Resuscitation plus最新文献

{"title":"Methodology for creating a novel cardiac arrest registry using the Trinetx electronic health record database","authors":"Ryan Huebinger ,&nbsp;Ryan A. Coute ,&nbsp;Larissa Myaskovsky ,&nbsp;Cameron Crandall ,&nbsp;Ethan Abbott ,&nbsp;Keith E. Kocher ,&nbsp;Aditya C Shekhar ,&nbsp;Benjamin S. Abella","doi":"10.1016/j.resplu.2025.101102","DOIUrl":"10.1016/j.resplu.2025.101102","url":null,"abstract":"<div><h3>Background</h3><div>Care in the hospital, post-arrest care, is a crucial component of out-of-hospital cardiac arrest (OHCA) management, but current OHCA databases contain limited post-arrest care data. To address this, we present the methodology for assembling a multicenter, real-world post-arrest care research registry using the Trinetx database.</div></div><div><h3>Methods</h3><div>We queried the Trinetx research database (01/01/2000–02/19/2025), a federated database of electronic health record data from over 100 healthcare organisations in the US and internationally, to identify OHCAs from ICD codes for cardiac arrest related to emergency department (ED) visits. To define our cohort of patients eligible to receive post-arrest care, we identified OHCAs that survived to admission based on having a temporally associated inpatient encounter (based on encounter type/Current Procedure Terminology codes) or an ED visit lasting &gt;24 h. We defined survival to discharge as 1) having an encounter after the hospitalisation and 2) having a death date after the end of the hospitalisation. We report patient characteristics and the number of clinical variables available in each data table for the cohort.</div></div><div><h3>Results</h3><div>We identified 222,868 OHCAs and included 88,753 patients (39.8%) who survived to admission. The median age was 65, 60.3% were male, and 59.8% were White. Survival to discharge rate was 48.5%. The database contained 188,038,385 clinical data points: 40,868,707 vital signs, 52,145,594 labs, 17,781,035 procedures, 72,575,389 medication administrations, and 4,667,660 diagnoses.</div></div><div><h3>Conclusion</h3><div>Using Trinetx real-world data, it is possible to create a multicentre, OHCA post-arrest care database with a substantial number of clinical variables, enabling novel post-arrest care research.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"26 ","pages":"Article 101102"},"PeriodicalIF":2.4,"publicationDate":"2025-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145266373","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":"Association between bystander-initiated cardio-pulmonary resuscitation in pediatric out-of-hospital cardiac arrest and patient outcomes: Results from the French National Registry","authors":"Marguerite Lockhart-Bouron ,&nbsp;Valentine Baert ,&nbsp;Stéphane Leteurtre ,&nbsp;Matthieu Heidet ,&nbsp;Hervé Hubert ,&nbsp;Morgan Recher","doi":"10.1016/j.resplu.2025.101105","DOIUrl":"10.1016/j.resplu.2025.101105","url":null,"abstract":"<div><h3>Purpose</h3><div>Effects of bystander cardiopulmonary resuscitation (CPR) on patient outcomes during pediatric out-of-hospital cardiac arrest (OHCA) remain to be fully elucidated. This study investigated bystander-initiated CPR effects on return of spontaneous circulation (ROSC) and survival at hospital admission in comparative pediatric population experiencing OHCA.</div></div><div><h3>Methods</h3><div>Multicenter retrospective observational study conducted between January 2015 and December 2023 using the French National Cardiac Arrest Registry (RéAC) data. Pediatric patients (0–17 years) with OHCA were included. Patients who received bystander-initiated CPR were matched with those who did not using propensity score. Primary endpoints were ROSC and survival at hospital admission. Secondary endpoints were survival at D30 and favorable neurological outcomes (Cerebral Performance Category (CPC score of 1 or 2).</div></div><div><h3>Results</h3><div>Of 2162 eligible pediatric patients, 1289 (59.6 %) received bystander-initiated CPR. After propensity score matching (n = 645 pairs), bystander-initiated CPR (vs without CPR by a bystander) was associated with improved ROSC (31.2 % vs 23.7 %; adjusted OR [AOR] 1.7, 95 % CI 1.1–1.9) and survival at hospital admission (28.7 % vs 19.8 %; AOR 1.7, 95 % CI 1.3–2.2). No significant difference was observed for survival at D30 (3.7 % vs 3.9 %; AOR 0.9, 95 % CI 0.5–1.7) or favorable neurological outcomes.