Resuscitation plus最新文献

{"title":"The California Resuscitation Outcomes Consortium (CAL-ROC): A novel collaboration to facilitate the implementation of randomized clinical trials in the prehospital setting","authors":"Juliana Tolles ,&nbsp;Jake Toy ,&nbsp;Nichole Bosson ,&nbsp;David G. Dillon ,&nbsp;J. Joelle Donofrio-Odmann ,&nbsp;James J. Menegazzi ,&nbsp;Juan Carlos C. Montoy ,&nbsp;John M. VanBuren ,&nbsp;Marianne Gausche-Hill","doi":"10.1016/j.resplu.2025.100992","DOIUrl":"10.1016/j.resplu.2025.100992","url":null,"abstract":"<div><h3>Background</h3><div>Few large randomized clinical trials (RCTs) have been conducted to inform the prehospital phase of care for out-of-hospital cardiac arrest (OHCA). We describe the development of a consortium to facilitate large-scale prehospital RCTs through a novel research collaboration, leveraging pre-existing prehospital and hospital data capture infrastructure.</div></div><div><h3>Consortium description</h3><div>We developed a consortium consisting of 173 emergency medical services (EMS) Provider Agencies and four academic “hubs.” The consortium is an innovative collaboration consisting of a diverse set of EMS experts from across California and designed to overcome logistical, cost, and regulatory challenges associated with prehospital research. All participating agencies share data via a state EMS database, California EMS Information System (CEMSIS), and contribute data to the national Cardiac Arrest Registry to Enhance Survival (CARES) database. Data from CEMSIS and CARES will be linked to capture RCT outcomes. We abstracted two years of data from the CARES database to characterize the population served by the consortium and facilitate sample size calculations for future trials. We estimate that the consortium will have the ability to enroll a diverse population of patients with OHCA, at a rate of approximately 19,000 per year across all sites, for a future trial of cardiac arrest therapies.</div></div><div><h3>Conclusion</h3><div>This collaboration uses pre-existing data infrastructure to capture prehospital and hospital outcome data to facilitate large-scale prehospital RCTs for time-critical emergencies.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"24 ","pages":"Article 100992"},"PeriodicalIF":2.1,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144243568","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":"Comparative analysis of inflammatory response on post resuscitation syndrome in extracorporeal cardiopulmonary resuscitation","authors":"Kostiantyn Kozakov ,&nbsp;Zdenek Provaznik ,&nbsp;Maik Foltan ,&nbsp;Jing Li ,&nbsp;Walter Petermichl ,&nbsp;Christian Stadlbauer ,&nbsp;Sigrid Wiesner ,&nbsp;Dzmitry Turtsevich ,&nbsp;Andreas Keyser ,&nbsp;Leopold Rupprecht ,&nbsp;Christof Schmid ,&nbsp;Simon Schopka","doi":"10.1016/j.resplu.2025.100995","DOIUrl":"10.1016/j.resplu.2025.100995","url":null,"abstract":"<div><h3>Background</h3><div>Extracorporeal life support (ECLS) is increasingly employed for severe respiratory or cardiac failure, alongside a rising adoption of extracorporeal cardiopulmonary resuscitation (eCPR). Despite increased adoption, limited evidence underscores possible cytokines’ pivotal role in the inflammatory response during ECLS.</div></div><div><h3>Methods</h3><div>The study involved 546 eCPR patients using veno-arterial extracorporeal membrane oxygenation from 2013 to 2023. Categorized into in-hospital eCPR (IHCA, 358 patients) and out-of-hospital eCPR (OHCA, 188 patients) groups, a retrospective analysis explored associations among interleukin 6 (IL6), interleukin 8 (IL8), tumor necrosis factor-alpha (TNF-alpha), soluble interleukin-2 receptor (sIL2R), and pivotal post-resuscitation syndrome (PRS) components. Cytokine dynamics were assessed before and after ECLS initiation.</div></div><div><h3>Results</h3><div>CPR-to-ECLS time was significantly longer in the OHCA group (<em>p</em> = 0.009), correlating with elevated IL6 and IL8 levels. The IHCA group showed more favorable neurological outcomes (<em>p</em> &lt; 0.001), but presented with a higher incidence of multiple organ failure (<em>p</em> &lt; 0.001) compared to the OHCA group. The IHCA group exhibited pronounced IL6 and IL8 levels prior to ECLS initiation significantly decreasing post-ECLS initiation (<em>p</em> = 0.01 and <em>p</em> = 0.008), whereas OHCA patients showed peak levels of IL6 and IL8 during the course of ECLS (<em>p</em> &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>IL6 and IL8 are associated with key elements of the post-resuscitation syndrome (neurological outcome, organ dysfunction and hemodynamic status) in patients undergoing eCPR for refractory cardiac arrest, possibly providing a predictive ability of organ dysfunction in OHCA patients without a preceding pro-inflammatory burden.