Resuscitation plus最新文献

{"title":"Analyzing resuscitation conference content through the lens of the chain of survival","authors":"Nino Fijačko ,&nbsp;Sebastian Schnaubelt ,&nbsp;Vinay M Nadkarni ,&nbsp;Špela Metličar ,&nbsp;Robert Greif","doi":"10.1016/j.resplu.2025.100951","DOIUrl":"10.1016/j.resplu.2025.100951","url":null,"abstract":"<div><h3>Background</h3><div>Resuscitation science today often focuses on advanced topics such as extracorporeal cardiopulmonary resuscitation or targeted temperature management. However, the specific topics presented at resuscitation conferences have not been thoroughly analyzed. We thus analyzed resuscitation conferences abstracts using a chain of survival framework.</div></div><div><h3>Methods</h3><div>Two major resuscitation conferences (Resuscitation in Greece and Resuscitation Science Symposium in the USA) took place in the fall of 2024. We categorized all abstracts using chain of survival framework, analyzing authors’ countries by geography and income. Additionally, artificial intelligence, deep learning, and machine learning approaches for data analysis were examined.</div></div><div><h3>Results</h3><div>“Recognition and prevention” was the top category at both conferences, comprising 37% of topics at Resuscitation 2024 and 32% at Resuscitation Science Symposium 2024. “Early Call for Help”, “High-quality Cardiopulmonary Resuscitation”, and “Recovery and rehabilitation” were underrepresented, with each &lt;8%. At Resuscitation Science Symposium 2024, “Post-cardiac arrest care” (31%) and “Early defibrillation and advanced life support” (26%) were emphasized, compared to 21% each at Resuscitation 2024 for both chains. Resuscitation 2024 featured participants from 51 countries while Resuscitation Science Symposium 2024 included participants from 19 countries, predominantly high-income ones. At Resuscitation 2024, 54 abstracts, and at Resuscitation Science Symposium 2024, 47 abstracts used machine learning, each with one employing artificial intelligence. None used deep learning.</div></div><div><h3>Conclusions</h3><div>Conference abstracts aligned mainly with the early links of chain of survival and employing machine learning as a data analysis tool. Expanding participation from low-income countries could enhance inclusivity and contribute valuable perspectives to resuscitation science.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"23 ","pages":"Article 100951"},"PeriodicalIF":2.1,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143844982","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":"FirstCPR: A pragmatic community organisation-based cluster randomised trial to increase community training and preparedness to respond to out-of-hospital cardiac arrest","authors":"Sonali Munot ,&nbsp;Julie Redfern ,&nbsp;Janet E Bray ,&nbsp;Blake Angell ,&nbsp;Andrew Coggins ,&nbsp;Alan Robert Denniss ,&nbsp;Garry Jennings ,&nbsp;Sarah Khanlari ,&nbsp;Pramesh Kovoor ,&nbsp;Saurabh Kumar ,&nbsp;Kevin Lai ,&nbsp;Simone Marschner ,&nbsp;Paul M. Middleton ,&nbsp;Ian Oppermann ,&nbsp;Zoe Rock ,&nbsp;Christopher Semsarian ,&nbsp;Matthew Vukasovic ,&nbsp;Adrian Bauman ,&nbsp;Clara K. Chow","doi":"10.1016/j.resplu.2025.100949","DOIUrl":"10.1016/j.resplu.2025.100949","url":null,"abstract":"<div><h3>Background</h3><div>Bystander cardiopulmonary resuscitation (CPR) and defibrillation improve out-of-hospital cardiac arrest survival. However, basic life support (BLS) skills are low.</div></div><div><h3>Aim</h3><div>The FirstCPR cluster randomised controlled trial aimed to test the effectiveness of a community organisation-targeted BLS education and training approach.</div></div><div><h3>Methods</h3><div>Clusters (community organisations with 50+ members) were randomly allocated to intervention (12-month period of opportunities to access BLS education and training) or control (no intervention). Outcomes were assessed via surveys at 12 months and pre-specified analysis involved hierarchical mixed-models.