Resuscitation plus最新文献

{"title":"Realtime detection of spontaneous circulation in humans during cardiopulmonary resuscitation using a continuous hands-free carotid Doppler: a pilot study","authors":"Guro Mæhlum Krüger ,&nbsp;Sunniva Gjerald Birkeli ,&nbsp;Øystein Myrlund Hansen ,&nbsp;Bjørn Ove Faldaas ,&nbsp;Anders Norvik ,&nbsp;Hedda Juni Lund ,&nbsp;Gregory Louis Egil Hautois ,&nbsp;John Helge Flage ,&nbsp;Jon Urteaga ,&nbsp;Torbjørn Hergum ,&nbsp;Hans Torp ,&nbsp;Eirik Skogvoll ,&nbsp;Charlotte Björk Ingul","doi":"10.1016/j.resplu.2025.101080","DOIUrl":"10.1016/j.resplu.2025.101080","url":null,"abstract":"<div><h3>Background</h3><div>The resuscitation society calls for precision-guided cardiopulmonary resuscitation (CPR), as current methods are inaccurate and time-consuming. RescueDoppler, a novel hands-free Doppler ultrasound system, continuously measures carotid blood flow during CPR. This pilot study assessed its performance, safety, and ability to detect chest compression-generated blood flow, spontaneous circulation, and return of spontaneous circulation (ROSC).</div></div><div><h3>Method</h3><div>We investigated RescueDoppler in adult cardiac arrest patients at two centres, in-hospital (IHCA) and out-of-hospital (OHCA). The cardiac arrest team placed the RescueDoppler probe over the left common carotid artery with a self-adhesive patch, collecting blinded data during CPR. Data were later interpreted and time-synchronized with defibrillator data using custom MATLAB® software.</div></div><div><h3>Results</h3><div>RescueDoppler was used in 26 IHCA and 36 OHCA patients from October 2023 to September 2024. Carotid blood flow curves were analyzed in 36 patients and synchronized with defibrillator data in 30. The RescueDoppler identified blood flow velocities generated by chest compressions and detected spontaneous circulation during rhythm checks. ROSC was defined by the presence of systolic and diastolic blood flow. No adverse events were reported but there were 22 device deficiencies mostly related to the self-adhesive patch and connecting cable. The system is user-friendly and requires minimal training.</div></div><div><h3>Conclusion</h3><div>Real-time detection of blood flow in the carotid artery with hands-free Doppler ultrasound during CPR is safe and feasible, although the fastening patch and host unit need optimization. The RescueDoppler system detects spontaneous circulation and ROSC during rhythm checks and ongoing chest compressions. Further research is required to confirm clinical relevance.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"26 ","pages":"Article 101080"},"PeriodicalIF":2.4,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145109696","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":"Cardiac arrest in children: A Europe-wide epidemiological study on out-of-hospital cardiac arrest in children. A protocol for a subgroup analysis of the European registry of cardiac arrest THREE study","authors":"Inga K. Kelpanides ,&nbsp;Stephan Katzenschlager ,&nbsp;Ingvild B.M. Tjelmeland ,&nbsp;Jo Kramer-Johansen ,&nbsp;Leo Bossaert ,&nbsp;Holger Maurer ,&nbsp;Siobhán Masterson ,&nbsp;Rolf Lefering ,&nbsp;Johan Herlitz ,&nbsp;Fernando Rossell Ortiz ,&nbsp;Gavin Perkins ,&nbsp;Jan Wnent ,&nbsp;Jan-Thorsten Gräsner","doi":"10.1016/j.resplu.2025.101081","DOIUrl":"10.1016/j.resplu.2025.101081","url":null,"abstract":"<div><h3>Background</h3><div>Out-of-hospital cardiac arrest affecting children may result in death or hypoxic brain injury, with potentially devastating consequences for children, families, and societies. Efforts to reduce this impact require sound knowledge of current epidemiology. This protocol outlines a study of the epidemiology of out-of-hospital cardiac arrest in persons aged &lt;18 years across 28 European countries.