Resuscitation plus最新文献

{"title":"ECMO-facilitated rapid and deep hypothermia reduces brain injury on MRI following prolonged cardiac arrest in a translational swine model","authors":"Joseph E. Tonna ,&nbsp;Dustin Anderson-Bell ,&nbsp;Miriam E. Peckham ,&nbsp;Guillaume L. Hoareau ,&nbsp;Stavros Drakos ,&nbsp;Adam DeHavenon ,&nbsp;Matthew D. Alexander ,&nbsp;Austin M. Johnson ,&nbsp;Jacob Steenblik ,&nbsp;Scott T. Youngquist","doi":"10.1016/j.resplu.2025.101072","DOIUrl":"10.1016/j.resplu.2025.101072","url":null,"abstract":"<div><h3>Introduction</h3><div>Neuroprotective interventions after cardiac arrest are essential but largely lack evidence of efficacy. Early therapeutic hypothermia (TH) is the only intervention that has shown promise in humans. However, despite a consistent signal for efficacy in animal models, conflicting clinical data hamper clinical acceptance. Two potential causes for the lack of translation from animal studies to humans are the time to achieve target temperature in humans and the inability to cool to deep hypothermic states due to the inherent detrimental cardiac effects accompanying deep hypothermia. Given the observed inconsistent impact of TH on human patients with cardiac arrest despite animal data, we developed a perfusion-controlled, translational swine model to quantify the effects of rapid deep TH on HIBI, quantifying severity using magnetic resonance imaging (MRI) with diffusion-weighted imaging (DWI) at a controlled time threshold.</div></div><div><h3>Methods</h3><div>Ten swine underwent cardiac arrest with 20 min of “no-flow” state, followed by resuscitation and controlled reperfusion using extracorporeal membrane oxygenation (ECMO). Animals were randomized to either control (normal temperature reperfusion) or rapid hypothermic reperfusion (RHR) (29 °C through ECMO-facilitated cooling). All swine underwent brain MRI with Diffusion Weighted Imaging (DWI) before cardiac arrest and then 2 h after ECMO reperfusion. Whole-brain gray and white matter apparent diffusion coefficient (ADC) values were compared pre- and post-ECMO cannulation and arrest in all animals.</div></div><div><h3>Results</h3><div>At 45 min post-reperfusion, the mean temperature for RHR animals was 30.4 °C (95 % CI 29.6–31.1 °C), while for control animals it was 35.7 °C (95 % CI 34.9–36.5 °C, p &lt; 0.0001). Whole brain ADC in RHR swine increased by a mean of 1.36 ± 4.09 %, while in control swine it decreased by a mean of 4.36 ± 4.50 % (Median difference of −5.91, 95 %CI −12.13 to −0.15; P value = 0.047).</div></div><div><h3>Discussion</h3><div>Swine with induced cardiac arrest who underwent rapid ECMO-mediated cooling post-arrest had less cerebral hypoxic cellular injury, as quantified by changes on MRI DWI, than controls. These findings support the protective effect on neurologic injury of a rapid and brief period of induced deep hypothermia after cardiac arrest. Compared to prior translational models, our use of ECMO has the advantage of an ability to control important factors such as no-flow ischemic time and variability in post-arrest cardiac output as well as to mitigate complications of cardiac dysrhythmias that tend to arise from deep hypothermia. This portends a greater promise for translational success of ECMO-facilitated rapid cooling and potentially other ECMO-mediated models of cardiac arrest than experienced by previous attempts.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"26 ","pages":"Article 101072"},"PeriodicalIF":2.4,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145019641","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":"Real-time ventilation quality feedback devices efficacy in out-of-hospital cardiac arrest: a scoping review","authors":"Guillaume Debaty ,&nbsp;Nicholas J. Johnson ,&nbsp;Maya Dewan ,&nbsp;Laurie J. Morrison ,&nbsp;Janet E. Bray","doi":"10.1016/j.resplu.2025.101069","DOIUrl":"10.1016/j.resplu.2025.101069","url":null,"abstract":"<div><h3>Background</h3><div>New devices are now available to provide real-time feedback on ventilation for basic life support providers responding to out-of-hospital cardiac arrest (OHCA). This scoping review, conducted as part of the evidence review for the International Liaison Committee on Resuscitation, aimed to examine the extent of evidence examining ventilation feedback devices and to identify research gaps regarding these devices.