</div></div><div><h3>Results</h3><div>Of 165 randomised clusters (82 intervention), 58% were sports and 42% were social/faith-based. Most of the intervention clusters (74/82) participated in at least one intervention activity (15 in all activities). Factors such as the COVID-19 pandemic and organisation support impacted intervention uptake. Overall 924 members, across 93 clusters (407 from 57 intervention clusters; 517 from 36 control clusters), completed surveys. At 12-months, intervention organisation surveyed members reported higher rates of: being trained and willing to perform CPR on a stranger (primary outcome: 63.8% vs 46.9 %; Adjusted Odds Ratio (AOR) 2.22, 95% confidence interval (CI):1.50–3.30), confidence to use an automated external defibrillator (AED) (48.4% vs 26.4%; AOR:3.23, 95%CI:2.22–4.71) and willingness to use AEDs on a stranger (73.9% vs 62.9%; AOR:1.84, 95%CI:1.22–2.80).</div></div><div><h3>Conclusions</h3><div>The results should be interpreted cautiously as the survey response rates were very low. However, survey respondents showed desired outcomes and key learnings for future research were gained.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"23 ","pages":"Article 100949"},"PeriodicalIF":2.1,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143792542","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":"Resuscitation education science meets virtual and augmented reality: Evolution from potential concept to recommendations","authors":"Nino Fijačko ,&nbsp;Manuel Pardo Rios ,&nbsp;Federico Semeraro ,&nbsp;Vinay M Nadkarni ,&nbsp;Robert Greif","doi":"10.1016/j.resplu.2025.100950","DOIUrl":"10.1016/j.resplu.2025.100950","url":null,"abstract":"<div><h3>Aim of the study</h3><div>This study aims to examine the evolution of recommendations for integrating Virtual Reality (VR) and Augmented Reality (AR) into adult Basic Life Support (BLS) education over time.</div></div><div><h3>Data sources</h3><div>In December 2024, we conducted a two-phase search. First, we identified and reviewed publications available on the International Liaison Committee on Resuscitation (ILCOR) webpage, focusing on resuscitation education science, specifically addressing VR and/or AR in adult BLS education. In the second phase, we reviewed the references and citations of the included publication to identify relevant publications from the American Heart Association (AHA), European Resuscitation Council (ERC), and ILCOR.</div></div><div><h3>Results</h3><div>Across both phases, we included 29 AHA, ERC, and ILCOR publications on resuscitation education. These comprised 16 ILCOR CoSTRs, seven AHA/ERC guidelines (four ERC, three AHA), three ILCOR scientific statements, two AHA scientific statements, and one ILCOR review. The first mention of VR appeared in 2003, but the first recommendation was provided in 2020 AHA guidelines, suggesting its use for adult BLS training based on very low-quality evidence. In 2024, the ILCOR CoSTRs issued a weak recommendation supporting AR and a weak recommendation against VR for adult BLS training, both based on very low-quality evidence.</div></div><div><h3>Conclusion</h3><div>While VR/AR is gaining traction in resuscitation training, its effectiveness remains debated. Initially focused on professionals, it now extends to laypersons and schoolchildren. However, strong evidence is lacking. Future research should assess learning outcomes, guideline adherence, and patient impact to support stronger ILCOR recommendations.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"23 ","pages":"Article 100950"},"PeriodicalIF":2.1,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143844322","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":"“I can’t unsee him lying in my kitchen”: Understanding the trauma of family members who witness a loved one’s cardiac arrest","authors":"Katie N. Dainty ,&nbsp;Krystle Amog ,&nbsp;Sachin Agarwal ,&nbsp;M. Bianca Seaton","doi":"10.1016/j.resplu.2025.100944","DOIUrl":"10.1016/j.resplu.2025.100944","url":null,"abstract":"<div><h3>Background</h3><div>While there is a growing body of research in the field of post-cardiac arrest outcomes and survivorship, the lived experience of close family members who witness the arrest itself and who may have performed CPR, has not been specifically explored.</div></div><div><h3>Methods</h3><div>We employed qualitative interpretive descriptive methodology using key informant interviews for data collection. Participants were recruited internationally, and interviews were conducted virtually following a semi-structured format. Thematic data analysis was conducted using a constant comparative approach.