</div></div><div><h3>Conclusions</h3><div>In this nationwide French cohort, bystander-initiated CPR in pediatric OHCA was associated with improved ROSC and survival at hospital admission, but not with D30 survival or favorable neurological outcomes. These findings reinforce the importance of promoting bystander CPR, while highlighting the need for additional strategies to improve long-term outcomes in pediatric OHCA.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"26 ","pages":"Article 101105"},"PeriodicalIF":2.4,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145226940","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":"Tele-ultrasound enables EMT-Intermediate providers to identify occult haemorrhage: A novel, scalable SUPER-YL framework for prehospital POCUS","authors":"Wen-Hung Yang ,&nbsp;An-Fu Lee ,&nbsp;Chao-Chun Huang ,&nbsp;Tzu-Yun Hung ,&nbsp;Wen-Chu Chiang","doi":"10.1016/j.resplu.2025.101104","DOIUrl":"10.1016/j.resplu.2025.101104","url":null,"abstract":"","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"26 ","pages":"Article 101104"},"PeriodicalIF":2.4,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145226941","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":"Establishing a lifeline: the first publicly-managed ambulance dispatch system and advanced cardiac life support (ACLS) resuscitation in Somaliland, East Africa","authors":"Yacin Mohamed Abdillahi ,&nbsp;An-Fu Lee ,&nbsp;Chien-Te Pan ,&nbsp;Matthew Heui-Min Ma ,&nbsp;Wen-Chu Chiang","doi":"10.1016/j.resplu.2025.101106","DOIUrl":"10.1016/j.resplu.2025.101106","url":null,"abstract":"","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"26 ","pages":"Article 101106"},"PeriodicalIF":2.4,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145227045","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":"Causes of death and types of injuries of avalanche fatalities based on forensic data: a scoping review","authors":"Céliane Romy ,&nbsp;David Eidenbenz ,&nbsp;Silke Grabherr ,&nbsp;Ken Zafren ,&nbsp;Cécile Jaques ,&nbsp;Nicolas Hall ,&nbsp;Mathieu Pasquier","doi":"10.1016/j.resplu.2025.101101","DOIUrl":"10.1016/j.resplu.2025.101101","url":null,"abstract":"<div><h3>Background</h3><div>The main causes of death in avalanche victims are asphyxia, trauma, and hypothermia. However, most evidence is based on epidemiological studies with inconsistent forensic data. We aimed to integrate current evidence on causes of death and types of injuries in avalanche victims undergoing postmortem examination.</div></div><div><h3>Methods</h3><div>We conducted a scoping review of studies reporting forensic data on avalanche-related deaths. Eligible studies included victims who underwent postmortem examination, excluding those buried in buildings or vehicles. Extracted data included study and population characteristics, postmortem investigation (external examination, autopsy, histopathology, toxicology, and imaging), and results (causes of death, types of injuries).</div></div><div><h3>Results</h3><div>We included 38 studies, of which 31 reported original data involving 1543 fatalities. Of these, 862 (56 %) underwent postmortem examination, with 442 (51 %) receiving autopsies. Among 387 autopsied cases with reported causes of death, asphyxia accounted for 72 %, trauma 18 %, hypothermia 2 %, and combined causes 8 %. Asphyxia-related findings included pulmonary edema, organ congestion, and petechiae. Trauma-related deaths involved head, neck, and thoracic injuries. Hypothermia findings included Wischnewski spots and frostbite. Histopathology (n = 48) revealed asphyxia-related lesions in all victims, while hypothermia findings were infrequent. Postmortem imaging (n = 12) showed pulmonary edema. Toxicology detected ethanol in 4 %, cannabinoids in 11 % and cocaine in 1 % of cases tested.</div></div><div><h3>Conclusion</h3><div>Our review aligns with previous studies, confirming asphyxia as the leading cause of death, followed by trauma and hypothermia. Gaps in knowledge remain on autopsy-confirmed causes of death and related injuries. Standardized forensic protocols could improve death classification accuracy, particularly in cases with combined causes.