</div></div><div><h3>Methods</h3><div>This scoping review was conducted using Arksey and O’Malley’s framework and reported according to PRISMA-ScR guidelines. Medline, EMBASE and Cochrane were searched from database inception to March 13th, 2025. Studies examining real-time ventilation quality feedback in humans and manikins of any design were included. Ventilation feedback devices were defined as any device that can provide information on the delivery of each insufflation (including insufflation and/or exsufflation measured volume as well as rate) and to guide the ventilation through real-time feedback.</div></div><div><h3>Results</h3><div>We screened 794 titles, with 17 studies (including 4 conference abstracts) included: one randomised trial (RCT), one before-after prospective studies, two observational studies, one case series and 12 simulation studies. Only three simulation studies assessed a pediatric scenario. The RCT reported improved early outcomes (unadjusted return of spontaneous circulation and 30-hour survival) with real-time feedback, but no difference at hospital discharge. Two observational studies also found no change in patient outcomes, but noted improved ventilation rate and insufflation volumes. Most simulation studies showed improvements in ventilation parameters.</div></div><div><h3>Conclusion</h3><div>Real-time feedback devices seem to improve ventilations, but we found insufficient evidence of their effect on clinical outcomes to merit a systematic review at this time. Rigorous evaluation of the clinical efficacy and effectiveness of these devices is needed.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"26 ","pages":"Article 101069"},"PeriodicalIF":2.4,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144989362","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":"Influence of an educational program utilizing VAK and Kolb’s learning theories on basic cardiopulmonary resuscitation knowledge and practices among private home nurses in Qatar","authors":"Mohamed Elsayed Saad Aboudonya ,&nbsp;Hoda Diab Fahmy Ibrahim ,&nbsp;Safaa R. Osman","doi":"10.1016/j.resplu.2025.101071","DOIUrl":"10.1016/j.resplu.2025.101071","url":null,"abstract":"<div><h3>Background</h3><div>Basic CPR is vital for home nurses, yet knowledge and practice gaps remain. Theory-based training can enhance skill effectiveness.</div></div><div><h3>Aim</h3><div>This study aimed to evaluate the influence of VAK and Kolb’s learning theories on basic cardiopulmonary resuscitation knowledge and practices among private home nurses in Qatar.</div></div><div><h3>Methods</h3><div>Quasi–experimental pre–/post study. One–hundred–thirty–four nurses were randomized to VAK and Kolb group (each n = 67). A learning–style inventory, CPR knowledge questionnaire, basic life and automated external defibrillator checklists were completed at baseline, immediately post–training, and at 6 and 9  months. The intervention composed of multimodal training program combined a 1–h multimedia lecture incorporating case-based scenarios with a 3–h European Resuscitation Council four–stage workshop customized to cover all learning styles in both groups.</div></div><div><h3>Results</h3><div>Participants were predominantly female (88.1 %), aged 35–44  years (44.8 %) and bachelor–prepared (59.7 %). Immediately after training, satisfactory CPR knowledge rose from 35 % to 90 %, BLS competence from 1.5 % to 100 % and AED operation from 23 % to 100 % (all p &lt; 0.001). Retention fell sharply at 6  months (25.6 %, 25.6 % and 60.5 %, respectively) and only partly recovered by 9  months (53.3 %, 27.4 % and 71.4 %). Visual, auditory and concrete–experience learners showed the steepest decline, whereas kinesthetic and reflective–observer learners maintained the highest performance.</div></div><div><h3>Conclusion</h3><div>Retention patterns differed sharply across learning styles. Visual, auditory, and concrete–experience nurses reached near–perfect scores right after training but lost much of those gains within six months. By nine months, kinesthetic (VAK) and reflective–observer (Kolb) learners still led CPR and AED performance, while visual, active–experimenter, and abstract–conceptualizer groups showed the steepest drop–offs. Sustained competence therefore hinges on both refresher timing and the cognitive–sensory mode through which skills were first acquired.