</div></div><div><h3>Results</h3><div>Interviews were conducted with 33 family members who were present at the time of their loved ones cardiac arrest. Across the participant stories, we identified the core concept of ‘base trauma’ that centres around what family member witnesses initially experience at the time of the arrest itself. We postulate that this core theme influences six significant patterns of experience including: 1) feelings of responsibility, 2) fear of recurrence without them, 3) the impact of reliving the event, 4) the inability to escape triggers, 5) the delayed realization of their own trauma, and lastly 6) dealing with psychologic disconnect.</div></div><div><h3>Conclusions</h3><div>There is increasing research evidence that family members of cardiac arrest survivors have their own challenges as part of the recovery journey. We introduce novel concept of the compounded impact of the initial base trauma those that witness and respond to a loved ones cardiac arrest have. The nuanced experiences of this group point to the need to normalize their experience as a ‘trauma’ and suggest that support pathways need to recognize this.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"23 ","pages":"Article 100944"},"PeriodicalIF":2.1,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143777486","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":"A single early warning signs (SEWS) system for recognizing clinically deterioration outperforms the national early warning score (NEWS) by having a lower activation threshold, broader clinical scope, and faster response time","authors":"Raúl J. Gazmuri ,&nbsp;Rebecca Bieber ,&nbsp;Calis Lim ,&nbsp;Mylene Apigo ,&nbsp;Ma Lea Martin","doi":"10.1016/j.resplu.2025.100947","DOIUrl":"10.1016/j.resplu.2025.100947","url":null,"abstract":"<div><h3>Background</h3><div>The National Early Warning Score (NEWS) is a vital-signs point summation system developed to identify patients at risk of adverse events including cardiac arrests, unplanned ICU admissions, and deaths. The points are usually calculated by the Electronic Health Record after charting, recommending local actions and Rapid Response System (RRS) activation when reaching ≥ 7 points. NEWS, however, lacks consistent evidence that it improves outcome and may lead to alarm fatigue. At our institution we operate a Single Early Warning Signs (SEWS) system for RRS activation with a broader range of abnormal signs, without point summation, and bedside assessment within 10 min.</div></div><div><h3>Methods</h3><div>We analyzed 182 RRS activations using SEWS from July 1, 2022, to August 21, 2023, and compared the activation thresholds and dispositions that would have occurred had NEWS been used.</div></div><div><h3>Findings</h3><div>At the time of RRS activation using SEWS, only 10 patients (5.5%) had scored ≥ 7 NEWS points. Of the remaining 172 patients, 158 (86.8%) scored 0 to 4 NEWS points considered low risk and 14 (7.7%) scored 5 to 6 NEWS points considered medium risk (<em>p</em> &lt; 0.001). Yet, 122 patients (67%) were transferred to a higher level of care including 58 patients (31.8%) to ICU. The median in-hospital cardiac arrest during the reported period was 0.8 per 1000 hospital admissions, which is substantially lower than reported rates.</div></div><div><h3>Conclusion</h3><div>SEWS operating with a broader clinical scope, lower activation threshold, and faster RRS activation outperformed NEWS markedly reducing in-hospital cardiac arrests.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"23 ","pages":"Article 100947"},"PeriodicalIF":2.1,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143792543","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":"Factors associated with large watery stools after out-of-hospital cardiac arrest and their relationship with neurological outcomes: A retrospective observational study","authors":"Yasuyuki Kawai,&nbsp;Keita Miyazaki,&nbsp;Toru Osaki,&nbsp;Koji Yamamoto,&nbsp;Keisuke Tsuruta,&nbsp;Hideki Asai,&nbsp;Hidetada Fukushima","doi":"10.1016/j.resplu.2025.100946","DOIUrl":"10.1016/j.resplu.2025.100946","url":null,"abstract":"<div><h3>Aim</h3><div>To evaluate the association between large watery stools—a potential early sign of non-occlusive mesenteric ischaemia—and neurological outcomes.