Resuscitation plus最新文献

{"title":"Haemodynamic changes and mean airway pressure threshold in extremely preterm infants (22–24 weeks of gestation) with tension pneumothorax","authors":"Tomonori Kurimoto,&nbsp;Takuya Tokuhisa,&nbsp;Asataro Yara,&nbsp;Masaya Kibe,&nbsp;Hiroshi Ohashi,&nbsp;Masakatsu Yamamoto,&nbsp;Tsuyoshi Yamamoto,&nbsp;Eiji Hirakawa","doi":"10.1016/j.resplu.2025.100954","DOIUrl":"10.1016/j.resplu.2025.100954","url":null,"abstract":"<div><h3>Background</h3><div>Extremely preterm infants (22–24 weeks of gestation) are at high risk of tension pneumothorax, a life-threatening condition that causes haemodynamic instability. This study aimed to analyse the haemodynamic changes associated with tension pneumothorax and identify the mean airway pressure (MAP) threshold associated with its onset.</div></div><div><h3>Methods</h3><div>This retrospective descriptive study was conducted in a Level III Neonatal Intensive Care Unit (NICU) (2014–2024). Infants born between 22 + 0 to 24 + 6 weeks of gestation who developed tension pneumothorax within 72 h of birth were included. Haemodynamic parameters, including central venous pressure (CVP), mean arterial pressure (mBP), heart rate (HR), saturation of percutaneous oxygen (SpO₂), fraction of inspired oxygen (FiO₂), and MAP, were analysed at baseline, pneumothorax onset, and post-decompression. Statistical analyses included the Wilcoxon signed-rank test and generalised linear mixed model (GLMM).</div></div><div><h3>Results</h3><div>The CVP significantly increased at the onset of pneumothorax (<em>p</em> = 0.004) and decreased post-intervention (<em>p</em> = 0.004). The mBP and HR declined at onset (<em>p</em> = 0.0005) and partially recovered post-intervention. MAP was significantly higher at onset (<em>p</em> = 0.003), and GLMM analysis showed that an MAP increase of ≥1.3 cmH₂O was associated with pneumothorax risk.</div></div><div><h3>Conclusions</h3><div>A sudden increase in CVP may serve as an early indicator of tension pneumothorax. An MAP threshold of ≥12 cmH₂O was linked to higher pneumothorax risk, emphasising the need for cautious ventilatory management. Persistent haemodynamic instability after decompression highlights the need for close monitoring. Further studies are required to refine the neonatal care strategies.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"23 ","pages":"Article 100954"},"PeriodicalIF":2.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143916925","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":"Rib fractures after chest compressions for cardiac arrest: retrospective analysis of the AfterROSC1 and AfterROSC2 multicenter databases","authors":"Ivan Hemery-Allier ,&nbsp;Wulfran Bougouin ,&nbsp;Alain Cariou ,&nbsp;Julien Lorber ,&nbsp;Jeremy Bourenne ,&nbsp;Francois Javaudin ,&nbsp;Gwenhael Colin ,&nbsp;Nicolas Chudeau ,&nbsp;Marine Paul ,&nbsp;Guillaume Geri ,&nbsp;Jean Baptiste Lascarrou ,&nbsp;AfterROSC Network","doi":"10.1016/j.resplu.2025.100968","DOIUrl":"10.1016/j.resplu.2025.100968","url":null,"abstract":"<div><h3>Purpose</h3><div>External chest compressions for resuscitation after out-of-hospital cardiac arrest (OHCA) can cause rib fractures, which are best diagnosed by computed tomography (CT). We assessed the prevalence, management, and associations with outcomes of CT-documented rib fractures in patients with OHCA.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed data collected prospectively at five AfterROSC Network centers in 2020–2023. We included consecutive patients with return of spontaneous circulation and coma after non-traumatic OHCA who underwent CT within 6 h after admission. Rib fractures and other chest-wall injuries were recorded. Associations with the day-90 functional outcome were sought. Analgesic treatment was compared between patients with 0–2 vs. ≥3 rib fractures.</div></div><div><h3>Results</h3><div>Of 2129 patients, 233 (11%) underwent chest CT, which showed at least one rib fracture in 116 (50%). The mean number of rib fractures was 2.4 ± 3.4 and the median was 0 [0–4]. One patient had clinical flail chest. In patients with ≥3 rib fractures, the mean modified Cardiac Arrest Hospital Prognosis (mCAHP) score was higher (91 ± 23 vs. 82 ± 25) and a favorable day-90 neurological outcome (modified Rankin Scale score 0–3) was significantly less common, even after adjustment on mCAHP (18% vs. 35%; adjusted odds ratio, 0.37 [0.19–0.72]; <em>P</em> = 0.003). Analgesic therapy was not significantly different between patients with 0–2 and ≥3 rib fractures.