</div></div><div><h3>Recommendations</h3><div>Use VAK and Kolb profiling during initial competency checks to tailor refresher frequency (quarterly low-dose sessions for visual, auditory, and concrete learners; semi-annual for kinesthetic and reflective learners), conduct an annual full-skills audit, and assign a dedicated Resuscitation Officer to coordinate and monitor these activities.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"26 ","pages":"Article 101071"},"PeriodicalIF":2.4,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144922418","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":"An update on the impact of bystander cardiopulmonary resuscitation on favorable neurological outcomes of patients with out-of-hospital cardiac arrest accounting for effect modification by witnessed arrest: a post hoc analysis of the SOS-KANTO 2017 study","authors":"Hideki Endo ,&nbsp;Takahiro Miyoshi ,&nbsp;Hiroyuki Yamamoto ,&nbsp;Nobuya Kitamura ,&nbsp;Takashi Tagami ,&nbsp;Kiyotsugu Takuma ,&nbsp;Kiyoshi Murata","doi":"10.1016/j.resplu.2025.101066","DOIUrl":"10.1016/j.resplu.2025.101066","url":null,"abstract":"<div><h3>Aim</h3><div>To investigate the role of witnessed arrest as an effect modifier on neurological outcomes following bystander cardiopulmonary resuscitation (CPR) in patients with out-of-hospital cardiac arrest (OHCA).</div></div><div><h3>Methods</h3><div>This cohort study was conducted using an OHCA patient registry collected between September 2019 and March 2021 in Japan. The effect modification by witnessed arrest was analyzed using additive and multiplicative interactions with risk adjustment. The main outcome was a cerebral performance category of 1 or 2 at 30 days after OHCA.</div></div><div><h3>Results</h3><div>A total of 7496 patients from 42 hospitals were analyzed. Witnessed arrest and bystander CPR occurred in 3053 (40.7 %) and 3152 (42.0 %) patients, respectively. The adjusted odds ratio (OR) of witnessed arrest and bystander CPR for favorable neurological outcomes was 11.36 (95 % confidence interval [CI]: 7.10–18.17). The ORs for bystander CPR within each stratum of witnessed arrest were 2.38 (95 % CI: 1.34–4.24) for non-witnessed arrest and 3.80 (95 % CI: 2.61–5.55) for witnessed arrest. The additive interaction was 7.01 (95 % CI: 3.34–10.68) and the multiplicative interaction was 1.60 (95 % CI: 0.80–3.17). In the non-home arrest setting, bystander CPR had an adjusted OR of 1.23 (95 % CI: 0.58–2.62) for non-witnessed arrest and 2.77 (95 % CI: 1.69–4.53) for witnessed arrest. The additive interaction was 4.98 (95 % CI: 1.67–8.29) and the multiplicative interaction was 2.25 (95 % CI: 0.91–5.53).</div></div><div><h3>Conclusions</h3><div>The interaction effect of bystander CPR and witnessed arrest exhibited the second strongest form of interaction. The non-significant effect of bystander CPR in non-witnessed arrest in the non-home cardiac arrest setting warrants further investigation.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"26 ","pages":"Article 101066"},"PeriodicalIF":2.4,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144926499","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":"Avalanche transceiver search times during avalanche companion rescue – A prospective randomized single-blinded cross-over simulation study","authors":"Bernd Wallner ,&nbsp;Simon Woyke ,&nbsp;Manuel Winkler ,&nbsp;Fabio Caramazza ,&nbsp;Ivo B. Regli ,&nbsp;Gabriel Putzer ,&nbsp;Giacomo Strapazzon ,&nbsp;Markus Falk ,&nbsp;Hermann Brugger ,&nbsp;Katharina Hüfner ,&nbsp;Peter Mair","doi":"10.1016/j.resplu.2025.101065","DOIUrl":"10.1016/j.resplu.2025.101065","url":null,"abstract":"<div><h3>Background</h3><div>The aim of this study was to analyse the influence of voice navigation in a new generation of transceivers on the time and success rate of transceiver search in a simulated avalanche rescue scenario.</div></div><div><h3>Methods</h3><div>Fifty participants performed two randomized test runs, using two different transmitters with and without voice navigation. Primary outcome was success rate, total transceiver search and total location time, secondary outcome parameters comprised predefined time intervals (coarse search time, fine search time, probing time) and deviations from the recommended standard search procedure.