Resuscitation plus最新文献

{"title":"Morning peak and high prevalence of pulmonary embolism and psychiatric disorders in women with sudden cardiac arrest: results from the ReCaPTa study","authors":"Youcef Azeli,&nbsp;Eneko Barbería,&nbsp;Alberto Fernández,&nbsp;Inés Landín,&nbsp;Cristina Rey-Reñones,&nbsp;Silvia García-Vilana,&nbsp;Nina Vidal-González,&nbsp;Gil Bonet,&nbsp;Xavier Jiménez-Fàbrega,&nbsp;Alfredo Bardají","doi":"10.1016/j.resplu.2026.101416","DOIUrl":"10.1016/j.resplu.2026.101416","url":null,"abstract":"<div><h3>Background</h3><div>Sudden cardiac arrest (SCA) in women remains understudied, often leading to generalised approaches. We aimed to identify sex-specific differences in the clinical profile, risk factors, and causes of SCA to guide targeted interventions.</div></div><div><h3>Methods</h3><div>This prospective population-based study (ReCaPTa) analysed out-of-hospital cardiac arrests in a region of Spain (2014–2017). Data were triangulated from Emergency Medical Services, hospital records, and forensic autopsies. SCA was defined as an unexpected cardiac arrest, with a presumed cardiac cause, occurring within 1 h of symptom onset or seen to be alive and well within the last 24 h.</div></div><div><h3>Results</h3><div>Of 639 SCA cases, 191 (29.9%) were women. Compared with men, women were older (74 vs 66 years, <em>p</em> &lt; 0.001), had more morning SCA and had a higher prevalence of previous psychiatric disorders (15.6% vs 9.0%, <em>p</em> = 0.03) and alcohol abuse (25.4% vs 16.1%, <em>p</em> = 0.01). Toxicological analysis showed significantly higher antidepressant positivity in women (11.3% vs 1.8%, <em>p</em> = 0.004). Women had fewer shockable rhythms (21% vs 36%, <em>p</em> = 0.01), fewer resuscitation attempts, and lower survival rates (4.2% vs 9.9%, <em>p</em> = 0.01). While acute coronary disease was the leading cause in women (20.0%), they exhibited a distinct non-ischaemic profile: pulmonary embolism (PE) was more frequent than in men (13.3% vs 3.0%, <em>p</em> &lt; 0.001) and was universally fatal (0% survival).</div></div><div><h3>Conclusion</h3><div>Compared with men, women with SCA exhibited a disproportionately higher burden of PE and a greater involvement of psychotropic drugs and toxic substances.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"30 ","pages":"Article 101416"},"PeriodicalIF":3.1,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148634524","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validation of a hospital-wide risk stratification model for predicting code events among critically ill children","authors":"Colleen M. Badke,&nbsp;Sierra Strutz,&nbsp;Austin Wang,&nbsp;L. Nelson Sanchez-Pinto,&nbsp;Anoop Mayampurath","doi":"10.1016/j.resplu.2026.101419","DOIUrl":"10.1016/j.resplu.2026.101419","url":null,"abstract":"<div><h3>Objective</h3><div><strong>The pediatric Critical event Risk Evaluation and Scoring Tool</strong> (pCREST) is a validated, machine learning model that continuously predicts the risk of deterioration in children across hospital units. Our objective was to test the performance of pCREST in the early identification of code events in the pediatric intensive care unit (PICU).</div></div><div><h3>Methods</h3><div>This was a single-center, retrospective external validation study (2020–2023). The primary outcome was a code (receipt of cardiopulmonary resuscitation and/or code-dose epinephrine) within 12 h of any recorded vital sign or laboratory result. Code events were extracted from our hospital communications platform and electronic health record, and the first code event for each patient was identified. pCREST scores were calculated for each observation and their predictive performance assessed across various time points. Transfer learning was performed via a recurrent neural network (pCREST-RNN).</div></div><div><h3>Results</h3><div>Of 5254 encounters in the cohort, 2.6% experienced at least one code event. pCREST demonstrated good performance in predicting code events within 12 h (c-statistic 0.80), and also demonstrated a 13-fold improvement in detecting the outcome over the outcome’s prevalence (area under the precision recall curve: 0.034). Sensitivity analysis demonstrated high performance up to 18 h before the event. Transfer learning did not improve performance.</div></div><div><h3>Conclusions</h3><div>pCREST performs well at predicting code events in external setting at several time points before the outcome.