Resuscitation plus最新文献

{"title":"Cardiopulmonary resuscitation training for drivers: Mandatory training is an important step, but not the final one","authors":"Bálint Pozsgai, Ádám Éliás, Boróka Jobb, Henrietta Bánfai-Csonka, József Betlehem, Bálint Bánfai","doi":"10.1016/j.resplu.2025.101006","DOIUrl":"10.1016/j.resplu.2025.101006","url":null,"abstract":"","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"25 ","pages":"Article 101006"},"PeriodicalIF":2.1,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144338924","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}

{"title":"Data to decisions in pediatric post-cardiac arrest care using coding and large language models","authors":"Sultan Alam , Abdul Rahman , Javed K. Sheikh , Shahab S. Sohail","doi":"10.1016/j.resplu.2025.101002","DOIUrl":"10.1016/j.resplu.2025.101002","url":null,"abstract":"","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"25 ","pages":"Article 101002"},"PeriodicalIF":2.1,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144366588","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}

{"title":"Investigating the dynamics of intracranial pressure and cerebral autoregulation during extracorporeal cardiopulmonary resuscitation using a porcine model","authors":"Tito Porras ,&nbsp;Mingfeng Cao ,&nbsp;Jessica Briscoe ,&nbsp;Jin Kook Kang ,&nbsp;Ifeanyi David Chinedozi ,&nbsp;Zachary Darby ,&nbsp;Shivalika Khanduja ,&nbsp;Anastasios Bezerianos ,&nbsp;Nitish Thakor ,&nbsp;Glenn Whitman ,&nbsp;Debraj Mukherjee ,&nbsp;Steve Keller ,&nbsp;Sung-Min Cho","doi":"10.1016/j.resplu.2025.101003","DOIUrl":"10.1016/j.resplu.2025.101003","url":null,"abstract":"<div><h3>Background</h3><div>Extracorporeal cardiopulmonary resuscitation (ECPR) has emerged as a promising intervention for refractory cardiac arrest, with potential benefits in survival and neurological outcomes. However, the impact of ECPR’s rapid, non-pulsatile restoration of cerebral blood flow on intracranial physiology and autoregulation remains poorly understood.</div></div><div><h3>Methods</h3><div>Using a porcine model, this study investigated the dynamics of intracranial pressure (ICP), cerebral autoregulation, and pulsatility during key experimental phases: Baseline, Fibrillation, ECMO, and ROSC. ICP waveform features, including spectral entropy and centroid, were analyzed to assess signal complexity and dominant frequency shifts. Pressure reactivity index (PRx), the correlation between MAP and ICP, was used to assess impaired cerebral autoregulation (PRx &gt; 0.3). Pulsatility, quantified by pulse pressure (PP) and pulsatility index (PI), was evaluated for its interaction with PRx.</div></div><div><h3>Results</h3><div>Significant alterations in ICP and PRx were observed across experimental phases. During Fibrillation, ICP increased, waveforms lost pulsatile structure and complexity, and elevated PRx indicated impaired autoregulation. ECMO initiation resulted in a reduction of ICP fluctuations but reduced pulsatility due to the steady, non-physiological flow. Following ROSC, ICP pulsatility partially recovered, but PRx variability remained high, suggesting inter-subject differences in autoregulatory recovery. Negative correlations between pulsatility and PRx (slope = –0.096, 95% CI: –0.136 to –0.056, <em>p</em> = 3.07 × 10⁻⁶) suggested that pulsatility plays a critical role in autoregulatory function.</div></div><div><h3>Conclusion</h3><div>This study highlights the complex intracranial changes during ECPR, emphasizing the importance of pulsatility in maintaining cerebral autoregulation. Findings suggest the need for refined ECPR protocols to optimize cerebral protection and improve autoregulatory recovery.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"25 ","pages":"Article 101003"},"PeriodicalIF":2.1,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144330349","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}

