ,&nbsp;Yohei Okada ,&nbsp;Yih Yng Ng ,&nbsp;Dehan Hong ,&nbsp;Benjamin SH Leong ,&nbsp;Michael YC Chia ,&nbsp;Desmond R Mao ,&nbsp;Ling Tiah ,&nbsp;Wei Ming Mg ,&nbsp;Nausheen E Doctor ,&nbsp;Scott Compton ,&nbsp;Marcus EH Ong ,&nbsp;Singapore PAROS Investigators","doi":"10.1016/j.resuscitation.2025.110645","DOIUrl":"10.1016/j.resuscitation.2025.110645","url":null,"abstract":"<div><h3>Background</h3><div>The smartphone application to activate a community first responder (myResponder) was launched in 2015 to activate volunteer first responders for Out-of-Hospital Cardiac Arrest (OHCA) patients in Singapore. This study aimed to investigate the impact of myResponder on provision of bystander CPR, bystander AED, and patient survival outcomes.</div></div><div><h3>Methods</h3><div>This was a retrospective analysis using the Singapore Pan-Asian Resuscitation Outcomes Study between 2016 and 2019 that included adult non-traumatic OHCA patients. Patients were categorized into myResponder activated and non-activated groups. The primary outcomes were bystander CPR and bystander AED. The secondary outcome was survival at 30-days with favourable neurological outcomes (cerebral performance category 1–2). A multivariable logistic regression analysis was performed and we reported adjusted odds ratio [aOR] and 95% confidence interval for the effect of activation.</div></div><div><h3>Results</h3><div>9,167 patients were included in this analysis. The median (Interquartile range, IQR) age was 71 (59–82) years. The activated group comprised 5,499 (60%) of cases. The activated group was associated with higher bystander CPR (aOR [95%CI]: 5.69 [4.89–6.62]) and bystander AED (aOR [95% CI]: 2.23 [1.82–2.74]) compared to non-activated group. The activated group was associated with better survival at 30 days with favourable neurological outcomes (aOR [95% CI]: 1.54 [1.11–2.15]).</div></div><div><h3>Conclusion</h3><div>We found that the implementation of technology-activated first responders was associated with an improvement in the performance of bystander CPR, bystander AED application, and OHCA outcomes in an urban area. Further efforts should be made to promote the use of activated first responders in EMS systems.</div></div>","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":"212 ","pages":"Article 110645"},"PeriodicalIF":6.5,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144094743","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 significance of possible non-occlusive mesenteric ischemia in relation to neurological outcomes in patients with refractory cardiac arrest – Secondary analysis of the Prague OHCA study","authors":"Jana Smalcova ,&nbsp;Jacky Suen ,&nbsp;Michal Huptych ,&nbsp;Ondrej Franek ,&nbsp;Petra Kavalkova ,&nbsp;Helena Lahoda Brodska ,&nbsp;Martin Balik ,&nbsp;Jan Malik ,&nbsp;Jan Pudil ,&nbsp;Ondrej Smid ,&nbsp;Martin Fajkus ,&nbsp;Molly-rose McInerney ,&nbsp;Jan Belohlavek","doi":"10.1016/j.resuscitation.2025.110642","DOIUrl":"10.1016/j.resuscitation.2025.110642","url":null,"abstract":"<div><h3>Background</h3><div>Intestinal injury as a consequence of ischemia–reperfusion injury after refractory cardiac arrest is not fully understood. This study evaluates the occurrence of clinical signs reflecting possible non-occlusive mesenteric ischemia (NOMI) to outcomes in patients with refractory cardiac arrest.</div></div><div><h3>Methods</h3><div>In a post-hoc analysis of a randomized, prospective Prague OHCA study comparing ECPR vs. CPR approaches in refractory out-of-hospital CA, all patients who survived longer than one hour after hospital admission were analyzed. We assessed possible NOMI based on clinical signs (mainly profuse diarrhea and abdominal distension) and their onset within 12 h of admission. Its occurrence was correlated with neurologically unfavorable outcome (Cerebral Performance Category (CPC) Scale 3–5) at 180 days. Cox regression was used to evaluate the relationship of particular variables to adverse neurological outcomes.