</div></div><div><h3>Conclusions</h3><div>Rib fractures related to chest compressions are common in OHCA survivors. Having ≥3 rib fractures was associated with a poorer prognosis after adjustment on cardiac-arrest characteristics. The management of pain related to rib fractures may require reappraisal.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"24 ","pages":"Article 100968"},"PeriodicalIF":2.1,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143937766","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":"Bystander availability, CPR uptake, and AED use during out-of-hospital cardiac arrest","authors":"David B. Sidebottom ,&nbsp;Robyn Painting ,&nbsp;Charles D. Deakin","doi":"10.1016/j.resplu.2025.100969","DOIUrl":"10.1016/j.resplu.2025.100969","url":null,"abstract":"<div><h3>Background</h3><div>Bystander cardiopulmonary resuscitation (CPR) and defibrillation of a shockable rhythm improve survival following out-of-hospital cardiac arrest (OHCA). Little data exists on bystander participation during genuine cardiac arrest calls.</div></div><div><h3>Method</h3><div>This was a prospective audit of bystander participation during OHCA calls to a single ambulance service in the United Kingdom. A convenience sample of consecutive OHCA calls from March 2022 until April 2023, where an adult cardiac arrest was confirmed and CPR was advised, was audited by a call handler. Cases with a valid do not attempt CPR decision were excluded. Data on key time intervals and bystander participation were extracted and analysed in R (v4.2).</div></div><div><h3>Results</h3><div>In total, 451 cases were analysed. Median time until cardiac arrest recognition was 42 s (IQR 94.7 s) and until the initiation of CPR was 161 s (IQR 124 s). A lone bystander was present in 162 (35.9%) cases, two bystanders in 149 (33.0%) cases, and three or more bystanders in 140 (31.0%) cases. CPR was attempted by a bystander in 382 (84.7%) cases. Physical inability, refusal, and inability to correctly position patient were common reasons for not performing CPR. A defibrillator was retrieved before the arrival of emergency medical services in 36 (8%) cases and a shock was administered in 9 (2%) cases, while a shock was not advised in 20 (4%) further cases.</div></div><div><h3>Conclusion</h3><div>Cardiac arrest was identified rapidly but there was a delay to initiation of CPR. A lone bystander was present in over one third of cases, eliminating the possibility of bystander defibrillation in the absence of a lay first responder.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"24 ","pages":"Article 100969"},"PeriodicalIF":2.1,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144098444","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":"Physicians’ opinion of patients’ CPR decision: Secondary analysis from a pilot RCT","authors":"Stephanie Ji ,&nbsp;Alexa Pisciotti ,&nbsp;Mitsu Patel ,&nbsp;Catherine Chen ,&nbsp;Michael B. Steinberg ,&nbsp;Karthik J. Kota","doi":"10.1016/j.resplu.2025.100967","DOIUrl":"10.1016/j.resplu.2025.100967","url":null,"abstract":"<div><h3>Background</h3><div>While patients in the United States generally have final say in their code status, discussion with their physician plays an important role in decision-making. However, physicians do not discuss code status with every patient, and do not consistently mention patients’ prognosis following cardiopulmonary resuscitation (CPR). Understanding how physicians perceive patients’ CPR decisions is prerequisite to improving code status discussions.</div></div><div><h3>Methods</h3><div>We report a planned secondary analysis from a prospective randomized controlled trial of 102 English-speaking adults aged ≥65 evaluating whether “Allow Natural Death” was preferred to “Do Not Resuscitate” as the “no code” option in code status discussions. We measured physician agreement/disagreement with patient code status decisions and the correlation with objective outcome measures. Two clinically validated instruments—measuring likelihood of surviving resuscitation (Good Outcomes Following Attempted Resuscitations (GO-FAR)) and morbidity level/1- and 10-year mortality (Charlson Comorbidity Index (CCI))—were calculated for each participant.