Resuscitation plus最新文献

{"title":"REPLY TO: Comments on the journal article entitled “Translation and pilot testing of the ReSPECT form into Danish” published in Resuscitation Plus May 2026","authors":"Zoe Fritz, Mette Aaby Smith","doi":"10.1016/j.resplu.2026.101388","DOIUrl":"10.1016/j.resplu.2026.101388","url":null,"abstract":"","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"30 ","pages":"Article 101388"},"PeriodicalIF":3.1,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13352395/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148427311","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":"The efficacy of a smartwatch-based haptic metronome in standardising chest compression rate: a crossover simulation study","authors":"Mehmet Erdi Yılmaz,&nbsp;Talha Karahan","doi":"10.1016/j.resplu.2026.101389","DOIUrl":"10.1016/j.resplu.2026.101389","url":null,"abstract":"<div><h3>Background</h3><div>High-quality chest compressions are crucial for effective resuscitation, yet maintaining the guideline-recommended rate of 100–120 compressions per minute is challenging, particularly in stressful and noisy prehospital environments. Haptic feedback delivered through wearable technology may offer a reliable alternative to auditory cues by providing tactile rhythm guidance.</div></div><div><h3>Objective</h3><div>To evaluate the efficacy of a smartwatch-based haptic feedback system delivering 110 vibrations per minute in improving adherence to the target chest compression rate during simulated adult cardiac arrest, compared with unassisted cardiopulmonary resuscitation (CPR).</div></div><div><h3>Methods</h3><div>In this prospective, experimental, simulation-based crossover study, 80 volunteers (paramedic students, intern physicians, emergency medicine residents, and laypersons; <em>n</em> = 20 each) performed one minute of self-paced chest compressions on a Laerdal Little Anne QCPR manikin and, after a five-minute rest, repeated the task with a Samsung Galaxy Watch 5 delivering haptic impulses at 110 bpm. The primary endpoint was the percentage of compressions performed within the 100–120 bpm target range; secondary endpoints were the proportion of participants achieving the target rate and self-reported user experience. The study was designed and is reported in accordance with the Reporting Guidelines for Health Care Simulation Research.</div></div><div><h3>Results</h3><div>Haptic guidance substantially improved the percentage of compressions within the guideline-recommended 100–120 bpm range. The proportion of participants achieving the target compression rate increased from 45.0% at baseline to 93.75% with smartwatch-assisted feedback (McNemar test, <em>p</em> &lt; 0.001). The mean percentage of compressions delivered within the target range rose from 43.55% during unassisted CPR to 90.71% with haptic guidance, and significant within-group improvements were observed across all four professional cohorts. Participant experience was highly positive: 93.75% endorsed the device for real-world clinical use, 95.00% found it useful for CPR training, and 95.00% expressed willingness to use it again.</div></div><div><h3>Conclusion</h3><div>A smartwatch-based haptic metronome significantly improved adherence to the guideline-recommended chest compression rate across all experience levels. Given its high user acceptability and resilience to environmental noise, this wearable technology may provide a practical, low-cost adjunct to improve CPR quality in both training and prehospital settings.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"30 ","pages":"Article 101389"},"PeriodicalIF":3.1,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13351885/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148427329","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":"Basic life support knowledge transfer from schoolchildren to family members and friends: a scoping review and preliminary conceptual framework for training implementation","authors":"María García-Martínez,&nbsp;Santiago Martínez-Isasi,&nbsp;María Sobrido-Prieto,&nbsp;Luis Castro-Alonso,&nbsp;Antonio Rodríguez-Núñez","doi":"10.1016/j.resplu.2026.101407","DOIUrl":"10.1016/j.resplu.2026.101407","url":null,"abstract":"<div><h3>Introduction</h3><div>Out-of-hospital cardiac arrest is a leading cause of death in Europe, with most events occurring at home. Early recognition and initiation of resuscitation improve survival and neurological outcomes, yet they are not consistently performed by bystanders. School-based initiatives such as “Kids Save Lives” promote basic life support (BLS) training and encourage schoolchildren to disseminate this knowledge within their families. However, evidence on how this transfer occurs and how it can be assessed remains limited.