</div></div><div><h3>Results</h3><div>The study shows comparable results in success rate, total transceiver search time (111.1 s ± SD84.3 s) and total location time (134.4 s ± SD 112.6 s) for trials with and without voice navigation. Wrong initial search direction was corrected earlier in trials with voice (49.6 ± 6.9 s versus 93.7 ± 18.4 s p = 0.011). Participants were significantly faster in the second search trial (first 203.0 s versus 143.2 s; p = 0.002), a learning effect, more pronounced with voice navigation (voice 119.8 s vs. no-voice 164.8 s; p = 0.014). Deviations from the recommended standard search procedure were common (55 % of trials), without any difference between voice and no-voice navigation.</div></div><div><h3>Conclusions</h3><div>This study demonstrated a wide inter-individual variation in total transceiver search times and total location time in participants without experience. Voice navigation did not result in a significant reduction of transceiver search times but led to a faster correction of a wrong initial search direction and improved the learning effect significantly in second trials. Voice navigation could possibly optimize performance in participants without prior experience in stressful situations.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"26 ","pages":"Article 101065"},"PeriodicalIF":2.4,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144916344","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":"Near Field Communication (NFC) -assisted prehospital extracorporeal cardiopulmonary resuscitation activation: a novel tool to reduce cognitive load on emergency medical technicians","authors":"Yan-Bo Huang ,&nbsp;Sun-Hsin Liao ,&nbsp;Ming-Ta Hsieh ,&nbsp;Shang-Chiao Yang ,&nbsp;Chien-Hsiung Huang","doi":"10.1016/j.resplu.2025.101067","DOIUrl":"10.1016/j.resplu.2025.101067","url":null,"abstract":"","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"26 ","pages":"Article 101067"},"PeriodicalIF":2.4,"publicationDate":"2025-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144913416","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":"Are we overlooking the power of community in saving hearts?","authors":"Jose Eric M. Lacsa","doi":"10.1016/j.resplu.2025.101068","DOIUrl":"10.1016/j.resplu.2025.101068","url":null,"abstract":"","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"26 ","pages":"Article 101068"},"PeriodicalIF":2.4,"publicationDate":"2025-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144916345","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 secondary anterior-posterior defibrillator pad placement on chest compression interruptions: a three-arm randomised manikin-based simulation study among Dutch ambulance teams","authors":"Freek Coumou ,&nbsp;Dennie Wulterkens ,&nbsp;Cornelis Slagt ,&nbsp;Reinier Waalewijn ,&nbsp;Lars Mommers","doi":"10.1016/j.resplu.2025.101064","DOIUrl":"10.1016/j.resplu.2025.101064","url":null,"abstract":"<div><h3>Background</h3><div>Out-of-hospital cardiac arrest management prioritises effective treatment, with high-quality chest compressions and timely defibrillation being essential. While current European Resuscitation Council guidelines recommend sternal-apical defibrillator pad placement, alternative positions such as anterior-posterior (AP) are gaining interest. The integration of secondary AP pad placement with mechanical cardiopulmonary resuscitation devices (mCPR) remains underexplored.</div></div><div><h3>Methods</h3><div>This randomised, simulation-based study, assessed the impact of AP pad placement on chest compression interruptions, comparing manual versus mCPR strategies among 45 ambulance teams in the Netherlands. Teams were randomised into three groups: manual chest compressions with AP pad application, sequential mCPR and AP pad application, or simultaneous mCPR and AP pad application. The primary outcome was the duration of chest compression interruptions; secondary outcomes included user-feasibility and pad placement accuracy.</div></div><div><h3>Results</h3><div>Applying AP pads during manual compressions required 38.3 ± 13.3 s, resulting in 12.1 ± 6.0 s of interruptions. Sequential mCPR and AP pad application took 97.7 ± 23.7 s, with 51.7 ± 14.0 s of interruptions. Simultaneous application required 70.5 ± 16.1 s and 31.8 ± 12.3 s of interruptions. Pad placement accuracy was low: 0 % for sternal, 11 % for apical, 13 % for anterior and 2 % for posterior pads. Participants’ confidence in pad placement did not correlate with accuracy.