</div></div><div><h3>Results</h3><div>Of the 256 study participants, 61 developed possible NOMI: 46 (51.7%) in the ECPR group and 15 (16.5%) in the CPR group. Adverse neurological outcomes occurred in 41 (89%) and nine (60%) patients, respectively. The number of patients developing possible NOMI was higher in those treated with ECPR (<em>p</em> &gt; 0.01). Its occurrence correlated with cardiac arrest length, elevated levels of neuron-specific enolase and procalcitonin at 48 and 72 h. It was independently associated with adverse outcomes. In Cox regression, possible NOMI was associated with poor neurological outcomes in ECPR patients.</div></div><div><h3>Conclusion</h3><div>The development of profuse diarrhea, abdominal distension and other signs suggesting non-occlusive mesenteric ischemia in patients with refractory out-of-hospital cardiac arrest are observed more frequently in patients with poor neurological outcome at day 180, especially in patients treated with ECPR.</div><div><strong>Trial registration:</strong> <span><span>ClinicalTrials.gov</span><svg><path></path></svg></span>: NCT01511666.</div></div>","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":"214 ","pages":"Article 110642"},"PeriodicalIF":6.5,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144094753","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":"A novel TEE-guided algorithm for identifying pump mechanisms in cardiopulmonary resuscitation via cardiac morphology changes","authors":"Chih-Jung Chang,&nbsp;Sheng-En Chu,&nbsp;Matthew Huei‐Ming Ma,&nbsp;Wen‐Chu Chiang,&nbsp;Jen-Tang Sun","doi":"10.1016/j.resuscitation.2025.110640","DOIUrl":"10.1016/j.resuscitation.2025.110640","url":null,"abstract":"","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":"212 ","pages":"Article 110640"},"PeriodicalIF":6.5,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144086108","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":"Pre-hospital ECPR for refractory cardiac arrest – The PRECARE pilot feasibility study","authors":"Natalie Kruit ,&nbsp;Brian Burns ,&nbsp;Nicolas Shearer ,&nbsp;Jason Hui ,&nbsp;Andrew Coggins ,&nbsp;Hergen Buscher ,&nbsp;Emily Granger ,&nbsp;Kevin Ostrowski ,&nbsp;Brian Plunkett ,&nbsp;Timothy J. Southwood ,&nbsp;Paul Forrest ,&nbsp;Hannah Braithwaite ,&nbsp;Jan Dieleman ,&nbsp;Aidan Burrell ,&nbsp;Anthony Keech ,&nbsp;Mark Dennis","doi":"10.1016/j.resuscitation.2025.110631","DOIUrl":"10.1016/j.resuscitation.2025.110631","url":null,"abstract":"<div><h3>Background</h3><div>Survival from refractory out of hospital cardiac arrest (OHCA) treated with conventional cardiopulmonary resuscitation (CCPR) remains low. Extracorporeal cardiac resuscitation (ECPR) is increasingly be utilised in refractory OHCA, with outcomes influenced by the duration of cardiac arrest prior establishing ECMO flow (low flow time). Pre-hospital ECPR aims to reduce the low flow time. Pre-hospital physicians may represent a workforce who could deliver ECPR, increasing access and sustainability.</div></div><div><h3>Methods</h3><div>A single-arm open-label feasibility trial of pre-hospital ECPR delivered by pre-hospital physicians. Patients under the age of 70 years with a witnessed collapse, an initial shockable rhythm and within a 45-minute radius of the mobile team were eligible for pre-hospital ECPR. Once extracorporeal support flow was established, patients were transported to one of three ECMO capable centers. The primary aim was to assess the feasibility of pre-hospital ECPR in this setting.</div></div><div><h3>Results</h3><div>From August 2023 to June 2024, over 103 recruitment days, the pre-hospital ECPR team attended 123 confirmed cardiac arrests, 12 (10%) patients received pre-hospital ECPR equating to one case per 8 shifts. All patients were successfully cannulated on scene while the patient was in cardiac arrest. The mean time from dispatch to team arrival was 18.5 min (range 9–29); mean time from decision to ECMO flow was 17 min (range 10–34) and the mean total low flow time (arrest to ECMO flow) was 39 min (range 24–56). Four (33%) patients were successfully liberated from VA ECMO support, 3 (25%) patients survived to hospital discharge neurologically intact (CPC 1–2).