</div></div><div><h3>Methods</h3><div>We retrospectively analysed data from 495 adult patients with out-of-hospital cardiac arrest admitted to our tertiary centre between April 2015 and March 2024. Individuals who achieved return of spontaneous circulation but remained comatose after resuscitation were included. Large watery stools were defined as ≥300 mL of watery/loose stools occurring at least twice within 24 h after admission. We performed stepwise logistic regression analysis to identify predictors available at admission and assess the relationship between watery stool occurrence and neurological outcomes.</div></div><div><h3>Results</h3><div>Overall, 161 (32%) patients developed large watery stools within 24 h. Patients with watery stools experienced significantly higher rates of unfavourable neurological outcomes at discharge (favourable in 9% vs. 21% in patients without watery stools). Stepwise logistic regression analysis identified six independent predictors of large watery stools—lactate, low-flow interval, C-reactive protein, activated partial thromboplastin time, noradrenaline use, and creatinine—reflecting disturbances in metabolic status, perfusion, coagulation, and inflammatory responses. The final model demonstrated an ROC_AUC of 0.72 (95% CI [0.68–0.73]). After calibration, the Brier score improved from 0.21 (95% CI [0.20–0.23]) to 0.19 (95% CI [0.17–0.21]).</div></div><div><h3>Conclusion</h3><div>After out-of-hospital cardiac arrest, early-onset large watery stools is strongly associated with poor neurological outcomes, potentially serving as a clinical indicator of intestinal ischaemia and systemic inflammation. Incorporating coagulation and metabolic markers into predictive models may facilitate early identification of high-risk patients, aiding timely diagnosis and intervention.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"23 ","pages":"Article 100946"},"PeriodicalIF":2.1,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143783054","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":"Estimated caseload for a rotary wing prehospital extra-corporeal cardio-pulmonary resuscitation service in North West England: A retrospective eligibility study","authors":"John Weeks ,&nbsp;Steve Bell ,&nbsp;Thomas Nelson ,&nbsp;Ian Tyrrell-Marsh","doi":"10.1016/j.resplu.2025.100948","DOIUrl":"10.1016/j.resplu.2025.100948","url":null,"abstract":"<div><h3>Background</h3><div>Prehospital Extra-Corporeal Membrane Oxygenation Cardiopulmonary Resuscitation (ECPR) has the potential to improve survival from out of hospital cardiac arrest (OHCA). This study aims to estimate the potential caseload for an airborne ECPR service for refractory cardiac arrest in adults in North West England.</div></div><div><h3>Methods</h3><div>A retrospective analysis was carried out on cardiac arrest patients attended by The North West Air Ambulance Charity (NWAA) team, examining the time taken from the 999 call to emergency services, to team arrival at patient, this was used to create a mathematical model for travel times.</div><div>Secondly, a retrospective review of cardiac arrest cases attended by The North West Ambulance Service (NWAS) was performed. Two sets of criteria were applied to examine if prehospital cardiac arrest patients would be eligible for ECPR; a locally defined set (LIC), and an in-hospital criteria (AIC). Combined with our travel time model, we estimated the number of patients the service might see.</div></div><div><h3>Results</h3><div>Time taken for the NWAA team to reach cardiac arrest patients was given by the formula <em>y</em> = 0.2237<em>x</em> + 20.135 and there was a moderate linear distance and time correlation. 85 and 78 patients per annum would have been eligible, using the LIC and AIC, respectively. Using an estimated 30% survival rate 21.6–23.1 lives could be saved annually.</div></div><div><h3>Conclusion</h3><div>The two different criteria produced similar estimates of caseload. An ECPR service in this region would expect to treat to 1.4–1.5 patients per week, depending on the criteria used.