</div></div><div><h3>Conclusion</h3><div>AP defibrillator pad placement during active mCPR presents significant challenges. Ambulance crews should assess the need for AP pads before initiating mCPR to minimise delays. The findings highlight substantial variability in pad placement, underscoring the need for standardised instructional guidelines and targeted training.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"26 ","pages":"Article 101064"},"PeriodicalIF":2.4,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144913415","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 impacts of blood pressure variability on clinical outcomes in patients with out-of-hospital cardiac arrest","authors":"Shih-Neng Lin ,&nbsp;Chen-Hsi Chang ,&nbsp;Hao-Wei Lee ,&nbsp;Ming-Jen Kuo ,&nbsp;Pai-Feng Hsu ,&nbsp;I-Hsin Lee ,&nbsp;Teh-Fu Hsu ,&nbsp;Chorng-Kuang How ,&nbsp;Yenn-Jiang Lin ,&nbsp;Chin-Chou Huang","doi":"10.1016/j.resplu.2025.101061","DOIUrl":"10.1016/j.resplu.2025.101061","url":null,"abstract":"<div><h3>Background</h3><div>The impact of blood pressure variability (BPV) following out-of-hospital cardiac arrest (OHCA) is not well established. This study aims to investigate the relationship between BPV after the return of spontaneous circulation and clinical outcomes in OHCA patients.</div></div><div><h3>Methods</h3><div>Non-traumatic OHCA patients were enrolled retrospectively. Continuous intra-arterial blood pressure monitoring was recorded and documented hourly. BPV was assessed using the standard deviation and coefficient of variation within the first 24- and 48-h. The clinical outcomes included 30-day mortality and poor neurological outcomes at discharge, defined as Cerebral Performance Category scale 3–5.</div></div><div><h3>Results</h3><div>A total of 217 non-traumatic OHCA patients who survived more than 24 h were enrolled. There were 119 deaths within 30 days and 165 poor neurological outcomes at discharge. High BPVs were independently associated with greater risk of 30-day mortality (standard deviation of mean arterial pressure: hazard ratio [HR] = 1.06, 95 % confidence interval [CI] = 1.03–1.10, <em>P</em> &lt; 0.001; coefficient of variation of mean arterial pressure: HR = 1.06, 95 % CI = 1.03–1.08, <em>P</em> &lt; 0.001) and poor neurological outcomes at discharge (standard deviation of mean arterial pressure: HR = 1.08, 95 % CI = 1.05–1.10, <em>P</em> &lt; 0.001; coefficient of variation of mean arterial pressure: HR = 1.07, 95 % CI = 1.05–1.09, <em>P</em> &lt; 0.001). Further analysis on the 185 patients surviving more than 48 h revealed similar findings.</div></div><div><h3>Conclusion</h3><div>Greater BPV during the early post-resuscitation phase is strongly linked to increased mortality and poor neurological outcomes in OHCA patients.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"26 ","pages":"Article 101061"},"PeriodicalIF":2.4,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145019640","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":"Utilising a refractory ventricular fibrillation bundle to improve outcome in out of hospital cardiac arrest: A case report","authors":"Isabel Horne ,&nbsp;Thomas Gleeson-Hammerton ,&nbsp;James Plumb ,&nbsp;John Pike","doi":"10.1016/j.resplu.2025.101063","DOIUrl":"10.1016/j.resplu.2025.101063","url":null,"abstract":"<div><div>Cardiac arrest secondary to persistent ventricular fibrillation or ventricular tachycardia (pVF/VT) is challenging to manage, particularly in the prehospital setting. This report, prepared in keeping with CARE guidelines, discusses a 70-year-old male who survived to discharge with pre-morbid neurological function after a prolonged cardiac arrest with pVF. Clinical interventions included mechanical CPR, vector change defibrillation, de-emphasised adrenaline and intravenous esmolol. We believe this may be the first reported case of a paramedic-led team providing this care bundle in the UK outside of a research setting.</div><div>In this case a refractory pVF/VT bundle appeared to be associated with terminating pVF. This report may be of use to other pre-hospital services considering introducing specialised care bundles for this case type, as well as adding to the body of evidence for the complex pharmacological relationship between adrenergic agonists, antagonists and persistent shockable rhythms.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"26 ","pages":"Article 101063"},"PeriodicalIF":2.4,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144926500","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}