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Cerebral oxygen saturation in relation to end-tidal CO2 in cardiopulmonary resuscitation – Separate views of brain and body? 心肺复苏中脑氧饱和度与尾潮CO2的关系——脑和身体的分离观点?
IF 2.4
Resuscitation plus Pub Date : 2025-07-25 DOI: 10.1016/j.resplu.2025.101044
Andrea Kornfehl , Roman Brock , Christoph Veigl , Veronique Firich , Mathias Gatterbauer , Michael Girsa , Daniel Grassmann , Andreas Zajicek , Alexander Spiel , Christoph Testori , Michael Holzer , Mario Krammel , Thomas Uray , Sebastian Schnaubelt
{"title":"Cerebral oxygen saturation in relation to end-tidal CO2 in cardiopulmonary resuscitation – Separate views of brain and body?","authors":"Andrea Kornfehl ,&nbsp;Roman Brock ,&nbsp;Christoph Veigl ,&nbsp;Veronique Firich ,&nbsp;Mathias Gatterbauer ,&nbsp;Michael Girsa ,&nbsp;Daniel Grassmann ,&nbsp;Andreas Zajicek ,&nbsp;Alexander Spiel ,&nbsp;Christoph Testori ,&nbsp;Michael Holzer ,&nbsp;Mario Krammel ,&nbsp;Thomas Uray ,&nbsp;Sebastian Schnaubelt","doi":"10.1016/j.resplu.2025.101044","DOIUrl":"10.1016/j.resplu.2025.101044","url":null,"abstract":"<div><h3>Background</h3><div>An increase in both regional cerebral oxygen saturation (rSO<sub>2</sub>) measured by near-infrared spectroscopy (NIRS) and end-tidal carbon dioxide (etCO<sub>2</sub>) during advanced life support for out-of-hospital cardiac arrest (OHCA) is associated with a higher likelihood of return of spontaneous circulation (ROSC) and may predict neurological outcome. However, it remains unclear which marker is more predictive for which outcome parameter.</div></div><div><h3>Methods</h3><div>In this prospective observational study, we assessed rSO<sub>2</sub> and etCO<sub>2</sub> in patients treated for OHCA in the metropolitan area of Vienna between 05/2017 and 02/2022. Follow-up was performed for survival and neurological performance at hospital discharge and at six and 12 months after OHCA. rSO<sub>2</sub> and etCO<sub>2</sub> were compared between individuals with favourable and unfavourable outcomes, and cut-off values using ROC analyses were identified.</div></div><div><h3>Results</h3><div>Median rSO<sub>2</sub> and etCO<sub>2</sub> values of the included 176 patients during CPR were higher in those achieving sustained ROSC (rSO<sub>2</sub>: 59 % (IQR 16.1) vs 46 % (IQR 14.3), p &lt; 0.001; etCO<sub>2</sub>: 40 (IQR 18.7) vs. 25 (IQR 20.9) mmHg, p &lt; 0.001) and in patients with cerebral performance category (CPC) 1 or 2 (rSO<sub>2</sub>: 66 % (IQR 15.5) vs 48 % (IQR 14.8), p &lt; 0.001; etCO<sub>2</sub>: 50 (IQR 16.1) vs. 28 mmHg, p = 0.013). ROC analysis for median rSO<sub>2</sub> values yielded an optimal cutoff of 60 % (sensitivity 86 %, specificity 87 %) for CPC 1/2, and for median etCO<sub>2</sub> values 49 mmHg (sensitivity 67 %, specificity 94 %) for CPC 1/2. In ROC analyses, etCO<sub>2</sub> trends achieved better results for sustained ROSC prediction than rSO<sub>2</sub>. In contrast, rSO<sub>2</sub> outperformed etCO<sub>2</sub> for the prediction of neurological outcome.</div></div><div><h3>Conclusion</h3><div>Measuring RSO<sub>2</sub> and etCO<sub>2</sub> during advanced life support is associated with critical clinical outcomes. Our findings suggest that these two parameters reflect different physiological aspects of resuscitation and may provide complementary information. Further research should examine the potential of using rSO<sub>2</sub> alongside etCO<sub>2</sub> in CPR algorithms.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"25 ","pages":"Article 101044"},"PeriodicalIF":2.4,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144757041","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Temporal trends and hospital variation in post-resuscitation fever for in-hospital cardiac arrest 院内心脏骤停复苏后发热的时间趋势和医院差异