</div></div><div><h3>Results</h3><div>Physicians agreed with patients’ code status decisions 88.3% of the time. Physician agreement with code status was not correlated with GO-FAR or CCI scores. GO-FAR and CCI scores do not always align, indicating that illness severity and CPR outcome are not directly linked.</div></div><div><h3>Conclusions</h3><div>This study highlights that while physicians tend to agree with patient’s code status, their decisions do not align with data from clinically validated predictors of coding success or illness severity/mortality prediction. Further research is required as to how physicians perceive whether attempting CPR is appropriate or not.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"24 ","pages":"Article 100967"},"PeriodicalIF":2.1,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143946852","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":"Pulse check accuracy in pediatrics during resuscitation: a systematic review","authors":"Stephan Katzenschlager ,&nbsp;Jason Acworth ,&nbsp;Lokesh Kumar Tiwari ,&nbsp;Monica Kleinmann ,&nbsp;Michelle Myburgh ,&nbsp;Jimena del Castillo ,&nbsp;Vinay Nadkarni ,&nbsp;Thomaz Bittencourt Couto ,&nbsp;Janice A. Tijssen ,&nbsp;Laurie J. Morrison ,&nbsp;Allan DeCaen ,&nbsp;Barnaby R. Scholefield ,&nbsp;International Liaison Committee on Resuscitation ILCOR ILCOR Pediatric Life Support Task Force","doi":"10.1016/j.resplu.2025.100959","DOIUrl":"10.1016/j.resplu.2025.100959","url":null,"abstract":"<div><h3>Aim of the study</h3><div>Current guidelines advise rescuers to initiate cardiopulmonary resuscitation if a child is unresponsive, not breathing normally, and shows no signs of life. Manual pulse checks are considered unreliable and time-consuming. This systematic review evaluates the accuracy and duration of recommended pulse check methods during pediatric cardiac arrest and explores emerging diagnostic techniques.</div></div><div><h3>Methods</h3><div>For this systematic review (PROSPERO ID CRD42024549535) three databases (PubMed, Embase, and Cochrane) were searched for articles published on this topic. An initial search was conducted on April 24, 2024, with an updated search using the same search strategy on February 16, 2025. Two authors independently screened the articles. One author extracted the data while a second author double-checked it. Quality and certainty of the evidence were evaluated using the QUADAS-2 and GRADE tools evaluated the evidence’s quality and certainty. Studies were included if they compared manual pulse checks against alternative pulse check sites or other methods in pediatric patients. The data is presented descriptively.</div></div><div><h3>Results</h3><div>A total of three studies were included. These studies involved 39 pediatric patients and a total of 376 pulse checks. Out of the 47 infants and children included, only 14 were in cardiac arrest. The remaining 33 patients were on mechanical circulatory support with either VA-ECMO or LVAD. In total, 183 nurses and 181 physicians performed 376 pulse or ultrasound checks. Due to their specialty, 122 nurses and 89 doctors were classified as experienced. Sensitivity and specificity of manual pulse check ranged from 76 to 100% and 64–79%, respectively. When experienced providers conducted pulse checks, sensitivity and specificity were higher (76–100% and 62–82%, respectively) compared to inexperienced providers (67–82% and 44–95%).</div><div>The mean duration of pulse checks was 20 s, with an accuracy of 85%.</div></div><div><h3>Conclusion</h3><div>Despite high heterogeneity among included studies, manual pulse checks only achieved moderate accuracy with a prolonged duration. This suggests that manual pulse checks are unreliable in children for determination cardiac arrest state and need for ongoing CPR.