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"24 ","pages":"Article 100995"},"PeriodicalIF":2.1,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144212506","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":"Proteomics identify pathogenesis and novel biomarkers for monitoring and early prognostication of brain injury after cardiac arrest: a randomized animal study","authors":"Zhun Yao ,&nbsp;Yuanrui Zhao ,&nbsp;Liping Lu ,&nbsp;Song Xu ,&nbsp;Yinping Li ,&nbsp;Zhui Yu","doi":"10.1016/j.resplu.2025.100993","DOIUrl":"10.1016/j.resplu.2025.100993","url":null,"abstract":"<div><h3>Aim</h3><div>Post-cardiac arrest brain injury (PCABI) is the leading cause of death and disability after resuscitation. This study aimed to investigate the pathogenesis and novel biomarkers for monitoring the progression and early prognostication of PCABI.</div></div><div><h3>Methods</h3><div>Mouse model of PCABI was induced by hyperkalemia-induced asystole and successful resuscitation. Young adult male C57BL/6 mice were randomized into sham-operation or asystole/resuscitation. The sham-operated mice were selected as control. Neurological examinations were performed at 24 h after resuscitation, and three groups were set: control (<em>n</em> = 4), severe PCABI (<em>n</em> = 3), and mild PCABI (<em>n</em> = 3). Cerebral cortexes were collected for data-independent acquisition-proteomic analyses. The pathogenesis and potential biomarkers were identified through the pairwise comparisons of three subgroups and subsequent bioinformatics analyses. Human serum proteomes profiles, extracted from a published work of the second analysis of TTM-trial, were used for joint analyses to identify the common and clinically relevant biomarkers at the same timepoint. Experimental and external validation were performed to verify the association between novel biomarkers and neural death in PCABI.</div></div><div><h3>Results</h3><div>The proteomic analysis identified and quantified 7,745 proteins. The most prominent proteomic changes were related to response to external stimulus, stress response, regulation of biological and metabolic process, endomembrane system, and inflammatory response in the PCABI progression. 10 potential biomarkers were identified by the pairwise comparisons of three groups, and lipocalin-2 and angiotensinogen are common biomarkers with human studies at 24 h after resuscitation. Experimental validation verified that lipocalin-2 was closely associated with neurodegeneration in PCABI.</div></div><div><h3>Conclusions</h3><div>Stress, inflammatory, and metabolic responses play important roles in the progression of PCABI. Lipocalin-2 is a novel biomarker for monitoring and early neuroprognostication at 24 h after resuscitation.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"24 ","pages":"Article 100993"},"PeriodicalIF":2.1,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144221387","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":"Energy doses for paediatric defibrillation in cardiac arrest: systematic review and meta-analysis","authors":"Jason Acworth ,&nbsp;Jimena del Castillo ,&nbsp;Lokesh Kumar Tiwari ,&nbsp;Dianne Atkins ,&nbsp;Allan de Caen ,&nbsp;Arun Bansal ,&nbsp;Thomaz Bittencourt Couto ,&nbsp;Stephan Katzenschlager ,&nbsp;Monica Kleinman ,&nbsp;Jesus Lopez-Herce ,&nbsp;Ryan W. Morgan ,&nbsp;Michelle Myburgh ,&nbsp;Vinay Nadkarni ,&nbsp;Janice A. Tijssen ,&nbsp;Barnaby R. Scholefield ,&nbsp;International Liaison Committee on Resuscitation Paediatric Life Support Task Force","doi":"10.1016/j.resplu.2025.100991","DOIUrl":"10.1016/j.resplu.2025.100991","url":null,"abstract":"<div><h3>Background</h3><div>Early defibrillation is the foundation of treatment of shockable ventricular arrhythmias (VF, pVT) but optimal energy doses for initial and subsequent shocks in paediatric cardiac arrest remain controversial.</div></div><div><h3>Objectives</h3><div>To assess the use of different energy doses for initial defibrillation in infants, children and adolescents with ventricular fibrillation (VF) or pulseless ventricular tachycardia (pVT) during cardiac arrest.</div></div><div><h3>Methods</h3><div>A systematic review was performed by the ILCOR Paediatric Life Support Task force. This systematic review was prospectively registered as PROSPERO CRD42024548898. A search of PubMed, EMBASE, and Cochrane Controlled Register of Trials (CENTRAL) was performed for clinical trials and observational studies, published before 1 January 2025, involving cardiac defibrillation in infants and children (excluding newborn infants) in cardiac arrest. Investigators reviewed studies for relevance, extracted data, and assessed risk of bias using the ROBINS-I framework. Critical outcomes included survival to hospital discharge and return of spontaneous circulation. Results were compiled into a Summary of Findings table using the GRADEpro Guideline Development tool. Statistical calculations and Forest plot generation were performed using RevMan.