IF 2.4
Resuscitation plus Pub Date : 2025-07-25 DOI: 10.1016/j.resplu.2025.101042
Mohammad Abdel Jawad , John A. Spertus , Kensey L. Gosch , Evan O’Keefe , Nobuhiro Ikemura , Paul S. Chan
{"title":"Temporal trends and hospital variation in post-resuscitation fever for in-hospital cardiac arrest","authors":"Mohammad Abdel Jawad ,&nbsp;John A. Spertus ,&nbsp;Kensey L. Gosch ,&nbsp;Evan O’Keefe ,&nbsp;Nobuhiro Ikemura ,&nbsp;Paul S. Chan","doi":"10.1016/j.resplu.2025.101042","DOIUrl":"10.1016/j.resplu.2025.101042","url":null,"abstract":"<div><h3>Background</h3><div>A goal of post-resuscitation care among patients successfully resuscitated from in-hospital cardiac arrest (IHCA) is fever avoidance. However, the incidence of post-resuscitation fever after the initial therapeutic hypothermia trials in 2002 and after the Targeted Temperature Management (TTM) trial in 2013 is unknown.</div></div><div><h3>Methods</h3><div>Within the U.S. Get With The Guidelines-Resuscitation registry for IHCA, we identified adults with return of spontaneous circulation (ROSC). Patients with sepsis or COVID-19 were excluded. Temporal trends in post-resuscitation fever (≥100 °F) within 24 h of ROSC following the initial hypothermia trials (2005–2013) and after the TTM trial (2014–2022) were described. Hospital-level variation in post-resuscitation fever rates was assessed for the latter period.</div></div><div><h3>Results</h3><div>Among 41,155 patients, mean age was 64.8 ± 15.0 years, 40.0 % were women, and 68.6 % were White. Overall, 11,745 (28.5 %) had post-resuscitation fever. Annual rates of post-resuscitation fever decreased from 39.1 % in 2005 to 29.0 % in 2013 (<em>P for trend</em> &lt;0.001), and modestly from as high as 29.0 % in 2015 to 26.0 % in 2022 (<em>P for trend</em> of 0.003). Among 127 hospitals since the publication of the TTM trial, the rate of post-resuscitation fever varied widely from 3.4 % to 46.0 %, with a median OR of 1.81 (95 % CI: 1.72–1.91), indicating that, on average, the odds of post-resuscitation fever for patients with identical characteristics from two randomly selected hospitals varied by 81 %.</div></div><div><h3>Conclusions</h3><div>Post-resuscitation fever rates have decreased among patients with IHCA after the initial therapeutic hypothermia trials, but substantial hospital-level variation remains. Our findings highlight potential opportunities for improvement in post-resuscitation care.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"25 ","pages":"Article 101042"},"PeriodicalIF":2.4,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144757043","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The impact of additional special emergency medical service units on non-traumatic adult out-of-hospital cardiac arrest outcomes in a high-resource metropolitan area 在资源丰富的大都市地区,增加特殊紧急医疗服务单位对非创伤性成人院外心脏骤停结果的影响
IF 2.4
Resuscitation plus Pub Date : 2025-07-25 DOI: 10.1016/j.resplu.2025.101046
Andrea Kornfehl , Mario Krammel , Daniel Grassmann , Maximilian de Zordo , Roman Brock , Christoph Veigl , Rene Adler , Sabine Dunkl , Mathias Gatterbauer , Philipp Gonzo , Bertram Schadler , Patrick Aigner , Michael Girsa , Patrick Glaninger , Andreas Zajicek , Patrick Sulzgruber , Thomas Uray , Sebastian Schnaubelt