</div></div><div><h3>Methods/design</h3><div>The European Registry of Cardiac Arrest (EuReCa) THREE study, a prospective, multi-centre cohort study, collected data for cases of out-of-hospital cardiac arrest between September 1st and November 30th 2022. This paediatric substudy will analyse features of cardiac arrests in children. Subsequently, the paediatric group will be compared to a cohort of younger adults (18–65 years) to identify differences. Incidences of out-of-hospital cardiac arrest will be calculated using relevant population data and presented per 100,000 child- and person-years for participating countries and overall, alongside national groupings of precipitating causes underlying cardiac arrest. Logistic regression will be performed to identify modifiable factors impacting the outcomes survived event and survival to hospital discharge or 30 days. Independent variables will include features of cardiac arrest, including presumed cause, witnessed status, shockable rhythm, epidemiological, and resuscitation factors. Logistic regression analysis results will be displayed in tables, and statistical significance set at the 0.05 level.</div></div><div><h3>Discussion</h3><div>The results will be used to identify possible targets for preventing cardiac arrest, e.g. by raising awareness of important causes among the public and healthcare providers. Furthermore, the study may identify opportunities for optimising resuscitation chains in Europe to improve outcomes.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"26 ","pages":"Article 101081"},"PeriodicalIF":2.4,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145049488","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":"Impact of extended eligibility criteria on survival after veno-arterial extracorporeal membrane oxygenation for refractory cardiac arrest: a 8-year single-center study","authors":"Bjarke Risgaard ,&nbsp;Sebastian Wiberg ,&nbsp;Jesper Kjærgaard ,&nbsp;André Martin Korshin ,&nbsp;Lene Holmvang ,&nbsp;Jacob Eifer Møller ,&nbsp;Peter Hasse Møller-Sørensen","doi":"10.1016/j.resplu.2025.101084","DOIUrl":"10.1016/j.resplu.2025.101084","url":null,"abstract":"<div><h3>Aim</h3><div>Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) may improve survival in refractory in- or out-of-hospital cardiac arrest (IHCA/OHCA), yet optimal selection criteria remain uncertain. We aimed to report contemporary survival rates after VA-ECMO for cardiac arrest (E-CPR) and to explore prognostic significance of extended criteria in improving patient selection.</div></div><div><h3>Methods</h3><div>We conducted an observational single-center study of patients treated with E-CPR from 2017 to 2024. Patients were stratified according to four extended inclusion criteria in favor of E-CPR (arterial pH &gt; 6.8, lactate &lt; 15  mmol/L, low-flow time &lt; 100  min, signs of life during CPR). Primary outcome was 180-day survival.</div></div><div><h3>Results</h3><div>Of 159 patients included, 59 (37 %) were alive at 180 days, and 82 % of survivors had favorable neurological outcomes. Transient ROSC (OR 0.25, 95 % CI 0.13–0.49) and signs of life during CPR (OR 0.37, 95 % CI 0.19–0.75) were associated with lower mortality in univariate analysis. In multivariate analysis, only age (OR 1.03, 95 % CI 1.00–1.06) and transient ROSC (OR 0.25, 95 % CI 0.11–0.56) remained independently associated with 180-day mortality. Kaplan-Meier survival analysis showed significant differences between groups (log-rank <em>p</em> &lt; 0.05), with survival ranging from 21 % in patients meeting none or one criterion in favor of E-CPR to 56 % in those meeting all four.</div></div><div><h3>Conclusion</h3><div>In this single-center cohort, we observed a 180-day survival rate of 38 % among patients treated with E-CPR for refractory cardiac arrest. Notably, our study suggests acceptable survival rates of 21 % even in patients with an adverse risk profile.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"26 ","pages":"Article 101084"},"PeriodicalIF":2.4,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145049487","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":"Journal Club Article: The STEROHCA trial – Optimizing post resuscitation haemodynamics by prehospital high dose corticosteroids","authors":"Sebastian Billig ,&nbsp;Jennifer Dermer ,&nbsp;Lykke Kjærsgaard ,&nbsp;Joseph Hamilton ,&nbsp;Joyce Yeung","doi":"10.1016/j.resplu.2025.101078","DOIUrl":"10.1016/j.resplu.2025.101078","url":null,"abstract":"","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"26 ","pages":"Article 101078"},"PeriodicalIF":2.4,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145019563","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":"Traumatic cardiac arrest in older adults in the United