</div></div><div><h3>Results</h3><div>We identified 7 relevant observational studies. The majority of studies involved in-hospital cardiac arrest. The overall certainty of evidence was very low. Critical (survival to hospital discharge, return of spontaneous circulation) and important (termination of VF/pVT) outcomes were not significantly better or worse when initial defibrillation doses of &lt;1.5 J/kg or &gt;2.5 J/kg were used for children in cardiac arrest with a shockable rhythm compared with initial doses approximating 2 J/kg.</div></div><div><h3>Conclusions</h3><div>The current available data suggest that outcomes are not significantly better or worse when initial defibrillation doses of &lt;1.5 J/kg or &gt;2.5 J/kg are used for children in cardiac arrest with a shockable rhythm (VF or pVT) compared with initial doses approximating 2 J/kg. Well-designed randomised trials are needed to address this important question.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"24 ","pages":"Article 100991"},"PeriodicalIF":2.1,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144203605","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":"How likely is the patient to be in cardiac arrest? Caller breathing descriptors in ambulance calls that were dispatched as cardiac arrest","authors":"Nirukshi Perera ,&nbsp;Marine Riou ,&nbsp;Tanya Birnie ,&nbsp;Judith Finn ,&nbsp;Austin Whiteside ,&nbsp;David Majewski ,&nbsp;Stephen Ball","doi":"10.1016/j.resplu.2025.100990","DOIUrl":"10.1016/j.resplu.2025.100990","url":null,"abstract":"<div><h3>Background</h3><div>In emergency ambulance calls, callers use a variety of ways to describe patients’ breathing, or the absence thereof. Call-takers have the task of interpreting these descriptions, and for unconscious patients, determining if they fit with the dispatch system’s requirements for a cardiac arrest. We aimed to categorise the breathing descriptions callers use and determine the likelihood of patients being in cardiac arrest for different breathing description categories.</div></div><div><h3>Method</h3><div>Using call audio and ambulance dispatch data from St John Western Australia (Jan-Jun 2021) for cases dispatched as out-of-hospital cardiac arrest (OHCA) during initial “case entry” questioning, we created a schema of breathing descriptors and coded calls for their occurrence. For each descriptor we determined the percentage of cases confirmed by Emergency Medical Services (EMS) as being in arrest (true positive cases) on arrival at the scene.</div></div><div><h3>Results</h3><div>Of 375 cases dispatched as OHCA, 85.3% (320) were true positives. Callers used a wide range of descriptors, across 23 categories. Descriptors with a high percentage of true positive cases were <em>Dead</em>, <em>NOT breathing, Blue/Purple</em> and <em>Unsure.</em> Some descriptors, notably <em>Barely</em>, <em>Gasp</em> and <em>Laboured</em> were less commonly OHCA, but still had over 50% true positives.</div></div><div><h3>Conclusion</h3><div>Patients who are dispatched as OHCA by call-takers have a diverse range of caller descriptors for their breathing status. While descriptor categories varied in the percentage of EMS-confirmed OHCAs, none had a low percentage. We recommend exposing call-takers to the broad range of breathing descriptors which can be applied to their role in identifying OHCA and addressing caller perceptions of patient signs of life.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"24 ","pages":"Article 100990"},"PeriodicalIF":2.1,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144221436","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":"Discrepancies between physician review and algorithmic detection of the zoll rescuenet post-cardiac arrest case review","authors":"Ayal Z. Pierce ,&nbsp;Cody Couperus ,&nbsp;Jordan Parker ,&nbsp;Allison LaRocco ,&nbsp;Michael Mazzeffi ,&nbsp;Nicholas A. Morris","doi":"10.1016/j.resplu.2025.100989","DOIUrl":"10.1016/j.resplu.2025.100989","url":null,"abstract":"<div><h3>Background</h3><div>Accurate measurement of CPR quality metrics is critical for improving cardiac arrest outcomes. Impedance based automated devices have demonstrated limitations. Zoll RescueNet CaseReview, rather, uses accelerometry to analyze chest compressions and automatically provides code feedback, including CPR pause number, length, and chest compression fraction. However, the reliability of these automated measurements compared to manual physician review remains uncertain.