{"title":"The impact of additional special emergency medical service units on non-traumatic adult out-of-hospital cardiac arrest outcomes in a high-resource metropolitan area","authors":"Andrea Kornfehl ,&nbsp;Mario Krammel ,&nbsp;Daniel Grassmann ,&nbsp;Maximilian de Zordo ,&nbsp;Roman Brock ,&nbsp;Christoph Veigl ,&nbsp;Rene Adler ,&nbsp;Sabine Dunkl ,&nbsp;Mathias Gatterbauer ,&nbsp;Philipp Gonzo ,&nbsp;Bertram Schadler ,&nbsp;Patrick Aigner ,&nbsp;Michael Girsa ,&nbsp;Patrick Glaninger ,&nbsp;Andreas Zajicek ,&nbsp;Patrick Sulzgruber ,&nbsp;Thomas Uray ,&nbsp;Sebastian Schnaubelt","doi":"10.1016/j.resplu.2025.101046","DOIUrl":"10.1016/j.resplu.2025.101046","url":null,"abstract":"<div><h3>Background</h3><div>Out-of-hospital cardiac arrest (OHCA) requires an effective cardiopulmonary resuscitation (CPR) and emergency medical service (EMS) response, yet survival rates remain low at 8.0–11.3 %. Factors such as team size, training and leadership influence outcomes, but optimal strategies are debated. The Vienna EMS routinely deploys field supervisors (FISU) to improve the quality of care. The aim of this study was to assess their impact on OHCA outcomes.</div></div><div><h3>Methods</h3><div>This retrospective observational study analyzed all consecutive adult non-traumatic OHCA cases in Vienna between 01/2019 and 12/2023, focusing on the impact of additional specialised units (FISU or supervising senior emergency physician) on cardiac arrest outcomes (ROSC rates, survival to hospital discharge, neurological performance). Statistical analysis used descriptive statistics, group tests, and logistic regression.</div></div><div><h3>Results</h3><div>A FISU was present in 45.7 % of cases, and its presence improved outcomes significantly including any ROSC (40.6 % vs 26.3 %; OR 1.963, CI 1.773–2.172, p &lt; 0.001), survived event (sustained ROSC) (30.6 % vs 20.6 %; OR 1.720, CI 1.542–1.918, p &lt; 0.001), survival to discharge (10.6 % vs 8.3 %; OR 1.263, 1.072–1.487, p = 0.005) and CPC 1/2 (7 % vs 6.4 %; OR 1.034, CI 1.152–1.253, p = 0.037). Multivariate analysis confirmed that the presence of FISU had an independently positive effect (any ROSC: OR 1.616, CI 1.440–1.813, p &lt; 0.001; survived event: OR 1.335, CI 1.180–1.510, p &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>The presence of additional EMS special units like field supervisors can improve outcomes of non-traumatic out-of-hospital cardiac arrest in a high-resource metropolitan area.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"25 ","pages":"Article 101046"},"PeriodicalIF":2.4,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144757042","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Artificial intelligence as a virtual dispatcher: Decision support for lay responders in simulated cardiac arrest scenarios 作为虚拟调度员的人工智能:在模拟心脏骤停场景中为非专业响应者提供决策支持
IF 2.4
Resuscitation plus Pub Date : 2025-07-25 DOI: 10.1016/j.resplu.2025.101043
Bálint Bánfai, József Betlehem, Henrietta Bánfai-Csonka
{"title":"Artificial intelligence as a virtual dispatcher: Decision support for lay responders in simulated cardiac arrest scenarios","authors":"Bálint Bánfai,&nbsp;József Betlehem,&nbsp;Henrietta Bánfai-Csonka","doi":"10.1016/j.resplu.2025.101043","DOIUrl":"10.1016/j.resplu.2025.101043","url":null,"abstract":"","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"25 ","pages":"Article 101043"},"PeriodicalIF":2.4,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144738301","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Cardiac arrest in the pregnant patient – Using simulation to improve internal medicine resident competency 妊娠病人心脏骤停——用模拟提高内科住院医师的能力
IF 2.4
Resuscitation plus Pub Date : 2025-07-22 DOI: 10.1016/j.resplu.2025.101038
Carleen R. Spitzer , Philip P. Huang , Philip Y. Chang , Allison Rossetti , Jeff Barbee