States","authors":"Aditya C. Shekhar ,&nbsp;Zachary Kuschner ,&nbsp;Michael Altman-Ezzard ,&nbsp;Jennifer Carter ,&nbsp;Bojana Milekic ,&nbsp;Michael Redlener ,&nbsp;Ethan E. Abbott ,&nbsp;Benjamin S. Abella ,&nbsp;Yuji Yamada","doi":"10.1016/j.resplu.2025.101076","DOIUrl":"10.1016/j.resplu.2025.101076","url":null,"abstract":"<div><h3>Introduction</h3><div>Traumatic cardiac arrest is associated with lower survival rates compared with other arrest etiologies. Relatively little research has examined potential variation in traumatic cardiac arrest parameters as a function of patient age. We hypothesize that traumatic cardiac arrest in the older adult population may be appreciably different with regards to demographics and clinical features from traumatic cardiac arrest in other age groups.</div></div><div><h3>Methods</h3><div>We examined a nationally-representative database of emergency medical services (EMS) activations in the United States (NEMSIS). We included all adult (≥18 years) out-of-hospital cardiac arrests responded to by ground ambulance EMS crews in 2022 and 2023 documented as having a traumatic etiology. Arrests were grouped based on whether they involved adult patients (18–60 years) or older adult patients (61+ years) based on pre-existing classifications within the dataset. Key arrest data were compared across the two groups using two-tailed two-proportion z-tests; significance was defined as <em>p</em> &lt; 0.05.</div></div><div><h3>Results</h3><div>Across 10,573 older adult (61+ years) traumatic cardiac arrests and 34,203 adult (18–60 years) traumatic cardiac arrests, traumatic cardiac arrests in older adults were less likely to be witnessed (35.9 % vs. 39.5 %; <em>p</em> &lt; 0.00001), less likely to receive pre-EMS cardiopulmonary resuscitation (CPR) (29.7 % vs. 33.1 %; <em>p</em> &lt; 0.00001), more likely to be initially-shockable (3.7 % vs. 2.4 %; <em>p</em> &lt; 0.00001), and more likely to achieve return of spontaneous circulation (ROSC) (11.3 % vs. 7.5 %; <em>p</em> &lt; 0.00001). Traumatic cardiac arrests in older adults were also less likely to be associated with mass casualty incidents (MCIs) (0.7 % vs. 0.9 %; <em>p</em> = 0.02642) or the use of alcohol/drugs (3.5 % vs. 6.4 %; <em>p</em> &lt; 0.00001).</div></div><div><h3>Conclusion</h3><div>Our analysis of a large and nationally-representative database of EMS activations in the United States reveals traumatic cardiac arrest in older adults is associated with several key differences. Further study is needed to identify potential mechanisms underpinning these differences and develop approaches to mitigate the risk of traumatic cardiac arrest across all ages.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"26 ","pages":"Article 101076"},"PeriodicalIF":2.4,"publicationDate":"2025-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145019564","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":"Rethinking the 2-minute rule in adult basic life support cardiopulmonary resuscitation","authors":"Emma Menant ,&nbsp;Guillaume Debaty ,&nbsp;Janet Bray ,&nbsp;Thomas Rea ,&nbsp;Xavier Jouven","doi":"10.1016/j.resplu.2025.101070","DOIUrl":"10.1016/j.resplu.2025.101070","url":null,"abstract":"<div><div>The standard 2-minute cycle of cardiopulmonary resuscitation (CPR) followed by rhythm analysis has long guided out-of-hospital cardiac arrest basic life support. However, recent studies suggest this method may not optimize return of spontaneous circulation. Research shows most ventricular fibrillation recurrences occur within a minute post-shock, supporting earlier defibrillation and rhythm analysis during CPR to improve survival. Conversely, when no shock is needed, longer CPR durations may be more beneficial. This commentary article reviews the evolution of CPR guidelines and critically assesses new evidence, advocating for a re-evaluation of the 2-minute interval in favour of more flexible, patient-specific resuscitation strategies.