</div></div><div><h3>Aim</h3><div>To map how BLS knowledge transfer from schoolchildren to family members and friends has been implemented and evaluated, and to identify potential key limitations for measurement and reporting.</div></div><div><h3>Methods</h3><div>A scoping review was conducted following PRISMA-ScR. Searches were performed in PubMed, Scopus, and Web of Science in February 2026. Studies involving adolescents (10–19 years) trained in BLS at school who subsequently taught family members and friends were included. Evidence was synthetized descriptively, focusing on training characteristics, transfer processes, and reported outcomes.</div></div><div><h3>Results</h3><div>Four quasi-experimental studies and one prospective observational study were included. Training was mainly based on self-instruction kits, and knowledge transfer was typically conducted without supervision. Outcomes focused primarily on theoretical knowledge, with limited assessment of practical skills or long-term retention. The reported multiplier effect ranged from 0.33 to 4.9, with substantial variability and inconsistent measurement.</div></div><div><h3>Conclusion</h3><div>Schoolchildren may act as transmitters of BLS knowledge to family members and friends, but current evidence is limited, heterogeneous, and largely based on indirect or self-reported outcomes. More structured and standardized approaches are needed to better understand, evaluate, and optimize this potentially relevant knowledge transfer process.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"30 ","pages":"Article 101407"},"PeriodicalIF":3.1,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148634666","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":"Step-by-step: Translating deliberate practice to the bedside","authors":"Maya Harel-Sterling,&nbsp;Tasuku Takadera,&nbsp;Elana Thau,&nbsp;Laura Simone,&nbsp;Deborah Schonfeld,&nbsp;Jabeen Fayyaz,&nbsp;Noa Kvatinsky,&nbsp;Sasha Litwin,&nbsp;Lianne McLean","doi":"10.1016/j.resplu.2026.101410","DOIUrl":"10.1016/j.resplu.2026.101410","url":null,"abstract":"","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"30 ","pages":"Article 101410"},"PeriodicalIF":3.1,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148737190","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":"Knowledge, attitudes, and applied practices regarding “Do Not Attempt Resuscitation” among healthcare workers in Aljouf, Saudi Arabia: a multicenter cross-sectional questionnaire-based survey","authors":"Hana Felemban,&nbsp;Farid Merzoug,&nbsp;Bassam Alshammari,&nbsp;Aiman Alshammari,&nbsp;Bandar Alruwaili","doi":"10.1016/j.resplu.2026.101411","DOIUrl":"10.1016/j.resplu.2026.101411","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Do Not Attempt Resuscitation (DNAR) decisions are ethically and clinically complex, shaped by prognostic uncertainty, communication barriers, and sociocultural factors. In Saudi Arabia, Fatwa No. 12086 and Ministry of Health national policy permit withholding cardiopulmonary resuscitation (CPR) without family consent when three qualified physicians deem resuscitation futile. Despite this established framework, inconsistent DNAR implementation persists across Saudi clinical settings.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;div&gt;To assess the knowledge, attitudes, and applied practices regarding DNAR among multidisciplinary healthcare workers (HCWs) in the Aljouf region of northern Saudi Arabia and to identify barriers to its consistent implementation.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;In this multicenter cross-sectional survey, 461 licensed HCWs, including physicians, nurses, and allied health professionals, from 10 hospitals and 7 primary healthcare centers across the Aljouf region completed a structured, bilingual, self-administered online questionnaire between September 20 and November 15, 2025. Data were analyzed using descriptive statistics, the Kruskal–Wallis test with Bonferroni-corrected post-hoc comparisons, and multivariable logistic regression to identify independent predictors of high knowledge scores. Exposures and outcomes were defined a priori.