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"23 ","pages":"Article 100959"},"PeriodicalIF":2.1,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143873380","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":"Evaluation of the optimal timing for advanced airway management for adult patients with out-of-hospital cardiac arrest: A retrospective observational study from a multicenter registry","authors":"Yuki Kishihara ,&nbsp;Shunsuke Amagasa ,&nbsp;Hideto Yasuda ,&nbsp;Masahiro Kashiura ,&nbsp;Yutaro Shinzato ,&nbsp;Takashi Moriya","doi":"10.1016/j.resplu.2025.100957","DOIUrl":"10.1016/j.resplu.2025.100957","url":null,"abstract":"<div><h3>Aim</h3><div>We aimed to investigate the appropriate timing for advanced airway management (AAM) in witnessed adult non-traumatic out-of-hospital cardiac arrest (OHCA) by adjusting for resuscitation time bias and limiting the analysis to witnessed OHCA.</div></div><div><h3>Methods</h3><div>This retrospective observational study used a multicentre OHCA registry involving 99 participating hospitals in Japan and included adult patients with witnessed non-traumatic OHCA who underwent AAM during resuscitation. The primary and secondary outcomes were favourable 30-day neurological outcomes and survival, respectively. The time from emergency medical service contact to AAM was categorised as follows: 1–5, 6–10, 11–15, 16–20, 21–25, and 26–30 min. In each group, we calculated the time-dependent propensity score using a Fine-Gray regression model. After propensity score matching, we used a generalised estimating equation (GEE).</div></div><div><h3>Results</h3><div>A total of 16,448 patients who underwent AAM were matched with patients at risk of requiring AAM. AAM was associated with favourable 30-day neurological outcomes when performed at 6–10 and 16–20 min with RRs (95% CIs) of 1.41 (1.12–1.78), but not at 16–20 min (0.74 [0.56–0.99]), respectively. AAM was associated with improved 30-day survival at 1–5 and 6–10 min (1.22 [1.05–1.41], 1.33 [1.16–1.54], respectively), but not at 16–20 min (0.78 [0.62–0.97].</div></div><div><h3>Conclusions</h3><div>Performing AAM within 10 min was associated with improved outcomes compared with those at risk of receiving AAM. However, the results were not consistent across all groups, therefore, careful interpretation is required.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"23 ","pages":"Article 100957"},"PeriodicalIF":2.1,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143868057","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":"Implementation of school-based CPR training – A systematic review and mixed-methods meta-analysis","authors":"Mahan Sadjadi ,&nbsp;Rebecca Brülle ,&nbsp;Umut Onbasilar ,&nbsp;Hendrik Booke ,&nbsp;Christian Strauß ,&nbsp;Thilo von Groote ,&nbsp;Hugo van Aken ,&nbsp;Antje Gottschalk","doi":"10.1016/j.resplu.2025.100955","DOIUrl":"10.1016/j.resplu.2025.100955","url":null,"abstract":"<div><h3>Aim</h3><div>Despite initiatives like “Kids Save Lives”, CPR trainings are often poorly implemented, and bystander CPR rates remain low. This systematic review and mixed-methods <em>meta</em>-analysis of qualitative and quantitative studies aims to identify enablers and barriers to the implementation of school-based CPR training.</div></div><div><h3>Methods</h3><div>A systematic search was conducted across seven databases. Qualitative data were analyzed using thematic synthesis, and findings were evaluated with GRADE-CERQual. Quantitative data were synthesized through qualitative findings, providing deeper context using a convergent qualitative <em>meta</em>-integration approach.</div></div><div><h3>Results</h3><div>A total of 18 reports (7 qualitative and 11 quantitative) on school-based CPR training were included from an initial pool of 7914 records. Key enablers of successful school-based CPR training implementation were related either to program characteristics or to environmental factors, with both being equally important. Generally, programs are better implemented if they include high-quality resources, incur low costs in terms of funds, time and staffing, show adaptability to the setting in which they are implemented, and provide standardized training for teachers or implementers. Regarding environment factors, implementation is facilitated by broad support from school stakeholders (leadership, teachers, and parents) and is more successful where, supported by mandatory legislation and government endorsement, health is framed as a core business of schools.