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"30 ","pages":"Article 101419"},"PeriodicalIF":3.1,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148634525","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Conservative versus liberal oxygen therapy in hypoxic ischemic encephalopathy following cardiac arrest: a trial-based cost-effectiveness analysis","authors":"Zhomart Orman,&nbsp;Carol Hodgson,&nbsp;Michael Bailey,&nbsp;Diane Mackle,&nbsp;Anne M Mather,&nbsp;Paul Young,&nbsp;Alisa M. Higgins,&nbsp;LOGICAL Investigators and the Australian and New Zealand Intensive Care Society Clinical Trial Group","doi":"10.1016/j.resplu.2026.101403","DOIUrl":"10.1016/j.resplu.2026.101403","url":null,"abstract":"<div><h3>Background</h3><div>The cost-effectiveness of conservative versus liberal oxygen therapy in critically ill adults with post-cardiac arrest hypoxic ischemic encephalopathy is unknown.</div></div><div><h3>Methods</h3><div>A cost-effectiveness analysis alongside the LOGICAL trial was conducted from a health system perspective. Conservative oxygen targeted arterial oxygen saturation (SpO₂) of 90–95% using the lowest fraction of inspired oxygen (FiO₂), while liberal oxygen had no upper SpO₂ limit and a minimum FiO₂ of 0.3 during invasive ventilation. Patient-level data were analyzed from 53 intensive care units (ICU) in Australia, New Zealand, and Ireland. Costs (2024, US$) included ICU, ward, and inpatient rehabilitation stays. Health outcomes included favorable functional outcome (Glasgow Outcome Scale-Extended score 5–8) and quality-adjusted life years (QALYs) at 180 days derived from EQ-5D-5L. Uncertainty was explored using bootstrapping. Discounting was not applied.</div></div><div><h3>Results</h3><div>Among 1821 participants (median age 62 years; 28.6% female), 873 were randomized to conservative and 948 to liberal oxygen. Mean per-patient cost was $33,629 ($33,517) in the conservative group, with an incremental cost of −$1392 (95% CI, −$4696 to $1911). Favorable functional outcome occurred in 38.2% with conservative oxygen (risk difference, −1.5 percentage points; 95% CI, −6.1 to 3.2). Incremental QALYs were −0.002 (95% CI, −0.013 to 0.008). Conservative oxygen was associated with cost-savings of $635,151 per QALY forgone with considerable uncertainty (&gt;55% bootstrapped replications). Incremental net monetary benefit was $1173 (95% CI, −$2096 to $4442) at $100,000 per QALY.</div></div><div><h3>Conclusions</h3><div>Conservative oxygen was associated with modest cost savings and small differences in health outcomes, with no clear economic advantage over liberal oxygen.</div><div><br><strong>Trial number:</strong> ACTRN12621000518864.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"30 ","pages":"Article 101403"},"PeriodicalIF":3.1,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13393807/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148581809","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Timing and outcomes of out-of-hospital traumatic cardiac arrest: results of a multicentre, retrospective cohort study","authors":"Romana Erblich,&nbsp;Matthias Noitz,&nbsp;Marius Knöll,&nbsp;Helmut Trimmel,&nbsp;Wolfgang Voelckel,&nbsp;Luca Carenzo,&nbsp;Marius Rehn,&nbsp;Dominik Jenny,&nbsp;Jens Meier,&nbsp;Martin W. Dünser","doi":"10.1016/j.resplu.2026.101393","DOIUrl":"10.1016/j.resplu.2026.101393","url":null,"abstract":"<div><h3>Background</h3><div>Out-of-hospital traumatic cardiac arrest (TCA) is associated with high mortality. Outcomes may depend on the timing of TCA onset. This study aimed to characterize the timing of out-of-hospital TCA and its association with patient outcomes.</div></div><div><h3>Methods</h3><div>In this multicentre, retrospective, observational study, patients with out-of-hospital TCA attended by a nationwide helicopter emergency medical service (HEMS) were included. TCA timing was stratified into three prehospital intervals: on scene before arrival of the first emergency medical service (EMS) unit, on scene after EMS arrival, and during HEMS transport. Primary outcomes were proportions of TCA across time intervals. Secondary outcomes included sustained return of spontaneous circulation (ROSC), 30-day survival, and 1-year survival in patients without criteria to withhold resuscitation. Multivariable regression was used to identify predictors of sustained ROSC and 1-year survival among patients sustaining TCA before EMS arrival.</div></div><div><h3>Results</h3><div>Among 1532 patients, 90.2% sustained TCA before EMS arrival, 8.2% after EMS arrival, and 1.6% during HEMS transport. Sustained ROSC occurred in 20.8%, 47.2%, and 92.0% of patients, respectively (<em>p</em> &lt; 0.001). One-year survival was 3.5%, 10.0%, and 15.0% (<em>p</em> &lt; 0.001), respectively. In patients with TCA before EMS arrival, an initial electrocardiographic rhythm other than asystole was the only independent predictor of sustained ROSC and 1-year survival.</div></div><div><h3>Conclusion</h3><div>Nine out of ten out-of-hospital TCAs occur before EMS arrival. Timing of out-of-hospital TCA is associated with resuscitation success and survival. Meaningful survival rates are, however, achievable irrespective of TCA onset. This supports resuscitation efforts in all patients with out-of-hospital TCA and no criteria to withhold resuscitation.