{"title":"Optimization of dispatcher instruction for public-access automated external defibrillator retrieval and use: A scoping review","authors":"Lucas Snow ,&nbsp;James Whiting ,&nbsp;Theresa M. Olasveengen ,&nbsp;Janet E. Bray ,&nbsp;Christopher M. Smith","doi":"10.1016/j.resplu.2025.101005","DOIUrl":"10.1016/j.resplu.2025.101005","url":null,"abstract":"<div><h3>Background</h3><div>Public-access defibrillation is a key step in the chain of survival. Emergency Medical Services dispatchers can help the public locate and use public-access Automated External Defibrillators (AEDs), but there is little information about effectiveness of dispatcher instructions for AED use. This scoping review investigates evidence about the effect of dispatch instruction for public-access AED retrieval and use on process and patient outcomes.</div></div><div><h3>Methods</h3><div>The research team searched MEDLINE, EMBASE and Cochrane libraries, performed bibliography searches and reviewed ‘related articles’ identified by PubMed and Google Scholar. We reported patient outcomes including survival to hospital discharge, and process outcomes including rates of and time to AED retrieval and use, and competent AED use.</div></div><div><h3>Results</h3><div>We identified 21 articles: eight clinical observational studies and 13 simulation studies. The only study reporting on clinical outcomes reported that AED application following dispatcher assistance was associated with statistically significant increases in survival to hospital discharge (adjusted odds ratio [AOR] 3.01, 95% confidence interval [CI] 1.56–5.82) and survival with favourable neurological outcome (AOR 5.46, 95% CI 1.95–15.3), but shock delivery itself was not. Clinical studies reported that dispatch instruction facilitated AED retrieval and use. In simulations, dispatch instruction resulted in an overall shorter time to first shock but, if measuring only the time interval after the AED had arrived, dispatch instructions introduced delay to first shock. Dispatch instruction also resulted in competent AED use more frequently. There were conflicting results about the benefits of video dispatch instructions.</div></div><div><h3>Discussion</h3><div>There is little high-quality evidence about the effect of dispatcher instruction for AED retrieval and use on patient outcomes.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"25 ","pages":"Article 101005"},"PeriodicalIF":2.1,"publicationDate":"2025-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144338922","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}

{"title":"Epidemiology and outcomes of out-of-hospital cardiac arrests treated by an anaesthetist-staffed emergency medical service: a 3-year registry analysis in The Friuli-Venezia-Giulia region","authors":"Carlo Pegani ,&nbsp;Alberto Peratoner ,&nbsp;Manila Andrian ,&nbsp;Laura Magagnin ,&nbsp;Luca Gambolò ,&nbsp;Alice Pravisani ,&nbsp;Michele Zuliani ,&nbsp;Serena Rakar ,&nbsp;Cristina Lutman ,&nbsp;Alessio Della Mattia ,&nbsp;Katya Fabretto ,&nbsp;Annarita Tullio ,&nbsp;Giuseppe Stirparo ,&nbsp;Erik Roman Pognuz ,&nbsp;Giuseppe Ristagno ,&nbsp;FVG-OHCA registry network","doi":"10.1016/j.resplu.2025.101000","DOIUrl":"10.1016/j.resplu.2025.101000","url":null,"abstract":"<div><h3>Objectives</h3><div>Out-of-hospital cardiac arrest (OHCA) presents significant regional variations in incidence, management, and survival rates. The Friuli-Venezia-Giulia (FVG) region in northeastern Italy has established a cardiac arrest registry to evaluate epidemiological trends and the effectiveness of its emergency medical service (EMS) interventions. This study analyses EMS-treated OHCAs over a three-year period, focusing on patient characteristics, resuscitation practices, and survival outcomes.</div></div><div><h3>Methods</h3><div>A retrospective cohort study was conducted using prospectively collected data from the FVG-OHCA registry between January 2021-December 2023. All adult OHCAs where resuscitation was attempted by EMS were included. Demographics, OHCA characteristics, bystander interventions, EMS response and treatments, and outcomes were analysed. Logistic regression was used to identify factors associated with survival to hospital admission, six-month survival, and good neurological recovery (Cerebral Performance Category (CPC) 1–2).</div></div><div><h3>Results</h3><div>A total of 4,089 OHCA cases were recorded, with an incidence of 113/100,000 inhabitants/year. Although bystander CPR rate was 67%, public AED use was low (4.3%). Resuscitation was attempted by EMS in 48% of cases, and an advanced airway was placed in 75% of patients. Survival to hospital admission was 22.9%, while six-month survival was 9.7%, and 7.6% of patients had a CPC 1–2. Younger age, male gender, shockable rhythm, and public location were associated with long-term survival. High-quality bystander CPR, use of mechanical CPR, and advanced airway placement during CPR were associated only with survival to hospital admission.</div></div><div><h3>Conclusions</h3><div>This study provides comprehensive insights into OHCA epidemiology and outcomes in the FVG region and emphasises the importance of early intervention, high-quality bystander CPR, and specialised prehospital care.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"25 ","pages":"Article 101000"},"PeriodicalIF":2.1,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144338923","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}