{"title":"Cardiac arrest in the pregnant patient – Using simulation to improve internal medicine resident competency","authors":"Carleen R. Spitzer ,&nbsp;Philip P. Huang ,&nbsp;Philip Y. Chang ,&nbsp;Allison Rossetti ,&nbsp;Jeff Barbee","doi":"10.1016/j.resplu.2025.101038","DOIUrl":"10.1016/j.resplu.2025.101038","url":null,"abstract":"<div><h3>Background</h3><div>While cardiac arrest during pregnancy is uncommon, its consequences can be severe and life-threatening. Existing literature suggests that providers have knowledge gaps regarding resuscitation in peripartum patients. Simulation has been used to train obstetrics nurses and other trainees in Advanced Cardiac Life Support (ACLS). However, training curricula designed for providers with little formal obstetric resuscitation experience is lacking.</div></div><div><h3>Aims</h3><div>To improve internal medicine residents’ knowledge and confidence related to the resuscitation of pregnant patients.</div></div><div><h3>Methods</h3><div>This was a one-group pre-test, immediate post-test, delayed post-test observational study. Prior to the simulation, residents completed a survey assessing their confidence managing pregnant patients as well as knowledge related to ACLS in pregnancy. Each team then participated in a 30-min simulation, received immediate feedback on their performance, and completed an immediate post-simulation knowledge assessment measure. Residents who agreed to participate in the study then completed a delayed post-simulation knowledge and confidence assessment survey three months following the training session.</div></div><div><h3>Results</h3><div>Eighty-six residents participated in the research study. Immediately after completing the simulation, participants exhibited significant improvements in knowledge related to uterine positioning (+34%), epinephrine dosing (+11%), and timing of perimortem delivery (+22%). Participants also reported increased confidence with managing cardiac arrest in pregnant patients and satisfaction with the simulation. Knowledge and confidence improvements were sustained at the three-month follow-up.</div></div><div><h3>Conclusion</h3><div>High fidelity simulation can be used to train internal medicine residents to manage cardiac arrest in pregnancy. Simulation training is associated with sustained improvements in medical knowledge and confidence related to peripartum resuscitation.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"25 ","pages":"Article 101038"},"PeriodicalIF":2.4,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144757363","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Manikin vs. mannequin: terminological consistency in simulation-based resuscitation research 人体模型与人体模型:基于模拟的复苏研究中的术语一致性
IF 2.4
Resuscitation plus Pub Date : 2025-07-22 DOI: 10.1016/j.resplu.2025.101041
Špela Metličar, Nino Fijačko
{"title":"Manikin vs. mannequin: terminological consistency in simulation-based resuscitation research","authors":"Špela Metličar,&nbsp;Nino Fijačko","doi":"10.1016/j.resplu.2025.101041","DOIUrl":"10.1016/j.resplu.2025.101041","url":null,"abstract":"","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"25 ","pages":"Article 101041"},"PeriodicalIF":2.4,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144724527","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Association of human immunodeficiency virus with acute myocardial infarction and presumed sudden cardiac death 人类免疫缺陷病毒与急性心肌梗死和假定的心源性猝死的关系
IF 2.4
Resuscitation plus Pub Date : 2025-07-19 DOI: 10.1016/j.resplu.2025.101035
Patricia Jabre , Richard Chocron , Thomas Laurenceau , Marion Chabrol , Ugo Meli , Younès Youssfi , Marie Cécile Perier , Wulfran Bougouin , Frankie Beganton , Thomas Loeb , François Revaux , Daniel Jost , Alain Cariou , Jean-Philippe Empana , Frédéric Adnet , Xavier Jouven