</div></div><div><h3>Trial registration</h3><div>Not applicable.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"23 ","pages":"Article 100948"},"PeriodicalIF":2.1,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143821533","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":"Measuring disparities in out of hospital cardiac arrest outcomes in Chicago community areas","authors":"Marina Del Rios ,&nbsp;Shaveta Khosla ,&nbsp;Joseph Weber ,&nbsp;Pavitra Kotini-Shah ,&nbsp;Katie Tataris ,&nbsp;Eddie Markul ,&nbsp;Terry Vanden Hoek ,&nbsp;Illinois Heart Rescue","doi":"10.1016/j.resplu.2025.100929","DOIUrl":"10.1016/j.resplu.2025.100929","url":null,"abstract":"<div><h3>Background</h3><div>Advances in resuscitation science have improved survival rates after an out-of-hospital cardiac arrest (OHCA) in select geographies, but survival rates vary widely by community. The purpose of this study was to assess the variations in bystander interventions and subsequent OHCA outcomes by predominance of a race/ethnicity within community areas in a large city.</div></div><div><h3>Methods</h3><div>This is a retrospective cohort study of OHCA treated by Chicago Fire Department EMS from January 1st 2014 through December 31st 2021. Community areas were grouped into categories based on having a majority (&gt;50%) of a race or ethnicity (i.e., predominantly White, Black, Hispanic, Integrated or Asian).</div></div><div><h3>Results</h3><div>Of the 13,778 OHCA cases meeting inclusion criteria, 62.1% were male, and 47.5% were from predominantly Black community areas, 17.9% from predominantly Hispanic community areas, 20.0% from White, and 14.0% from Integrated; the remaining 0.6% were from Asian community areas. Mean age was lowest (59.9 years) in Hispanic followed by Black (61.8 years) community areas compared to White (62.4 years) community areas. Cases from Black and Hispanic community areas had lower rates of shockable rhythms (12.6% and 14.9% versus 19.8%). Bystander cardiopulmonary resuscitation (CPR) and automated external defibrillator (AED) use was lowest in Black community areas. OHCA in Hispanic and Black community areas &gt; 30% less likely to have favorable neurologic survival compared to White community areas. Females were more likely to survive to hospital admission across all community areas; however, neurologic survival in females was better only in White and Integrated community areas. Public location and shockable rhythm were significant predictors of favorable neurologic survival across all community area categories; AED use before EMS was a significant predictor in Black, Hispanic and Integrated community areas but not in White community areas. Bystander CPR was associated with favorable neurologic survival White (aOR = 1.40) and Integrated (aOR = 2.02) community areas, but there was no significant association in Black or Hispanic community areas.</div></div><div><h3>Conclusion</h3><div>Our study revealed significant variations in favorable OHCA characteristics across different community areas. While certain cardiac arrest features and modifiable factors play a significant role in some community areas, their effect may be less pronounced in other community areas.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"23 ","pages":"Article 100929"},"PeriodicalIF":2.1,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143767456","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":"Duration of resuscitation, regain of consciousness and histopathological severity of hypoxic-ischemic encephalopathy after cardiac arrest","authors":"Christian Endisch ,&nbsp;Katharina Millard ,&nbsp;Sandra Preuß ,&nbsp;Werner Stenzel ,&nbsp;Jens Nee ,&nbsp;Christian Storm ,&nbsp;Christoph J. Ploner ,&nbsp;Christoph Leithner","doi":"10.1016/j.resplu.2025.100945","DOIUrl":"10.1016/j.resplu.2025.100945","url":null,"abstract":"<div><h3>Purpose</h3><div>To study the histopathologically quantified severity of hypoxic-ischemic encephalopathy (HIE) in deceased cardiac arrest unbiased by death causes and correlated with demographic parameters.</div></div><div><h3>Methods</h3><div>We conducted a retrospective, single-centre study including cardiac arrest patients with postmortem brain autopsies. Using the selective eosinophilic neuronal death (SEND), the histopathological severity of HIE was quantified in the cerebral neocortex, hippocampus, basal ganglia, cerebellum, and brainstem, and correlated with demographic parameters.