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"26 ","pages":"Article 101070"},"PeriodicalIF":2.4,"publicationDate":"2025-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144989360","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":"Defibrillation: prevention, safety and literacy are key","authors":"D. Savary ,&nbsp;F. Morin ,&nbsp;L. Gargouri ,&nbsp;M. Servent ,&nbsp;A. Descatha","doi":"10.1016/j.resplu.2025.101077","DOIUrl":"10.1016/j.resplu.2025.101077","url":null,"abstract":"","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"26 ","pages":"Article 101077"},"PeriodicalIF":2.4,"publicationDate":"2025-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144925958","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":"Geospatial mapping of disparities in out-of-hospital cardiac arrests in the Swiss canton of Fribourg, 2018–2022: A retrospective observational study","authors":"Cynthia Gay ,&nbsp;Ludovic Galofaro ,&nbsp;Théophile Emmanouilidis ,&nbsp;Diane Blaser ,&nbsp;Sébastien Pugnale ,&nbsp;Dorian Garin ,&nbsp;Alexis Cogne ,&nbsp;Vincent Ribordy ,&nbsp;Youcef Guechi","doi":"10.1016/j.resplu.2025.101075","DOIUrl":"10.1016/j.resplu.2025.101075","url":null,"abstract":"<div><h3>Background</h3><div>Out-of-hospital cardiac arrest (OHCA) has a high mortality rate worldwide. A first responder (FR) and automated external defibrillator (AED) network was implemented to complement emergency medical services (EMS) in the Swiss canton of Fribourg. This study aims to assess geospatial disparities in FR deployment, AED usage and prehospital response efficiency relative to OHCA clusters.</div></div><div><h3>Methods</h3><div>This retrospective observational study analysed all OHCA cases recorded in the Swiss Registry of Cardiac Arrest between 2018 and 2022, which occurred in the canton of Fribourg. We used visual spatial mapping to illustrate clusters of OHCA survival and explore their relationship with FR presence and AED use, including outcome proportions in five predefined geographical zones. Multivariate exact logistic regression models were constructed to assess the impact of the five geographical zones in which OHCA occurred on survival to hospital discharge.</div></div><div><h3>Results</h3><div>Of 1127 OHCA included, 34 % had a FR on-site and an AED was used in 19 % of cases. All OHCA clusters corresponded to the most densely inhabited areas. Survival rates were highest in urban areas (8.5 %) but decreased to 3.6 % in sparsely populated zones. Cardiopulmonary resuscitation (CPR) performance and AED use by first responders or bystanders showed no statistically significant impact across geographic areas. Heatmaps of FR deployment showed a lower intensity in urban areas and a more even distribution across the territory. Despite a higher AED density in urban areas, usage remained low (12 %). By the end of 2022, 2050 FRs and 549 AEDs were registered in the canton, which remains below international recommendations.</div></div><div><h3>Conclusion</h3><div>Geospatial disparities highlighted the need for optimized FR recruitment, improved AED distribution and refined EMS activation strategies to enhance OHCA survival rates. These findings provide actionable insights for targeted resource allocation of the existing system at the cantonal level.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"26 ","pages":"Article 101075"},"PeriodicalIF":2.4,"publicationDate":"2025-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145019639","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":"Serum sodium trajectories impact clinical outcomes in extracorporeal resuscitation of cardiac arrest: A multicenter retrospective cohort study","authors":"Yu Amemiya ,&nbsp;Ryo Hisamune ,&nbsp;Kazuma Yamakawa ,&nbsp;Ryosuke Zushi ,&nbsp;Hitoshi Kobata ,&nbsp;Akihiko Inoue ,&nbsp;Toru Hifumi ,&nbsp;Tetsuya Sakamoto ,&nbsp;Yasuhiro Kuroda ,&nbsp;Akira Takasu","doi":"10.1016/j.resplu.2025.101074","DOIUrl":"10.1016/j.resplu.2025.101074","url":null,"abstract":"<div><h3>Background</h3><div>Dysregulation of serum sodium levels subsequent to out-of-hospital cardiac arrest (OHCA) has the potential to influence neurological outcomes. The patterns of sodium correction remain inadequately studied in individuals undergoing extracorporeal cardiopulmonary resuscitation (ECPR). This investigation aimed to elucidate the correlation between the trajectories of serum sodium concentration and clinical outcomes in patients subjected to ECPR.