{"title":"Airway management by ambulance nurses during out-of-hospital cardiac arrest","authors":"Lotte C. Doeleman ,&nbsp;Julian F.F. de Jong ,&nbsp;Vera G.M. van Eeden ,&nbsp;Patrick Schober ,&nbsp;Markus W. Hollmann ,&nbsp;Hans van Schuppen","doi":"10.1016/j.resplu.2025.100999","DOIUrl":"10.1016/j.resplu.2025.100999","url":null,"abstract":"<div><h3>Background</h3><div>Adequate airway management in out-of-hospital cardiac arrest (OHCA) is crucial for ventilation and oxygenation. Advanced airway management with a supraglottic airway device (SAD) or endotracheal tube (ETT) follows bag-valve-mask (BVM) ventilation, with emergency front-of-neck access as a rescue-option. EMS protocols on airway management in OHCA have changed over the years and during the COVID-pandemic. This study assessed subsequent changes in airway management and the success of different strategies.</div></div><div><h3>Methods</h3><div>An observational study was conducted with data from ARREST, 2019–2023. All consecutive adult OHCA patients who had resuscitation attempted by EMS were included. Patients were excluded if helicopter emergency medical services were involved. Changes in devices used intra-arrest and their first-pass success were analyzed.</div></div><div><h3>Results</h3><div>The proportion of cases with an SAD attempt increased, and with an ETT decreased. The definitive airway device used was an SAD in 59% (95% CI: 57–60%), an ETT in 21% (95% CI: 19–22%), and BVM in 14% (95% CI: 13–15%). First pass success for ETT increased from 53% to 68%. Average SAD first pass success was 93%.</div></div><div><h3>Conclusion</h3><div>During cardiopulmonary resuscitation (CPR) by ambulance nurses, the use of SADs increased, and that of ETTs decreased. Although ETT first pass success improved, it was lower than the guideline-recommended standard for performing intubations prehospitally. First pass success for SAD was high. This adds support for current Dutch ambulance guidelines recommending an SAD for primary choice of advanced airway by EMS during CPR. However, improvement of intubation techniques and skills remain a necessity for selected OHCA patients.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"25 ","pages":"Article 100999"},"PeriodicalIF":2.1,"publicationDate":"2025-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144307646","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}

{"title":"Considerations on multi-dimensional optimization of the CPR muscle fatigue mechanism","authors":"Meng-Yuan Shen ,&nbsp;Rong Zhou ,&nbsp;Jian-Nong Wu","doi":"10.1016/j.resplu.2025.100998","DOIUrl":"10.1016/j.resplu.2025.100998","url":null,"abstract":"","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"25 ","pages":"Article 100998"},"PeriodicalIF":2.1,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144298661","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}

{"title":"Extracorporeal cardiopulmonary resuscitation for pediatric in-hospital cardiac arrest in single ventricle patients: a systematic review and meta-analysis","authors":"Tia T. Raymond ,&nbsp;Anne Marie Guerguerian ,&nbsp;Javier J. Lasa ,&nbsp;Michael Alice Moga ,&nbsp;Gurpreet S. Dhillon ,&nbsp;Jason Acworth ,&nbsp;Dianne L. Atkins ,&nbsp;Barnaby R. Scholefield ,&nbsp;the Paediatric Life Support Task Force for the International Liaison Committee on Resuscitation ILCOR","doi":"10.1016/j.resplu.2025.100997","DOIUrl":"10.1016/j.resplu.2025.100997","url":null,"abstract":"<div><h3>Objectives</h3><div>Assess the use of extracorporeal cardiopulmonary resuscitation (ECPR), compared with manual/mechanical cardiopulmonary resuscitation (CPR), for in-hospital cardiac arrest (IHCA) in pediatric patients with single ventricle (SV) congenital heart disease (CHD).</div></div><div><h3>Methods</h3><div>PRISMA guidelines were followed with PROSPERO registration (CRD42023479671). We searched Medline, Embase, Web of Science, PubMed, and the Cochrane Library for studies published before January 23, 2025. The population included pediatric patients (&lt;18 years old) with IHCA. Two investigators reviewed studies for relevance, extracted data, and assessed risk of bias using the ROBINS-I tool. Certainty of evidence was evaluated using the GRADE framework. Outcomes included short-term and long-term survival and favorable neurological outcome.</div></div><div><h3>Results</h3><div>We identified 20 studies: 15 described ECPR in SV patients without a comparator group, and 5 compared SV ECPR patients vs. SV extracorporeal membrane oxygenation (ECMO) without ECPR (ECMO non-ECPR). Pooled synthesis for survival to hospital discharge was analyzed in 3 observational studies with 91 SV patients (pooled OR 0.66, 95% CI 0.37–1.01) and separately in 2 registry studies with 968 SV patients (OR 0.76, 95% CI 0.35–1.37 and OR 1.06, 95% CI 0.78–1.41) with very low certainty of evidence (downgraded for risk of bias and imprecision). These studies found no significant difference in survival to hospital discharge in ECPR compared to ECMO non-ECPR in pediatric SV patients. No studies were identified that compared pediatric SV patients who received ECPR vs. conventional/manual CPR.</div></div><div><h3>Conclusions</h3><div>There is no direct evidence to either support or refute the use of ECPR during IHCA in pediatric patients with SV CHD, and there is inconclusive evidence to either support or refute the use of ECPR compared to ECMO non-ECPR. Additional research is needed to address the use of ECPR in this specific cardiac population.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"25 ","pages":"Article 100997"},"PeriodicalIF":2.1,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144262182","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}