</div></div><div><h3>Results</h3><div>We included 319 patients with a median time of return from cardiac arrest to spontaneous circulation (tROSC) of 10 min, of whom 62(19.4%) had a regain of consciousness (RoC) before death. The tROSC was significantly correlated with the SEND in all brain regions (<em>p</em> &lt; 0.05, Spearman’s rho = 0.14 to 0.29). The SEND in the neocortex, hippocampus, and basal ganglia was significantly correlated with RoC (<em>p</em> &lt; 0.05, Spearman’s rho = −0.25 to −0.11). In 9 patients with tROSCs less than 1 min, all had a brainstem SEND less than 30%, and 8(88.9%) had neocortical SEND less than 30%. Among 69 patients with tROSCs greater than 20 min, 47.8–82.6% showed a SEND less than 30% across brain regions.</div></div><div><h3>Conclusions</h3><div>We found less SEND and RoC was more likely in patients with shorter tROSCs. A tROSC less than 1 min was mostly associated with SEND less than 30% in all brain regions. Prolonged resuscitations with tROSCs greater than 20 min did not exclude a SEND less than 30% in a relevant proportion of patients. Future histopathological studies are warranted to investigate the impact of modifiable clinical parameters on the severity of HIE.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"23 ","pages":"Article 100945"},"PeriodicalIF":2.1,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143767403","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":"Manikin physical realism for resuscitation education: A systematic review","authors":"Aaron Donoghue ,&nbsp;Katherine Allan ,&nbsp;Sebastian Schnaubelt ,&nbsp;Andrea Cortegiani ,&nbsp;Robert Greif ,&nbsp;Adam Cheng ,&nbsp;Andrew Lockey","doi":"10.1016/j.resplu.2025.100940","DOIUrl":"10.1016/j.resplu.2025.100940","url":null,"abstract":"<div><h3>Aim</h3><div>To evaluate the impact of higher physical realism of manikins on educational and clinical outcomes during life support education.</div></div><div><h3>Methods</h3><div>This systematic review was conducted as part of the continuous evidence evaluation process of the International Liaison Committee on Resuscitation (ILCOR). A search of PubMed, Embase, and Cochrane was conducted from January 1, 2005 until April 30, 2024. Studies comparing training with higher physical realism manikins and lower realism manikins were eligible for inclusion. Studies comparing manikins to other forms of training (e.g. screen-based, virtual reality) were excluded. Risk of bias was assessed using Cochrane Risk of Bias 2 (RoB 2) for randomized trials and Risk Of Bias In Non-Randomized Studies of Interventions (ROBINS-I) for observational studies. For outcomes reported by four or more randomized studies, random effects <em>meta</em>-analysis using standardized mean difference was performed.</div></div><div><h3>Results</h3><div>Of the 1276 articles identified and screened, 21 articles comprised the final review (19 randomized trials, 2 observational studies). Meta-analysis of eight RCTs reporting simulation skill performance in a simulated clinical scenario at course conclusion demonstrated a benefit from the use of higher- realism manikins compared with lower realism manikins (standardized mean difference 0.66, 95% CI 0.08 – 1.25). Meta-analysis of seven RCTs reporting knowledge at course conclusion showed no significant difference between the use of both types of manikins. Significant risk of bias and a high degree of heterogeneity were found among the included studies.</div></div><div><h3>Conclusion</h3><div>This systematic review found that higher manikin realism during resuscitation training was associated with improved simulated clinical scenario performance at course conclusion; without an effect on knowledge at course conclusion. Future studies should examine the impact of resource requirements for high realism simulation on generalizability and implementation.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"23 ","pages":"Article 100940"},"PeriodicalIF":2.1,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143747464","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}