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"26 ","pages":"Article 101101"},"PeriodicalIF":2.4,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145157915","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":"Assessment of adherence to the neonatal resuscitation program using video recording: a prospective observational study","authors":"Mananya Sukthong,&nbsp;Pracha Nuntnarumit,&nbsp;Pharuhad Pongmee","doi":"10.1016/j.resplu.2025.101097","DOIUrl":"10.1016/j.resplu.2025.101097","url":null,"abstract":"<div><h3>Background</h3><div>Although evidence-based guidelines from the Neonatal Resuscitation Program (NRP) are widely used, adherence to the NRP algorithm remains inconsistent across healthcare settings. This study aimed to assess adherence to the NRP algorithm using video recording.</div></div><div><h3>Methods</h3><div> <!-->A prospective observational study was conducted at a university hospital in Bangkok, Thailand. Video recordings of resuscitations for high-risk deliveries, attended by pediatric residents and neonatal fellows, were reviewed from February 2023 to January 2024. Adherence was evaluated using a specified assessment form for procedural steps and techniques according to the 8th edition of the NRP algorithm published by the American Academy of Pediatrics.</div></div><div><h3>Results</h3><div>Out of 498 video-recorded resuscitations, common deviations during basic resuscitation included overstimulation (53.4 %), excessive suctioning (14.7 %), and inadequate heat loss prevention for preterm neonates ≤32 weeks’ gestation (30.6 %). For positive pressure ventilation, common deviations included inconsistent face mask seal (16.9 %), improper finger positioning with the C-E technique (12.3 %), and incorrect ventilation rate (12.3 %). Among 34 intubation attempts, the success rate of the first-attempt intubation was 41.2 %, and prolonged intubation (lasting more than 30 s) occurred in 61.8 %.</div></div><div><h3>Conclusions</h3><div>This study demonstrated that video recordings effectively identified several deviations from the NRP algorithm, offering insights into areas for improvement. These<!--> <!-->recordings may serve as a valuable supplementary tool for NRP training.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"26 ","pages":"Article 101097"},"PeriodicalIF":2.4,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145157914","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":"Cognitive limitations in depth estimation for dispatcher-assisted cardiopulmonary resuscitation: a prospective simulation study","authors":"Min Woo Kim ,&nbsp;Stephen Gyung Won Lee ,&nbsp;Tae Han Kim ,&nbsp;Yoon Ha Joo ,&nbsp;Ki Jeong Hong","doi":"10.1016/j.resplu.2025.101093","DOIUrl":"10.1016/j.resplu.2025.101093","url":null,"abstract":"<div><h3>Background</h3><div>Dispatcher-assisted cardiopulmonary resuscitation (DACPR) protocols often instruct bystanders to perform chest compressions to a target depth of 50–60 mm. However, whether laypersons can accurately perceive and achieve these depth targets remains unclear. This study evaluated laypersons’ ability to estimate 50 mm in horizontal length, vertical depth, and chest compression depth.</div></div><div><h3>Methods</h3><div>We conducted a prospective simulation study enrolling adult laypersons without cardiopulmonary resuscitation (CPR) training within two years. Participants were asked to draw a 50 mm line, press a vertical measurement plate to an estimated depth of 50 mm, and perform chest compressions to 50 mm. Tasks were repeated after provision of a 50 mm visual reference. Accuracy was assessed by calculating the mean difference from 50 mm and the proportion of estimations within the acceptable range (45–55 mm).</div></div><div><h3>Results</h3><div>100 participants were enrolled. Horizontal length was significantly underestimated (mean difference −3.5 ± 16.6 mm, <em>p</em> = 0.036), with 25.0 % (95 % confidence interval [CI], 16.9 %–34.7 %) within the acceptable range. Vertical depth was significantly overestimated (mean difference +4.9 ± 19.4 mm, <em>p</em> = 0.044), with 26.0 % (95 % CI, 17.7 %–35.7 %) within range. Chest compression depth was significantly underestimated both before (44.5 ± 10.7 mm) and after (44.7 ± 11.0 mm) provision of visual reference (both <em>p</em> &lt; 0.001), with no significant improvement after reference exposure (<em>p</em> = 0.548).</div></div><div><h3>Conclusion</h3><div>Laypersons have significant difficulty estimating 50 mm in length, vertical depth, and applying target chest compression depth. Providing a visual reference did not significantly improve performance.