</div></div><div><h3>Conclusions</h3><div>Pre-hospital ECPR delivery by trained pre-hospital medical teams is possible and reduces OHCA low flow times. Larger studies are required to assess efficacy and cost effectiveness.</div></div>","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":"212 ","pages":"Article 110631"},"PeriodicalIF":6.5,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144079790","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":"Dispatch-assisted cardiopulmonary resuscitation and prior bystander training influence neurological outcomes after out-of-hospital cardiac arrest","authors":"Guillaume Debaty,&nbsp;Nicolas Segond","doi":"10.1016/j.resuscitation.2025.110637","DOIUrl":"10.1016/j.resuscitation.2025.110637","url":null,"abstract":"","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":"212 ","pages":"Article 110637"},"PeriodicalIF":6.5,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144054376","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 hemodynamic response to epinephrine during CPR: a renewed call for precision resuscitation","authors":"Ryan W. Morgan ,&nbsp;Robert A. Berg","doi":"10.1016/j.resuscitation.2025.110635","DOIUrl":"10.1016/j.resuscitation.2025.110635","url":null,"abstract":"","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":"212 ","pages":"Article 110635"},"PeriodicalIF":6.5,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144036595","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 Gordian challenge of selective vulnerability in post-cardiac arrest brain injury: the problem or the solution?","authors":"Anthony Bishara,&nbsp;Annie Kathuria,&nbsp;Romergryko G. Geocadin","doi":"10.1016/j.resuscitation.2025.110636","DOIUrl":"10.1016/j.resuscitation.2025.110636","url":null,"abstract":"","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":"212 ","pages":"Article 110636"},"PeriodicalIF":6.5,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144042350","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":"Intraosseous vs. intravenous access during out-of-hospital cardiac arrest: a Bayesian secondary analysis of a randomised clinical trial","authors":"Mikael Fink Vallentin ,&nbsp;Mathias J. Holmberg ,&nbsp;Asger Granfeldt ,&nbsp;Thomas Lass Klitgaard ,&nbsp;Søren Mikkelsen ,&nbsp;Fredrik Folke ,&nbsp;Helle Collatz Christensen ,&nbsp;Amalie Ling Povlsen ,&nbsp;Alberthe Hjort Petersen ,&nbsp;Sofie Winther ,&nbsp;Lea Wildt Frilund ,&nbsp;Carsten Meilandt ,&nbsp;Kristian Blumensaadt Winther ,&nbsp;Allan Bach ,&nbsp;Thomas H. Dissing ,&nbsp;Christian Juhl Terkelsen ,&nbsp;Steffen Christensen ,&nbsp;Line Kirkegaard Rasmussen ,&nbsp;Lone Riis Mortensen ,&nbsp;Mads Ladefoged Loldrup ,&nbsp;Lars W. Andersen","doi":"10.1016/j.resuscitation.2025.110634","DOIUrl":"10.1016/j.resuscitation.2025.110634","url":null,"abstract":"<div><h3>Aim of the study</h3><div>This study aimed to apply a Bayesian probabilistic framework to the Intravenous vs. Intraosseous Vascular Access for Out-of-Hospital Cardiac Arrest (IVIO) trial data to evaluate the likelihood of benefit for each vascular access method while incorporating various prior beliefs.</div></div><div><h3>Methods</h3><div>The IVIO trial was a randomised trial comparing intraosseous to intravenous access in 1,479 adults with non-traumatic out-of-hospital cardiac arrest. Bayesian analyses were pre-planned in the protocol and conducted using both non-informative and informative priors to calculate posterior probabilities for sustained return of spontaneous circulation, 30-day survival, and 30-day survival with a favourable neurologic outcome.</div></div><div><h3>Results</h3><div>Using non-informative priors for return of spontaneous circulation, the posterior probabilities that the effect of either vascular access exceeds the hypothesised difference were 1.2% (risk ratio &gt; 1.27, favouring intraosseous access) and &lt; 0.1% (risk ratio &lt; 0.79 [1/1.27], favouring intravenous access). For 30-day survival and survival with a favourable neurologic outcome, the posterior probability that the risk ratio for intraosseous compared to intravenous access is between 0.83 (1/1.2) and 1.2 was 58% and 55%, respectively. For all analyses with informative priors, the results did not provide probabilities strongly favouring either intraosseous or intravenous access.