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Overall, 96% of participants achieved satisfactory knowledge scores (≥60%), with a median score of 9 out of 10 (IQR: 8–9). However, two clinically critical gaps were identified: only 52.9% correctly recognized that family consent is not legally required for DNAR in Saudi Arabia, and only 51.2% identified the correct management of cardiac arrest following confirmed brain death. Physicians scored significantly higher than nurses, technicians, and pharmacists (Kruskal–Wallis, &lt;em&gt;p&lt;/em&gt; = 0.0003). In multivariable logistic regression, prior direct involvement in a DNAR decision was the strongest independent predictor of high knowledge (OR 2.39; 95% CI 1.11–5.16; &lt;em&gt;p&lt;/em&gt; = 0.03), while nurses were approximately 50% less likely than physicians to achieve a high knowledge score (OR 0.50; 95% CI 0.29–0.83; &lt;em&gt;p&lt;/em&gt; = 0.008). Although 78.3% considered DNAR ethically necessary and 82.2% agreed it protects patients from unnecessary suffering, 78.5% found family discussions challenging and 83.1% acknowledged strong cultural influences on DNAR decisions. Only 55.1% knew where to locate their institutional DNAR protocol.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;This study suggests that, although most HCWs appear to possess adequate theoretical knowledge of DNAR policy, two clinically critical gaps were identified: widespread misconception that family consent is legally required and poor understanding of cardiac arrest management following confirmed brain death. Acknowledging the limitations of convenience sampling and potential self-select","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"30 ","pages":"Article 101411"},"PeriodicalIF":3.1,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13396893/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148586479","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":"First real-world implementation of video-based emergency calls (VEC) in Germany: from vision to reality","authors":"Henning Schmidtpott,&nbsp;Felix Reiser,&nbsp;Erik Lachfeld,&nbsp;Sebastian Heinrich,&nbsp;Julian Ganter","doi":"10.1016/j.resplu.2026.101398","DOIUrl":"10.1016/j.resplu.2026.101398","url":null,"abstract":"<div><div>Emergency call handling relies primarily on verbal information, which is often constrained by stress, language barriers, and limited situational awareness. This article describes the conceptual design and real-world implementation of video-assisted emergency calls (VEC) at the Freiburg dispatch center (Public Safety Answering Point, PSAP). Building on longstanding experience with innovative digital dispatch solutions, the Freiburg system integrates real-time video as a dispatcher-controlled, supplementary information channel, next to the voice call, within existing emergency call workflows. The approach is characterized by defined cases, standardized activation procedures, dedicated dispatcher training including psychological safeguards, and a security-focused IT architecture separated from critical dispatch infrastructure. The Freiburg model demonstrates a structured, pragmatic, and scalable pathway for responsibly integrating live video into emergency dispatch operations.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"30 ","pages":"Article 101398"},"PeriodicalIF":3.1,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13380737/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148521826","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":"Consistency of definitions used in International Liaison Committee on Resuscitation Neonatal Life Support documents","authors":"Ruth Guinsburg,&nbsp;Maria Fernanda de Almeida,&nbsp;Bobbi J. Byrne,&nbsp;Emer Finan,&nbsp;Jorge Fabres,&nbsp;Mandira D. Kawakami,&nbsp;Marije Hogeveen,&nbsp;Mario Rüdiger,&nbsp;Yacov Rabi,&nbsp;Georg M. Schmölzer,&nbsp;Myra H. Wyckoff,&nbsp;Gary M. Weiner,&nbsp;Helen G. Liley","doi":"10.1016/j.resplu.2026.101414","DOIUrl":"10.1016/j.resplu.2026.101414","url":null,"abstract":"<div><h3>Introduction</h3><div>The International Liaison Committee on Resuscitation (ILCOR) disseminates scientific evidence reviews and neonatal resuscitation treatment recommendations through its Neonatal Life Support Task Force. Clear and consistent terminology is essential when developing clinical guidelines for international stakeholders. The objective of this study was to assess the consistency of the terms and definitions used in Neonatal Life Support Task Force documents related to participants, interventions and outcomes.</div></div><div><h3>Methods</h3><div>Investigators manually searched four types of Neonatal Life Support Task Force documents, including (1) protocols for reviews and (2) treatment recommendations published since 2019, (3) 2020 consensus outcome ratings, and (4) 2023 guidelines for uniform reporting for resuscitation-related terminology. Only terms defined in at least two documents were included. Investigators from the Neonatal Life Support Task Force and invited content experts reviewed the included terms and definitions for consistency.