{"title":"Association of human immunodeficiency virus with acute myocardial infarction and presumed sudden cardiac death","authors":"Patricia Jabre ,&nbsp;Richard Chocron ,&nbsp;Thomas Laurenceau ,&nbsp;Marion Chabrol ,&nbsp;Ugo Meli ,&nbsp;Younès Youssfi ,&nbsp;Marie Cécile Perier ,&nbsp;Wulfran Bougouin ,&nbsp;Frankie Beganton ,&nbsp;Thomas Loeb ,&nbsp;François Revaux ,&nbsp;Daniel Jost ,&nbsp;Alain Cariou ,&nbsp;Jean-Philippe Empana ,&nbsp;Frédéric Adnet ,&nbsp;Xavier Jouven","doi":"10.1016/j.resplu.2025.101035","DOIUrl":"10.1016/j.resplu.2025.101035","url":null,"abstract":"<div><h3>Background</h3><div>While extensive evidence linking human immunodeficiency virus (HIV) infection to acute myocardial infarction (AMI), several studies have also suggested an association between HIV and presumed sudden cardiac death (PSCD). Our objective was to evaluate the association between HIV and PSCD compared to AMI. Understanding whether HIV confers differential risks for distinct cardiovascular outcomes is essential to guide prevention strategies and risk stratification in this population.</div></div><div><h3>Methods</h3><div>The study design was a case-control study. We combined data from the large prospective population-based Paris Sudden Death Expertise Center Registry on PSCD and from the French National Health Insurance (SNDS) database. The SNDS database contains comprehensive data on all reimbursements for health-related expenditures and detailed medical information on all admissions to French public and private hospitals. In this study, adult patients with PSCD that occurred between 2011 and 2020 in Paris and the 3 adjacent departments were matched with AMI controls. We identified HIV patients in the 2 populations. We used a logistic regression to estimate the association between HIV and PSCD compared to HIV and AMI, adjusted for confounders.</div></div><div><h3>Results</h3><div>In this study, 22,510 PSCD patients (60% men, age 71 (17) years) were matched with 22,510 AMI controls (60% men, age 72 (17) years). Among them, 245 (1%) and 104 (1%) had a positive HIV status preceding PSCD and AMI respectively. The odds of PSCD was 97% higher than the odds of AMI in HIV patients (adjusted odds-ratio, 1.97; 95% confidence interval: 1.55–2.49)<strong>.</strong></div></div><div><h3>Conclusions</h3><div>Our findings, based on big data analysis, strongly suggest a significant association between HIV status and PSCD, also among patients without a history of AMI. The underlying mechanisms still remain incompletely defined and further studies are needed.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"25 ","pages":"Article 101035"},"PeriodicalIF":2.4,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144721162","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Fluid balance after cardiac arrest: Any impact on outcome? Insights from the MIMIC IV database 心脏骤停后体液平衡:对结果有影响吗?来自MIMIC IV数据库的见解
IF 2.4
Resuscitation plus Pub Date : 2025-07-17 DOI: 10.1016/j.resplu.2025.101037
Juliette Didier , Juliette Murris , Hélène Schopper , Emmanuelle Guérin , Nolwen Flajoliet , Marine Amiot , Bertrand Hermann , Stéphane Germain , Alain Cariou , Jean-Luc Diehl , Sandrine Katsahian , Nicolas Bréchot
{"title":"Fluid balance after cardiac arrest: Any impact on outcome? Insights from the MIMIC IV database","authors":"Juliette Didier ,&nbsp;Juliette Murris ,&nbsp;Hélène Schopper ,&nbsp;Emmanuelle Guérin ,&nbsp;Nolwen Flajoliet ,&nbsp;Marine Amiot ,&nbsp;Bertrand Hermann ,&nbsp;Stéphane Germain ,&nbsp;Alain Cariou ,&nbsp;Jean-Luc Diehl ,&nbsp;Sandrine Katsahian ,&nbsp;Nicolas Bréchot","doi":"10.1016/j.resplu.2025.101037","DOIUrl":"10.1016/j.resplu.2025.101037","url":null,"abstract":"<div><h3>Background</h3><div>Fluid balance is closely associated with outcomes in septic shock. Post-cardiac arrest (CA) shock, which accounts for one-third of deaths after CA, shares many pathophysiological features with sepsis. However, the impact of fluid balance has not been analyzed in this setting. This study aimed to assess the impact of fluid balance on mortality during post-CA shock.