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"30 ","pages":"Article 101393"},"PeriodicalIF":3.1,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13355779/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148427636","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Automated External Defibrillator pad placement pictograms in Japan: sex representation in publicly available product information","authors":"Kentaro Omatsu,&nbsp;Hinata Abe,&nbsp;Takahiro Sakai,&nbsp;Aika Takahashi,&nbsp;Wataru Suzuki,&nbsp;Hiromu Shouji,&nbsp;Taiki Hoshino,&nbsp;Yutaka Takei","doi":"10.1016/j.resplu.2026.101417","DOIUrl":"10.1016/j.resplu.2026.101417","url":null,"abstract":"","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"30 ","pages":"Article 101417"},"PeriodicalIF":3.1,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148737188","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimizing automated external defibrillator incremental deployment to improve out-of-hospital cardiac arrest coverage: a spatial optimization study","authors":"Pengfei Cheng,&nbsp;Ding Luo,&nbsp;Hua Zhang,&nbsp;Baichao Xu,&nbsp;Pengyu Yang,&nbsp;Huachen Xue,&nbsp;Xiaobing Zhai,&nbsp;Ying Xiao","doi":"10.1016/j.resplu.2026.101408","DOIUrl":"10.1016/j.resplu.2026.101408","url":null,"abstract":"<div><h3>Background</h3><div>Public access defibrillation (PAD) is critical for out-of-hospital cardiac arrest (OHCA) response, yet the effectiveness of existing automated external defibrillator (AED) networks remains limited in many urban settings. Evidence is lacking on how incremental AED deployment translates into coverage gains and when diminishing returns occur, particularly in resource-constrained cities.</div></div><div><h3>Methods</h3><div>A retrospective spatial analysis was conducted using Utstein-compliant OHCA registry data from Haikou City, China (2015–2021). AED coverage was assessed using Euclidean distance across response radii of 100–500 m. Incremental AED deployment was simulated using the maximal covering location problem (MCLP) model while holding the existing network fixed. Changes in coverage, marginal gains, saturation thresholds, and optimized location types were evaluated using geographic information system methods.</div></div><div><h3>Results</h3><div>Among 5792 eligible OHCA events, baseline AED coverage was limited (14.6% within 100 m; 45.7% within 500 m). Incremental deployment produced rapid early coverage gains across all distance thresholds, followed by diminishing marginal returns and eventual saturation. Near-saturation required substantially more AEDs at shorter radii (approximately 1467 additional devices at 100 m) compared with larger radii (308–499 devices at 300–500 m). Optimized deployment shifted priority toward restaurants and commercial/industrial settings, while home or private residence, transportation hubs, and government/educational institution yielded lower marginal gains despite hosting most existing AEDs.</div></div><div><h3>Conclusions</h3><div>Existing AED networks provide limited OHCA coverage due to spatial mismatch between placement and demand. MCLP-guided deployment shows early gains but diminishing returns, supporting phased, locally-calibrated expansion that maximizes effective emergency access, especially in resource-constrained settings.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"30 ","pages":"Article 101408"},"PeriodicalIF":3.1,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13396928/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148586508","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ethics in prehospital extracorporeal cardiopulmonary resuscitation","authors":"Richard B. Witkov,&nbsp;Dorian Alexander","doi":"10.1016/j.resplu.2026.101396","DOIUrl":"10.1016/j.resplu.2026.101396","url":null,"abstract":"<div><div>Prehospital extracorporeal cardiopulmonary resuscitation (ECPR) shows potential in improving outcomes in out-of-hospital cardiac arrest (OHCA) with emerging adoption in multiple systems internationally. Ethical implications differ between hospital-based and prehospital ECPR systems as the prehospital environment introduces unique considerations related to location, timing, consent, patient selection, triage, and patient access. Prehospital ECPR may have unique benefits in avoiding ethical pitfalls of in-hospital cannulation. Ethical considerations specific to prehospital ECPR should be assessed prior to implementation with thorough risk–benefit analysis utilizing fundamental ethical principles from the perspectives of affected stakeholders.