</div></div><div><h3>Methods</h3><div>We conducted a retrospective observational cohort study at a tertiary academic medical center, analyzing 212 in-hospital cardiac arrest cases recorded between July 1, 2023, and July 1, 2024. The study compared CPR metrics generated by the Zoll RescueNet CaseReview algorithm to manual physician review of raw defibrillator data, focusing on pause durations and chest compression fraction (CCF) using Bland-Altman plots.</div></div><div><h3>Results</h3><div>Bland-Altman plots indicated overestimation of individual pause times (mean difference 4.00 s), max pause time per arrest (mean difference 24.57 s) total pause time per arrest (mean difference 0.73 min), and average number of pauses per arrest, with corresponding underestimation of CCF (mean difference 8.33%). Substantial variability was present for all variables with increased disagreement for longer pause times.</div></div><div><h3>Conclusion</h3><div>The Zoll RescueNet CaseReview algorithm estimates longer CPR pause durations than manual physician review, thereby lowering the chest compression fraction estimate. These findings support manual review of raw data and improved algorithmic detection of compressions to ensure feedback to resuscitation teams is reliable.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"24 ","pages":"Article 100989"},"PeriodicalIF":2.1,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144177899","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":"Organisations supporting cardiac arrest survivors: An exploratory survey of organisational structures and activities","authors":"Lorenzo Gamberini ,&nbsp;Kirstie L. Haywood ,&nbsp;Sebastian Schnaubelt ,&nbsp;Mazarine Thyssens ,&nbsp;Federico Semeraro ,&nbsp;Koenraad G. Monsieurs","doi":"10.1016/j.resplu.2025.100986","DOIUrl":"10.1016/j.resplu.2025.100986","url":null,"abstract":"<div><h3>Background</h3><div>Cardiac arrest survivors have diverse needs beyond healthcare, including spirituality, social networks, practical, legal, and economic matters, highlighting the need for community-based support. While some non-governmental organisations support various patient groups, little is known about those dedicated to cardiac arrest survivors. The European Resuscitation Council (ERC) conducted a survey to identify and understand these organisations’ structures and activities.</div></div><div><h3>Methods</h3><div>An internet survey developed by the ERC was disseminated through media channels, national resuscitation councils, and social networks. Responses were verified against publicly available information to confirm declared activities and sustained support efforts. Organisations were classified based on whether their primary focus was on cardiac arrest survivors or if support was a secondary activity.</div></div><div><h3>Results</h3><div>Of fifty-six responses, eight organisations were identified as providing structured, continuous support. Six primarily focused on cardiac arrest survivors, while two had a broader scope. Most were established after 2000, with six in Europe and two in the United States. Membership ranged from 520 to 3000 survivors. Common activities included peer support and distributing information materials. Connections with healthcare systems varied, with three reporting none. Only two were represented in their national resuscitation councils (NRCs).</div></div><div><h3>Conclusions</h3><div>Organisations supporting cardiac arrest survivors are scarce but address important unmet needs. However, public presence is limited, and ties with institutions remain weak. Strengthening collaborations with healthcare providers, NRCs, and stakeholders could enhance support networks and improve long-term post-resuscitation care.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"24 ","pages":"Article 100986"},"PeriodicalIF":2.1,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144170142","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":"DESLIVES: Adolescents learning basic life support through reflective learning. A proof of concept","authors":"Santiago Martínez-Isasi,&nbsp;María García-Martínez,&nbsp;Graciela Gómez-Silva,&nbsp;Gabriel Reedy,&nbsp;Antonio Rodríguez-Núñez","doi":"10.1016/j.resplu.2025.100987","DOIUrl":"10.1016/j.resplu.2025.100987","url":null,"abstract":"","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"24 ","pages":"Article 100987"},"PeriodicalIF":2.1,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144243627","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":"Smartphone-based alert of community first responders: A multinational survey to characterise contemporary systems","authors":"Tore Marks ,&nbsp;Bibiana Metelmann ,&nbsp;Lorenzo Gamberini ,&nbsp;Camilla Metelmann ,&nbsp;Sebastian Schnaubelt ,&nbsp;Federico Semeraro ,&nbsp;Carolina Malta Hansen ,&nbsp;European Resuscitation Guidelines 2025 Systems Saving Lives Writing Group","doi":"10.1016/j.resplu.2025.100988","DOIUrl":"10.1016/j.resplu.2025.100988","url":null,"abstract":"<div><h3>Aim</h3><div>Several countries worldwide have implemented systems to alert community first responders (CFR) via smartphone applications to increase likelihood of survival after out-of-hospital cardiac arrest (OHCA). Substantial heterogeneity across CFR systems has been reported but recent reports are lacking. The European Resuscitation Council (ERC) conducted a survey to characterise and compare CFR systems focusing on requirements for joining CFR programs.