</div></div><div><h3>Methods</h3><div>This retrospective study used the Medical Information Mart for Intensive Care (MIMIC)-IV database. Fluid balance was quantified during the first 72 h. Multivariate logistic-regression analysis identified factors associated with early (by day 3) mortality.</div></div><div><h3>Results</h3><div>Among the 1800 patients resuscitated from CA, 868 (68 %) developed post-CA shock. Of these, 801 were analyzed; 334 (42 %) died within 3 days. Early non-survivors had a higher median fluid balance (+3289 mL [25th; 75th IQR + 502; +5806]) than early survivors (+930 mL [–2677; +4353]) (<em>P</em> &lt; 0.001). Positive fluid balance independently predicted death by day 3 (OR 2.23, 95 % CI [1.29; 3.14]; <em>P</em> = 0.005). Mortality increased significantly with increasing fluid balance, especially from 1000 mL and upwards (OR 4.11, 95 % CI [2.32; 2.47]; <em>P</em> &lt; 0.001). Other factors independently associated with early mortality included age &gt;66 years, maximum catecholamines dose, and peak serum lactate.</div></div><div><h3>Conclusions</h3><div>These findings confirm that fluid balance is associated with early mortality during post-CA shock.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"25 ","pages":"Article 101037"},"PeriodicalIF":2.4,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144721161","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Changes in T-lymphocyte subsets and natural killer cells of patients after out-of-hospital cardiac arrest and resuscitation: a retrospective study 院外心脏骤停复苏后患者t淋巴细胞亚群和自然杀伤细胞的变化:一项回顾性研究
IF 2.1
Resuscitation plus Pub Date : 2025-07-16 DOI: 10.1016/j.resplu.2025.101034
Zhenyu Shan , Chenchen Hang , Xingsheng Wang, Rui Shao, Le An , Ziren Tang
{"title":"Changes in T-lymphocyte subsets and natural killer cells of patients after out-of-hospital cardiac arrest and resuscitation: a retrospective study","authors":"Zhenyu Shan ,&nbsp;Chenchen Hang ,&nbsp;Xingsheng Wang,&nbsp;Rui Shao,&nbsp;Le An ,&nbsp;Ziren Tang","doi":"10.1016/j.resplu.2025.101034","DOIUrl":"10.1016/j.resplu.2025.101034","url":null,"abstract":"<div><h3>Purpose</h3><div>Immune dysregulation in patients resuscitated from out-of-hospital cardiac arrest (OHCA) represents a major clinical issue. This study aimed to analyze the changes in T-lymphocyte subsets and natural killer (NK) cells after the return of spontaneous circulation.</div></div><div><h3>Methods</h3><div>A total of 183 OHCA patients were enrolled in this study. The counts and percentages of T-lymphocyte subsets and NK cells were retrospectively collected. These patients were stratified into four groups based on the time interval from OHCA to sample collection: ≤12 h, 12–24 h, 24–48 h, and &gt;48 h. The outcome measures were survivors and neurological function as defined by the Cerebral Performance Category (CPC) scale at discharge.</div></div><div><h3>Results</h3><div>After ROSC, the counts of CD3+ T cells, CD4+ T cells, CD8+ T cells, and NK cells were all lower. The percentage of CD4+ T cells increased over time (≤12 h vs 12–24 h vs 24–48 h vs &gt;48 h: 28.6 ± 11.5 % vs. 37.9 ± 15.0 % vs. 39.0 ± 11.6 % vs. 40.9 ± 15.0 %, <em>P</em> = 0.008). Both the count and percentage of NK cells declined over time (count: 101.5[55.8–181]<em>n</em>/μL vs. 68[31.5–149.8]<em>n</em>/μL vs. 72.5[31.5–175]<em>n</em>/μL vs. 34[19–61]<em>n</em>/μL, <em>P</em> &lt; 0.001; percentage: 18.6[11.7–22.2] % vs. 9.7[6.2–21.8] % vs. 