</div></div><div><h3>Conclusion</h3><div>The successful implementation of school-based CPR training depends on both program characteristics and environmental factors, operating together in a “seed and soil” manner. Addressing both aspects is essential for effective program planning. Future research should more broadly explore health outcomes beyond CPR-related measures and investigate how CPR training can be integrated into wider health-promoting school initiatives.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"23 ","pages":"Article 100955"},"PeriodicalIF":2.1,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143848712","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":"Trends in tracheostomy placement after out-of-hospital cardiac arrest","authors":"Francisco Gallegos-Koyner ,&nbsp;Nelson Barrera ,&nbsp;Ricardo M. Carvalhais ,&nbsp;David H. Chong ,&nbsp;Anica Law ,&nbsp;Ari Moskowitz","doi":"10.1016/j.resplu.2025.100956","DOIUrl":"10.1016/j.resplu.2025.100956","url":null,"abstract":"<div><h3>Purpose</h3><div>Out-of-hospital cardiac arrest (OHCA) is a major public health burden. The purpose of this study was to assess the incidence of tracheostomy placement after OHCA and to evaluate trends over time and cost.</div></div><div><h3>Methods</h3><div>Using the National Inpatient Sample data 2016–2021, we examined a weighted sample of adults admitted after OHCA who underwent mechanical ventilation within the first 24 h of arrival and had an admission longer than 24 h. The primary outcome of interest was incidence of tracheostomy placement after cardiac arrest. Secondary outcomes of interest included hospitalization costs, days to tracheostomy placement, length of stay and discharge disposition.</div></div><div><h3>Results</h3><div>A total of 47,550 admissions fulfilled the inclusion criteria. Of those, 1,450 (3.0%) patients received a tracheostomy during their hospitalization. There was no change in the incidence of tracheostomy placement over the analyzed years. Median hospitalization costs for patients with OHCA who received a tracheostomy were $96,038 (IQR= $66,415−$148,633). Hospitalization costs steadily increased over the analyzed years, from $83,668 in 2016 to $109,032 in 2021. Median days to tracheostomy placement was 11 days (IQR = 8–15) and median length of stay of patients with OHCA and tracheostomy was 23 days (IQR = 16–36). There was no significant change over the years in days to tracheostomy placement or in length of stay to explain the increase in hospitalization costs. Among patients with tracheostomy, 76.2% were discharged to a Skilled Nursing Facility, 13.8% died, 4.8% were discharged to a short-term hospital, and 5.2% were discharged home.</div></div><div><h3>Conclusions</h3><div>An estimated 3.0% of patients who are admitted to the hospital after OHCA and require mechanical ventilation will receive a tracheostomy. Between 2016–2021 the rates and timing of tracheostomy placement remained stable in patients admitted with OHCA. However, we observed a rise in hospitalization costs associated with patients admitted for OHCA.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"23 ","pages":"Article 100956"},"PeriodicalIF":2.1,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143851948","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":"The use of social media platforms in adult basic life support research: a scoping review","authors":"Nino Fijačko ,&nbsp;Sebastian Schnaubelt ,&nbsp;Giuseppe Stirparo ,&nbsp;Elena Maria Ticozzi ,&nbsp;Giuseppe Ristagno ,&nbsp;Federico Semeraro ,&nbsp;Robert Greif","doi":"10.1016/j.resplu.2025.100953","DOIUrl":"10.1016/j.resplu.2025.100953","url":null,"abstract":"<div><h3>Background</h3><div>Social media (SoMe) is expanding globally, with increasing adoption in research, including resuscitation science. Its widespread reach and growing influence make it a valuable tool for research and knowledge dissemination. We aimed to assess the utilization of SoMe, highlight its applications, and identify future research areas, specifically in data collection and analysis, education and training, and professional networking and collaboration.