</div></div><div><h3>Conclusions</h3><div>The probability of a clinically meaningful difference in return of spontaneous circulation between intraosseous and intravenous access for out-of-hospital cardiac arrest was very low, while results for 30-day outcomes were uncertain, with no strong evidence favouring either method.</div></div><div><h3>Trial registration</h3><div>EU Clinical Trials number: 2022-500744-38-00.</div><div><span><span>ClinicalTrials.gov</span><svg><path></path></svg></span> number: NCT05205031.</div></div>","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":"212 ","pages":"Article 110634"},"PeriodicalIF":6.5,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144054378","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 between postresuscitation 12-lead ECG features and long-term neurological outcome after out-of-hospital cardiac arrest: a post-hoc subanalysis of the PEACE study","authors":"Sebastian Schnaubelt ,&nbsp;Andrea Kornfehl ,&nbsp;Enrico Baldi ,&nbsp;Benedikt Schnaubelt ,&nbsp;Johannes Vilsmeier ,&nbsp;Bianca Citterio ,&nbsp;Roberto Primi ,&nbsp;Sara Bendotti ,&nbsp;Alessia Currao ,&nbsp;Maria Luce Caputo ,&nbsp;Christoph Schriefl ,&nbsp;Mario Krammel ,&nbsp;Patrick Sulzgruber ,&nbsp;Hans Domanovits ,&nbsp;Simone Savastano ,&nbsp;Michael Holzer","doi":"10.1016/j.resuscitation.2025.110630","DOIUrl":"10.1016/j.resuscitation.2025.110630","url":null,"abstract":"<div><h3>Background</h3><div>Out-of-hospital cardiac arrest (OHCA) has low survival rates worldwide. For the diagnosis of acute coronary syndrome causing OHCA and the identification of patients eligible for immediate coronary angiography, the post-return of spontaneous circulation electrocardiogram (post-ROSC ECG) is crucial. However, it is still unclear whether post-ROSC ECG features also pose a sensible feature for outcome prediction.</div></div><div><h3>Methods</h3><div>This retrospective study analysed adult non-traumatic OHCA cases with post-ROSC ECGs admitted to one of the three participating centers in Vienna (Austria), Pavia (Italy) and Lugano (Switzerland) between 01/2015 and 12/2018, and reports ECG features, survival and neurological outcome (at hospital discharge and after one year). Univariable and multivariable logistic regression assessed associations between ECG features and neurological outcome.</div></div><div><h3>Results</h3><div>STEMI was diagnosed in 53.5% of post-ROSC ECGs. 68.1% of patients were discharged, with 59.5% having a favorable neurological outcome. One year later, 61.6% of non-STEMI patients had a favorable outcome compared to 54% of STEMI patients. Univariable analysis indicated that ST-elevations in II, III, and aVF, as well as a broader QRS complex significantly influenced neurological outcomes at one year.</div></div><div><h3>Conclusions</h3><div>ECG after ROSC can identify patients at high risk of death after OHCA earlier than other prognostic methods, not only in terms of short-term mortality, but also in terms of neurological outcome one year after OHCA. Wider QRS complex and ST-elevations in II, III, or aVF were identified as specific prognosticators.</div></div>","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":"212 ","pages":"Article 110630"},"PeriodicalIF":6.5,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143936904","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":"Inclusive intent, unequal output: GPT-4o image generation is not yet the answer to the visual resource gap in resuscitation education","authors":"David Purkarthofer,&nbsp;Valentina Bachner","doi":"10.1016/j.resuscitation.2025.110632","DOIUrl":"10.1016/j.resuscitation.2025.110632","url":null,"abstract":"","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":"212 ","pages":"Article 110632"},"PeriodicalIF":6.5,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144009713","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}