10.6[7.6–16.9] % vs. 7.2[3.5–9.9] %, <em>P</em> &lt; 0.001). The percentages of CD3+ T cells and CD4+ T cells increased over time in survivors (CD3+: <em>ρ</em> = 0.38, <em>P</em> &lt; 0.001; CD4+: <em>ρ</em> = 0.40, <em>P</em> &lt; 0.001) and CPC 1–2 (CD3+: <em>ρ</em> = 0.39, <em>P</em> = 0.02, CD4+: <em>ρ</em> = 0.51, <em>P</em> = 0.002), but not in patients with non-survivors and CPC 3–5 (all <em>P</em> &gt; 0.05). In death, the percentage and count of CD8+ cells decreased over time (percentage: <em>ρ</em> = −0.32, <em>P</em> = 0.006, count: <em>ρ</em> = −0.26, <em>P</em> = 0.03).</div></div><div><h3>Conclusions</h3><div>After OHCA, T-lymphocyte subsets and NK cells were present at low levels, and the temporal variation trends of different lymphocyte subsets differed.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"25 ","pages":"Article 101034"},"PeriodicalIF":2.1,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144703015","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Basic life support training targeted to family members or carers of those at high-risk of out-of-hospital cardiac arrest: a systematic review 针对院外心脏骤停高危人群的家庭成员或护理人员的基本生命支持培训:系统回顾
IF 2.1
Resuscitation plus Pub Date : 2025-07-15 DOI: 10.1016/j.resplu.2025.101031
Zakary Doherty , Janet E. Bray , Judith Finn , Susie Cartledge
{"title":"Basic life support training targeted to family members or carers of those at high-risk of out-of-hospital cardiac arrest: a systematic review","authors":"Zakary Doherty ,&nbsp;Janet E. Bray ,&nbsp;Judith Finn ,&nbsp;Susie Cartledge","doi":"10.1016/j.resplu.2025.101031","DOIUrl":"10.1016/j.resplu.2025.101031","url":null,"abstract":"<div><h3>Introduction</h3><div>This updated systematic review examined the impact of targeting basic life support (BLS) training to groups at high risk of out-of-hospital cardiac arrest (OHCA) on patient and educational outcomes.</div></div><div><h3>Methods</h3><div>Searches of databases (MEDLINE, EMBASE, CINAHL and Cochrane Library) were conducted from June 2014 to November 2024 (PROSPERO CRD42021233811). We identified pre-2014 studies from the 2015 International Liaison Committee on Resuscitation evaluation of this topic. Two reviewers independently screened titles and full-text papers, extracted data and assessed risk of bias (ROB-2 and ROBINS-I). The certainty of the evidence for each outcome was evaluated using GRADE methodology. A narrative synthesis was performed.</div></div><div><h3>Results</h3><div>A total of 48 studies (17 new non-randomised studies) were found. While there is evidence of subsequent use of skills and improved survival with the intervention, the quality of evidence remains very-low to low, due to the low number of OHCA events during follow-up and significant loss to follow-up. For educational outcomes, the quality of evidence for CPR skills, confidence and willingness to perform CPR was low to moderate, with most studies showing improvements in these outcomes or skills at guideline recommendations following training. Those trained were also likely to train others.</div></div><div><h3>Conclusions</h3><div>Despite a large number of studies examining BLS training to those at high-risk of OHCA, the quality of evidence remained largely unchanged. However, the evidence continues to demonstrate that targeting those at high-risk improves simulated CPR skills, and confidence and willingness to provide CPR in likely rescuers.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"25 ","pages":"Article 101031"},"PeriodicalIF":2.1,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144713274","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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