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"26 ","pages":"Article 101093"},"PeriodicalIF":2.4,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145109698","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":"Basic life support competency among healthcare professionals in Ethiopia: a systematic review and meta-analysis, 2025","authors":"Gebremeskel Kibret Abebe ,&nbsp;Addis Wondmagegn Alamaw ,&nbsp;Biruk Beletew Abate ,&nbsp;Befkad Derese Tilahun ,&nbsp;Alemu Birara Zemariam ,&nbsp;Tesfaye Engdaw Habtie ,&nbsp;Fekadu Takele Wolie","doi":"10.1016/j.resplu.2025.101098","DOIUrl":"10.1016/j.resplu.2025.101098","url":null,"abstract":"<div><h3>Background</h3><div>Sudden cardiac arrest is a major global health problem, accounting for nearly half of all cardiovascular deaths. Its burden is particularly high in low-income regions, partly due to limited healthcare facilities. Early Cardiopulmonary resuscitation (CPR) can increase survival rates to 50–70%. However, only a small proportion of cardiac arrest victims receive timely, adequate life-saving cardiopulmonary resuscitation, highlighting an urgent need for improvement.</div></div><div><h3>Objectives</h3><div>To conduct a systematic review and meta-analysis of knowledge, attitude, and associated factors on basic life support among healthcare professionals in Ethiopia.</div></div><div><h3>Methods</h3><div>A systematic review and meta-analysis were conducted by searching several databases, including PubMed, Medline, the Cochrane Database of Systematic Reviews, UpToDate, EMBASE, and the National Institute for Health and Care Excellence (NICE). Data on knowledge, attitudes, and associated factors related to basic life support among healthcare professionals were extracted. The pooled estimate of knowledge and attitude levels was calculated using a random-effects model. The Joanna Briggs Institute’s (JBI) critical appraisal checklist was used to assess the quality of the included studies.</div></div><div><h3>Results</h3><div>The final analysis included 12 studies with a total of 3045 participants. The pooled prevalence of good knowledge of basic life support among healthcare professionals in Ethiopia was 42.87 % (95 % CI: 29.15–56.59 %; I² = 98.86 %; p &lt; 0.001). The pooled prevalence of favorable attitudes towards basic life support was 71.46 % (95 % CI: 69.89–73.04 %; I² = 98.80 %; p &lt; 0.0001). Gender (being male; AOR = 0.31; 95 % CI: 0.07–0.56) was negativity associated with knowledge, while previous exposure to basic life support (AOR = 1.74; 95 % CI: 1.38–2.11) was positively associated. Assessment of publication bias revealed no evidences bias.</div></div><div><h3>Conclusion</h3><div>The overall prevalence good knowledge among healthcare professionals in Ethiopia remains below the Minimum standards, while their attitude towards basic life support was suboptimal. Male healthcare professionals less likely to have adequate knowledge on basic life support, where as those with pervious exposure to basic life support demonstrate good knowledge.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"26 ","pages":"Article 101098"},"PeriodicalIF":2.4,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145109695","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":"Clearing the airway? A pilot cadaveric study of the LifeVac™ device","authors":"Thomas L. Haupt,&nbsp;Lisa Chionis,&nbsp;Kevin H. Wang","doi":"10.1016/j.resplu.2025.101099","DOIUrl":"10.1016/j.resplu.2025.101099","url":null,"abstract":"<div><h3>Background</h3><div>Foreign body aspiration (FBA<strong>)</strong> is a leading cause of accidental death, especially among children and older adults. Suction-based airway clearance devices, such as the LifeVac™, an FDA-registered Class II medical device, have garnered attention as potential adjunctive tools in FBA management; however, data on their efficacy remain limited. This study evaluated the performance of the LifeVac™ in a cadaveric model simulating complete upper airway obstruction by commonly aspirated food items.