</div></div><div><h3>Methods</h3><div>Embase, Scopus, and PubMed were searched through October 30th, 2024. Titles and abstracts were screened, and duplicates removed. The PCC (Population, Concept, and Context) framework defined the population as SoMe users, the concept as adult BLS-related content, and the context as SoMe platforms used for data analysis, data collection, teaching, campaigns, communication, and sharing, excluding traditional media.</div></div><div><h3>Results</h3><div>The search yielded 5,427 articles, with 201 undergoing full-text review and 42 included. Most studies were from high-income countries (19/42; 45%) and had a cross-sectional design (16/42; 36%). SoMe was primarily used for data analysis (17/42; 41%) and data collection (16/42; 36%). YouTube and X were the frequently applied SoMe platforms (12 studies each; 29%), while Instagram and WhatsApp supported diverse applications. In contrast, Snapchat and TikTok were used less frequently and for narrower purposes.</div></div><div><h3>Conclusions</h3><div>Existing studies focus on data collection and analysis, mainly via YouTube and X, but inconsistencies in design and geography call for standardized reporting to enhance comparability and impact. Future studies could standardize reporting on SoMe applications in adult BLS using established frameworks to ensure comparability and effectiveness.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"23 ","pages":"Article 100953"},"PeriodicalIF":2.1,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143844320","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":"Organ donation under V-A ECMO support: insights and recommendations from Japan’s first two cases","authors":"Futoshi Nagashima ,&nbsp;Daisaku Matsui ,&nbsp;Takashi Hazama ,&nbsp;Korehito Takasu ,&nbsp;Tomoya Matsuda ,&nbsp;Tomoaki Nakai ,&nbsp;Naru Kageyama ,&nbsp;Tomohiro Oda ,&nbsp;Junko Nagata ,&nbsp;Eriko Sugie ,&nbsp;Yuki Yamaoka","doi":"10.1016/j.resplu.2025.100952","DOIUrl":"10.1016/j.resplu.2025.100952","url":null,"abstract":"<div><h3>Background</h3><div>The use of veno-arterial extracorporeal membrane oxygenation (V-A ECMO) has expanded globally as a life-saving intervention of cardiac arrest. However, brain death following successful resuscitation presents unique clinical and procedural challenges, particularly in apnea testing, electroencephalographic (EEG) monitoring, and organ donation. Despite increasing international adoption of ECMO, standardized protocol for brain death determination under ECMO remain limited.</div></div><div><h3>Methods</h3><div>This study describes Japan’s first two cases of legal brain death determination and organ donation under V-A ECMO support, conducted in accordance with Japan’s legal standards. Each case was managed through close multidisciplinary collaboration and tailored clinical planning. Key procedural challenges were addressed, including adaptation of apnea testing via controlled sweep gas flow reduction, minimization of EEG artifacts through strategic technical adjustments, and intraoperative planning to ensure stable organ perfusion. Based on these experiences, we developed an institutional protocol to support safe and standardized brain death determination and organ retrieval under ECMO.</div></div><div><h3>Results</h3><div>Both cases were successfully completed without significant complications, offering valuable insights into ECMO-assisted organ donation. Key considerations included optimizing sweep gas flow to achieve PaCO₂ targets during apnea testing, minimizing artifacts in EEG monitoring through strategic device placement, and ensuring effective organ perfusion by integrating a Y-shaped circuit into the ECMO system. While the absence of standardized protocols posed challenges, particularly in managing prolonged apnea testing and optimizing organ perfusion, these were overcome through robust multidisciplinary collaboration and meticulous planning.</div></div><div><h3>Conclusion</h3><div>This study suggests that brain death organ donation under ECMO can be performed under specific conditions, even in countries where its adoption has been limited. Establishing a safe and standardized determination process may enhance organ donation and expand the pool of transplantable organs.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"23 ","pages":"Article 100952"},"PeriodicalIF":2.1,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143844321","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}