</div></div><div><h3>Methods</h3><div>An online survey with 28 questions regarding general system description, CFR qualification and training was conducted using SurveyMonkey between October 2024 and January 2025. The survey was shared via QR-code at the ERC Congress 2024, e-mail invitations to all ERC national resuscitation councils, the ERC Guidelines 2025 webpage, ERC social media, ERC newsletter, and personal e-mail invitations to research groups and CFR systems.</div></div><div><h3>Results</h3><div>Thirty-five CFR systems from 19 countries participated in the survey. The majority of CFR systems (69%, <em>n</em> = 24) require some kind of Basic Life Support (BLS) training as a minimum qualification. In 80% (<em>n</em> = 28) the minimum age for participation is 18 years. App-specific training is offered by 51% (<em>n</em> = 18) and in 11% (<em>n</em> = 4) of CFR systems no dispatch centre is involved in the alert, 43% (<em>n</em> = 15) of systems alert exclusively to OHCA, and 17% (<em>n</em> = 6) of CFR systems only alert CFR to adult OHCAs.</div></div><div><h3>Conclusions</h3><div>There are multiple CFR systems with a high degree of heterogeneity regarding minimum required CFR qualification and training as well as alerting modalities. Understanding these differences across systems is paramount to design studies to test the effect of CFR on patient outcomes.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"24 ","pages":"Article 100988"},"PeriodicalIF":2.1,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144194843","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":"Hydrocortisone and arginine vasopressin in post-resuscitation shock: the HYVAPRESS trial","authors":"Guillaume Geri ,&nbsp;Jean-Baptiste Lascarrou ,&nbsp;Bruno Levy ,&nbsp;Pierre Asfar ,&nbsp;Grégoire Muller ,&nbsp;Stéphane Legriel ,&nbsp;Sylvie Ricôme ,&nbsp;Martin Cour ,&nbsp;Kada Klouche ,&nbsp;Bertrand Sauneuf ,&nbsp;Jean Pierre Quenot ,&nbsp;Wulfran Bougouin ,&nbsp;Alain Cariou ,&nbsp;HYVAPRESS investigators","doi":"10.1016/j.resplu.2025.100982","DOIUrl":"10.1016/j.resplu.2025.100982","url":null,"abstract":"<div><h3>Background</h3><div>Acute circulatory failure after successfull resuscitation of cardiac arrest remains challenging and multifactorial. As the main driver of early mortality after restoration of spontaneous circulation, its therapeutic management essentially relies on fluids administration and vasopressive support using noradrenaline. Data also support the potential impact of a hormonal defect in this setting. Steroids substitution as well as argini-vasopressin treatment should be evaluated in these patients.</div></div><div><h3>Methods</h3><div>The HYVAPRESS trial is a 2x2 factorial randomized placebo-controlled multicentric trial evaluating the effect of both hydrocortisone and arginin-vasopressin in successfully resuscitated (inhospital and out-of-hospital) cardiac arrest patients suffering an acute circulatory failure in the first 24 h after restoration of spontaneous circulation. The main outcome will be the favourable neurological outcome assessed by the Glasgow Outcome Scale (GOS). 380 patients will be included, i.e. 95 patients in each arm, allowing the detection of a 15% difference in mortality using a power of 80% and an alpha-risk of 5%.</div></div><div><h3>Discussion</h3><div>Assessing therapeutics in the hemodynamic failure in post −cardiac arrest patients is challenging as the mortality is very high. Besides the vasopressive support, few investigation have been led so far to improve the management of these patients. While hydrocortisone and arginin-vasopressive have been evaluated in septic shock patients, data are lacking in this very specific subgroup of patients suffering from a very high mortality. Enrollement is ongoing.</div></div><div><h3>Trial registration</h3><div>Clinical Trials NCT04591990, registered on 2020, October 19th.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"24 ","pages":"Article 100982"},"PeriodicalIF":2.1,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144124289","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}