</div></div><div><h3>Methods</h3><div>This study was a secondary analysis of the SAVE-J II study, a retrospective multicenter registry targeting OHCA adult patients resuscitated with extracorporeal membrane oxygenation in Japan. Using the k-means clustering method, patients were categorized into four clinically relevant clusters: normal range, corrected hyponatremia, overcorrected, and high trend. The primary outcome was a favorable neurological outcome at 30 days, and the secondary outcome was survival at hospital discharge.</div></div><div><h3>Results</h3><div>Among the 400 patients who were resuscitated with extracorporeal membrane oxygenation, 170 (42.5 %) had favorable neurological outcomes, and 305 (76.3 %) survived to discharge. Multivariable analysis revealed that younger age (OR: 0.97, 95 % CI: 0.95–0.99), bystander cardiopulmonary resuscitation (OR: 1.92, 95 % CI: 1.19–3.14), and transient return of spontaneous circulation (OR: 1.89, 95 % CI: 1.01–3.55) were associated with favorable neurological outcomes. No significant differences in neurological outcomes were observed between the clusters. Patients in the overcorrected cluster demonstrated significantly lower odds of survival at discharge (OR: 0.33, 95 % CI: 0.15–0.73).</div></div><div><h3>Conclusions</h3><div>While overcorrection of serum sodium levels in OHCA patients receiving ECPR was not associated with neurological outcomes, it was independently associated with decreased survival to hospital discharge.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"26 ","pages":"Article 101074"},"PeriodicalIF":2.4,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144933469","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":"Leg reperfusion technique optimization and ischemia diagnosis using ultrasound in patients treated with extracorporeal life support for refractory cardiac arrest – An observational cohort study","authors":"Sebastian Voicu ,&nbsp;Sergey Gurevich ,&nbsp;Marinos Kosmopoulos ,&nbsp;Rajat Kalra ,&nbsp;Alejandra Gutierrez ,&nbsp;Deborah Jaeger ,&nbsp;Tamas Alexy ,&nbsp;Bruno Megarbane ,&nbsp;Jason Bartos ,&nbsp;Demetris Yannopoulos","doi":"10.1016/j.resplu.2025.101073","DOIUrl":"10.1016/j.resplu.2025.101073","url":null,"abstract":"<div><h3>Objectives</h3><div>Lower limb ischemia after extracorporeal life support for refractory cardiac arrest may be prevented by effective distal perfusion catheter (DPC) placement. We describe the prevalence of cannulated lower limb ischemia, the DPC technique and its improvements over time, and the blood flow velocities by doppler ultrasound associated with ischemia.</div></div><div><h3>Methods</h3><div>Retrospective single-centre study including patients ≥18 years-old receiving extracorporeal life support under cardiopulmonary resuscitation. Data is expressed as frequencies (percentages), compared using Fisher’s exact test. Logistic regression evaluated technical improvements associated with absence of ischemia. Blood flow velocity cutoffs associated with ischemia were determined according to receiver operator characteristics curves.</div></div><div><h3>Results</h3><div>We included 338 patients, 60[50–66] years-old. Survival to discharge was 24%.</div><div>DPC was placed under ultrasound guidance using stiff wires: initial technique. This was improved resulting in the optimized technique by distal perfusion catheter heparin perfusion, using &gt;12 cm-long sheaths, and using braided sheaths to avoid kinking. Cannulated lower limb ischemia occurred in 23/338 [6.8 %] in the overall population, in 10/77[13 %] with the initial technique and 13/261[5 %] with the optimized technique, p = 0.01. Braided sheaths were associated with absence of ischemia in multivariable analysis, odds ratio 0.18, 95 % confidence interval [0.045–0.65], p = 0.001. Blood flow velocity associated with ischemia was ≤17 cm/s in the mid-superficial femoral artery, and ≤12 cm/s in the more distal arteries.</div></div><div><h3>Conclusions</h3><div>Using the optimized distal perfusion catheter technique, ischemia prevalence was 5 %. Braided catheters were associated with absence of lower limb ischemia. Blood flow velocity thresholds associated with cannulated lower limb ischemia were ≤17 cm/s.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"26 ","pages":"Article 101073"},"PeriodicalIF":2.4,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144989361","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}