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"30 ","pages":"Article 101396"},"PeriodicalIF":3.1,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13356671/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148431860","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Strengthening workplace emergency preparedness through a university CPR and first aid responder programme: four-year experience","authors":"Henrietta Bánfai-Csonka,&nbsp;József Betlehem,&nbsp;János Musch,&nbsp;Bálint Bánfai","doi":"10.1016/j.resplu.2026.101390","DOIUrl":"10.1016/j.resplu.2026.101390","url":null,"abstract":"","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"30 ","pages":"Article 101390"},"PeriodicalIF":3.1,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13329578/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148392928","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Deferred cord clamping in twin pregnancies: benefit, risk, or missed opportunity? A narrative review","authors":"Aimann Surak,&nbsp;Graeme Polglase,&nbsp;Georg M. Schmölzer","doi":"10.1016/j.resplu.2026.101406","DOIUrl":"10.1016/j.resplu.2026.101406","url":null,"abstract":"<div><div>Deferred umbilical cord clamping enhances placental transfusion and is associated with improved outcomes in preterm infants. Following lung aeration and prior to umbilical cord clamping, the increase in pulmonary blood flow contributes to establishing blood volume within the pulmonary vascular bed, which constitutes the mechanism of physiology-based cord clamping. While the benefits of deferred cord clamping have been well described in singleton deliveries, evidence in twin pregnancies remains limited. This is particularly relevant for monochorionic twins, who share a placental circulation and may be at risk of inter-twin transfusion. This narrative review summarizes and critically appraises the available literature on deferred cord clamping in twin pregnancies, with particular emphasis on monochorionic twins. We highlight potential benefits, risks, and current knowledge gaps. Individual Participant Data meta-analyses and adequately powered studies are needed to better evaluate outcomes in multiple gestations, including long-term neurodevelopment.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"30 ","pages":"Article 101406"},"PeriodicalIF":3.1,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148554573","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Point-of-care-ultrasound in in-hospital cardiac arrest","authors":"Bhavya Narala,&nbsp;Kinner Patel,&nbsp;Eyal Menashe,&nbsp;Muhammad Ahsan,&nbsp;Jignesh Patel,&nbsp;Karin Hasegawa,&nbsp;Jie Yang,&nbsp;Sahar Ahmad","doi":"10.1016/j.resplu.2026.101385","DOIUrl":"10.1016/j.resplu.2026.101385","url":null,"abstract":"<div><h3>Background</h3><div>The purpose of this study was to investigate the relationship between point-of-care-ultrasound (POCUS) findings and survivorship and neurological outcomes at various time points within in-hospital cardiac arrest (IHCA).</div></div><div><h3>Methods</h3><div>We conducted a single center, prospective, observational study in a tertiary center with data collected between 2014 and 2025. A total of 169 patients were included. Protocolized ultrasound imaging was performed during resuscitation. The primary outcome was the association between different POCUS findings and achievement of ROSC. Secondary outcomes included survival at 1 h, 24 h, 48 h, hospital discharge, and 6 months, and neurological outcomes using cerebral performance category (CPC) scores: 1–2 as good and 3–5 as poor.</div></div><div><h3>Results</h3><div>Compared to patients with true PEA, pseudo-PEA was associated with improved likelihood of ROSC (OR 3.31, 95% CI 1.52–7.21) and higher survival at 6 months (<em>p</em> = 0.003). Cardiac standstill was associated with significantly lower odds of ROSC (OR 0.10, 95% CI 0.05–0.21) and lower survival across all timepoints compared to patients with cardiac activity. Patients without RV stasis demonstrated higher survival proportions at all time points, although this did not reach statistical significance. No statistically significant associations were observed between ultrasound findings and neurological outcomes.</div></div><div><h3>Conclusion</h3><div>Cardiac standstill and RV stasis were associated with poorer survival in IHCA, while pseudo-PEA was associated with improved survival outcomes, when compared to true PEA. No significant association was observed between POCUS findings and neurological outcomes. Intra-arrest POCUS has implications for survival outcomes, but its role in predicting neurological recovery is an evolving area of investigation, requiring further studies.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"30 ","pages":"Article 101385"},"PeriodicalIF":3.1,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13316169/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148364637","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}