</div></div><div><h3>Methods</h3><div>Fresh cadavers with intact upper airway anatomy were used. Grapes, hot dog slices, and steak cubes were placed at the level of the true vocal folds under video-laryngoscopic guidance. Interventions were performed by a PGY-1 otolaryngology resident and a board-certified head and neck surgeon, following LifeVac™ manufacturer instructions. The primary outcome was successful foreign body removal within four minutes. Secondary outcomes included time to removal and evidence of oropharyngeal trauma. All trials were video recorded for technique verification and injury assessment.</div></div><div><h3>Results</h3><div>Across 21 trials performed on three cadavers, only one successful extraction occurred (1/21, 4.8 %), involving a hot dog segment removed by a PGY-1 resident. One cadaver was edentulous, which resulted in a poor mask seal and ineffective suction. No grapes or steak were successfully extracted. No visible oropharyngeal trauma was identified.</div></div><div><h3>Conclusion</h3><div>In this cadaveric model, LifeVac™ demonstrated limited efficacy, with successful removal occurring in only one instance. It is unclear if the lack of efficacy is due to device design or the limitations of the cadaveric model. Further research in physiologic or clinical settings is warranted.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"26 ","pages":"Article 101099"},"PeriodicalIF":2.4,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145157913","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":"Use of Auto Transfusion Tourniquet increases end-tidal-CO2 in out-of-hospital cardiac arrest patients – a feasibility pilot study","authors":"Maruša Esih ,&nbsp;Noam Gavriely ,&nbsp;Matej Strnad","doi":"10.1016/j.resplu.2025.101100","DOIUrl":"10.1016/j.resplu.2025.101100","url":null,"abstract":"<div><h3>Objectives</h3><div>Out-of-hospital cardiac arrest (OHCA) remains a leading cause of mortality, with low survival rates despite advancements in cardiopulmonary resuscitation (CPR) and emergency care. This study aimed to evaluate the safety and effectiveness of the HemaShock® Auto-Transfusion Tourniquet (A-TT) in OHCA patients by assessing its impact on ACLS quality, ROSC rate and end-tidal CO₂ partial pressure (PetCO₂).</div></div><div><h3>Methods</h3><div>This was a feasibility pilot study conducted in the pre-hospital setting of Maribor, Slovenia. The study was registered at <span><span>ClinicalTrials.org</span><svg><path></path></svg></span> #NCT06153160 and was approved by the Institutional Ethics Committee. Twenty-four OHCA patients were enrolled and divided into two groups: 12 patients received standard advanced cardiac life support (ACLS) plus A-TT (Study Group), while 12 received only ACLS (Control Group). The primary efficacy outcome was the difference in PetCO₂ before and after A-TT application in the Study Group. The primary safety outcome was assessed by evaluating the standard quality parameters of CPR in the two groups and by verifying that the rate of ROSC in the Study Group was not lower than in the Control Group.</div></div><div><h3>Results</h3><div>There were no significant demographic differences between the two groups.. A-TT was successfully applied in 12 patients, with one case being ineffective. Return of spontaneous circulation (ROSC) was achieved in 50 % of the Study Group and 33 % of the Control Group (NS). PetCO₂ increased by 24.8 % (<em>P</em> &lt; 0.005) immediately after A-TT application, sustaining for 5 min before returning to baseline. No adverse effects on ACLS delivery quality or patient management were observed.</div></div><div><h3>Conclusions</h3><div>The use of A-TT in OHCA patients did not interfere with ACLS protocols and did not reduce ROSC rate. The significant transient increase in PetCO₂ may be due to shifting of CO₂-loaded blood from the legs to the core by the A-TT, or due to improved tissue perfusion and O₂ delivery during resuscitation. Earlier application of A-TT may enhance its effect on outcome. Further randomized controlled studies with larger sample sizes are needed to assess its impact on survival and neurological outcomes.</div></div><div><h3>Open science</h3><div>The pilot study was registered into Clinical Trials in February 2023. The trial number is NCT06153160. The trial protocol can be assessed through the webpage <span><span>cinicaltrials.gov.org</span><svg><path></path></svg></span>.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"26 ","pages":"Article 101100"},"PeriodicalIF":2.4,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145109697","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}