</div></div><div><h3>Results</h3><div>A total of 227 unique resuscitation terms with explicit definitions were extracted from 67documents. After exclusion of 164 terms defined in only a single document, the definitions of 63 terms were assessed for consistency. The definitions of 23 (37%) terms were judged to be similar across documents. The remaining terms had inconsistencies in definitions used for the same term or for similar constructs using different terms.</div></div><div><h3>Conclusion</h3><div>Greater consistency of terminology within Neonatal Life Support Task Force documents has the potential to improve communication between researchers, clinicians, and educators. Additionally, variation in terminology may hinder evidence synthesis in systematic reviews. Efforts to develop consensus definitions for terms used in ILCOR documents are needed.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"30 ","pages":"Article 101414"},"PeriodicalIF":3.1,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148634658","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":"Late neurologic and functional outcomes in patients with severe anoxic brain injury after cardiopulmonary arrest: a multicenter cohort study","authors":"Jayne Chu,&nbsp;Doanh Ly,&nbsp;Y. Pham,&nbsp;Aileen Freer,&nbsp;Minetta Ralleca,&nbsp;Marlon Caballero,&nbsp;Baby Lyn Abadilla,&nbsp;Craig Hou","doi":"10.1016/j.resplu.2026.101415","DOIUrl":"10.1016/j.resplu.2026.101415","url":null,"abstract":"<div><h3>Background</h3><div>Neurological prognostication after cardiac arrest remains challenging, and most patients with severe anoxic brain injury have an indeterminate prognosis despite multimodal assessment. Although delayed awakening has been reported in the era of targeted temperature management, long-term functional outcomes in this population remain poorly described.</div></div><div><h3>Methods</h3><div>We conducted a retrospective multicenter cohort study across 18 hospitals to assess the late neurologic and functional outcomes of patients with severe anoxic-ischemic brain injury after cardiopulmonary arrest. Patients who were hospitalized between Jan 1, 2018 and Jan 1, 2023 with anoxic brain injury due to cardiopulmonary arrest were included if they were functionally independent at baseline (CPC 1–2) but remained comatose or in an unresponsive wakefulness syndrome (UWS)/vegetative state at 2 weeks. To study the natural course of disease, we included only patients whose families wanted to continue life-sustaining treatment at the time of inclusion, and those who survived at least three weeks after arrest. Neurological and functional outcomes were assessed longitudinally for up to 12 months using the Cerebral Performance Category (CPC) scale.</div></div><div><h3>Results</h3><div>A total of 169 patients met inclusion criteria (mean age 52.9 years). Initial hospitalization was prolonged (mean length of stay 61.2 days). Twenty-seven patients died before hospital discharge. Of the 142 patients discharged, an additional 40 died within 12 months, for a total of 67 deaths (39.6%). Forty-four of these deaths were due to eventual withdrawal of life support, due to deteriorating medical status with superimposed medical complications. Among the 102 patients alive at 12 months, 99 remained severely disabled (CPC 3–4). Only three patients (1.8% of the cohort) regained CPC 1–2 at 12 months.</div></div><div><h3>Conclusions</h3><div>In this large multicenter cohort of patients with severe anoxic brain injury who remained comatose or in a UWS/vegetative state at two weeks, functional recovery with CPC 1–2 at 12 months was rare. Although delayed neurological improvement may occur, favorable functional recovery was rare and prolonged aggressive care was most often associated with death or severe long-term disability. These findings provide additional outcome data to inform neuroprognostication and goals-of-care discussions after cardiac arrest.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"30 ","pages":"Article 101415"},"PeriodicalIF":3.1,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148634663","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":"Extracorporeal cardiopulmonary resuscitation for in-hospital cardiac arrest: a comparative cohort study from the first ECPR program in Brazil","authors":"Daniel Joelsons,&nbsp;Bruno de Arruda Bravim,&nbsp;Gustavo Saliba,&nbsp;Barbara Rubim Alves,&nbsp;Roberto Rabello Filho,&nbsp;Flávia Baldavira Hirano,&nbsp;Michele Jaures,&nbsp;Renato Carneiro de Freitas Chaves,&nbsp;Rogerio da Hora Passos","doi":"10.1016/j.resplu.2026.101386","DOIUrl":"10.1016/j.resplu.2026.101386","url":null,"abstract":"<div><h3>Background</h3><div>Extracorporeal cardiopulmonary resuscitation (ECPR) is a rescue therapy for refractory in-hospital cardiac arrest (IHCA), but Brazilian data are scarce. We compared ECPR with conventional CPR (cCPR) at the first Brazilian center with a protocolized ECPR program.