{"title":"Chest compressions techniques in microgravity: light years from a good quality resuscitation","authors":"Vincenzo Vanni,&nbsp;Jien Li Hu,&nbsp;Alessia Currao,&nbsp;Simone Savastano","doi":"10.1016/j.resplu.2025.100996","DOIUrl":"10.1016/j.resplu.2025.100996","url":null,"abstract":"","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"25 ","pages":"Article 100996"},"PeriodicalIF":2.1,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144298660","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}

{"title":"Psychometric evaluation of EQ-5D-5L in OHCA survivors from the TTM2 trial: a post hoc analysis","authors":"Mattias Bohm ,&nbsp;Kristofer Årestedt ,&nbsp;Susann Ullén ,&nbsp;Niklas Nielsen ,&nbsp;Josef Dankiewicz ,&nbsp;Hans Friberg ,&nbsp;Erik Blennow Nordström ,&nbsp;Alain Cariou ,&nbsp;Janus Christian Jakobsen ,&nbsp;Anders Morten Grejs ,&nbsp;Matthias Haenggi ,&nbsp;Naomi E. Hammond ,&nbsp;Katarina Heimburg ,&nbsp;Thomas R. Keeble ,&nbsp;Christoph Leithner ,&nbsp;Christian Rylander ,&nbsp;Johan Undén ,&nbsp;Matt P. Wise ,&nbsp;Tobias Cronberg ,&nbsp;Gisela Lilja","doi":"10.1016/j.resplu.2025.100994","DOIUrl":"10.1016/j.resplu.2025.100994","url":null,"abstract":"<div><h3>Aims</h3><div>Our aim was to investigate the psychometric properties of the health assessment instrument EQ-5D-5L in OHCA survivors.</div></div><div><h3>Methods</h3><div>We included survivors from the Targeted Hypothermia versus Targeted Normothermia after OHCA (TTM2) trial, who completed EQ-5D-5L at 6 months. Confirmatory factor analysis was used to evaluate the hypothesised unidimensional latent structure of EQ level sum score (EQ LSS), summarizing scores across <em>Mobility</em>, <em>Self-care</em>, <em>Usual activities</em>, <em>Pain/discomfort</em>, and <em>Anxiety/depression</em>. Differential item functioning was evaluated for age. We examined internal consistency and precision for the EQ LSS. We evaluated construct validity of EQ LSS, EQ value and EQ VAS, using the modified Rankin Scale and Montreal Cognitive Assessment, representing functional outcome and cognitive function—two common health challenges experienced by OHCA survivors.</div></div><div><h3>Results</h3><div>783 of 939 (84%) eligible survivors were included. Confirmatory factor analysis showed good model fit and strong factor loadings for all dimensions (0.61–0.90). We observed a significant but negligible effect of age on Mobility (β = 0.29, p &lt; 0.001, ΔR² = 0.019). Internal consistency was 0.88. The floor effect was 35%. Survivors with more functional dependency and/or cognitive problems reported significantly worse health by EQ LSS, EQ value, and EQ VAS (all, p &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>The psychometric properties of EQ LSS support its use to measure health status in OHCA research. The strong association between health and functional dependency indicate robust and comparable construct validity for EQ LSS, EQ value, and EQ VAS in this sample.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"24 ","pages":"Article 100994"},"PeriodicalIF":2.1,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144221386","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}