</div></div><div><h3>Methods</h3><div>Retrospective single-center cohort at Einstein Hospital Israelita, São Paulo. Adults (18–75 years) with witnessed and refractory IHCA fulfilling institutional ECPR eligibility were included. The cCPR cohort (2017–2025) comprised eligible patients who did not receive ECPR due to absence of 24/7 ECMO coverage; the ECPR cohort (2020–2025) included all protocolized cases. The primary outcome was hospital survival with favorable neurological outcome (Cerebral Performance Category, CPC, of 2 or less). Groups were compared descriptively; survival was estimated by the Kaplan-Meier method with the log-rank test, and the absolute risk reduction and number needed to treat were calculated.</div></div><div><h3>Results</h3><div>Thirty-eight patients were analyzed (16 ECPR, 22 cCPR). Hospital survival was higher in the ECPR group (43.7% vs 13.6%, <em>p</em> = 0.04), corresponding to an absolute risk reduction of 30.1% (95% CI 1.9–58.3) and a number needed to treat of 4. Estimated 30-day survival was 50.0% versus 12.1% (log-rank <em>p</em> = 0.02). All survivors achieved CPC of 2 or less. The groups differed substantially at baseline, including in age and sex.</div></div><div><h3>Conclusions</h3><div>In this first Brazilian single-center cohort, hospital survival was higher and neurological recovery uniformly favorable among patients treated with ECPR for refractory IHCA. These descriptive findings are hypothesis-generating and support the feasibility of a structured in-hospital ECPR program in the Brazilian setting.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"30 ","pages":"Article 101386"},"PeriodicalIF":3.1,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13316195/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148364675","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":"Regional cerebral oxygen saturation as an adjunctive tool for termination-of-resuscitation decisions in out-of-hospital cardiac arrest: a prospective observational study","authors":"Chun‑Yen Huang,&nbsp;Jen-Tang Sun,&nbsp;Chiao-Yin Cheng,&nbsp;Chih‑Jung Chang,&nbsp;Sheng-En Chu,&nbsp;Chih-Yueh Chang,&nbsp;Thi-Chau-Loan Phan,&nbsp;Chih-Hung Wang,&nbsp;Wen-Chu Chiang,&nbsp;Yao-Jen Liang","doi":"10.1016/j.resplu.2026.101399","DOIUrl":"10.1016/j.resplu.2026.101399","url":null,"abstract":"<div><h3>Background</h3><div>Widely accepted in-hospital termination-of-resuscitation (TOR) rules are currently lacking, and existing approaches do not incorporate real-time physiological monitoring. Regional cerebral oxygen saturation (rSO₂) has been associated with return of spontaneous circulation (ROSC) during cardiopulmonary resuscitation (CPR), but its role in TOR assessment remains unclear.</div></div><div><h3>Methods</h3><div>In this prospective observational study, adult patients with out-of-hospital cardiac arrest who underwent resuscitation with cerebral oximetry monitoring in the emergency department were enrolled. The primary objective was to identify low rSO₂ thresholds associated with failure to achieve ROSC. Futility-based threshold analyses were performed, with an emphasis on specificity for predicting non-ROSC cases and the corresponding residual risk of ROSC.</div></div><div><h3>Results</h3><div>Of 408 screened patients, 145 were included and 59 (40.9%) achieved ROSC. No patient achieved ROSC when cumulative peak rSO₂ remained &lt;46% on the left side (0/23) or &lt;47% on the right side (0/29) within the first 30 min of CPR. The corresponding observed specificity for non-ROSC was 100% in this cohort, although the exact 95% confidence intervals for residual ROSC risk were 0.0–14.8% and 0.0–11.9%, respectively.</div></div><div><h3>Conclusion</h3><div>Low cumulative peak rSO₂ thresholds identified subgroups with no observed ROSC and high specificity for non-ROSC in this cohort. Cerebral oximetry may provide adjunctive, prospectively observable physiological information for TOR-oriented assessment during resuscitation, although these thresholds are exploratory and require external validation.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"30 ","pages":"Article 101399"},"PeriodicalIF":3.1,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148567318","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}