Resuscitation plus最新文献

{"title":"Methods matter: unpacking the survival impact of first responder CPR in OHCA","authors":"Shaun Theodor Florentz Sødergren , Julian Lennertz , Adam Mellett-Smith , Ravini Shanika , Kasper Glerup Lauridsen","doi":"10.1016/j.resplu.2025.101060","DOIUrl":"10.1016/j.resplu.2025.101060","url":null,"abstract":"","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"26 ","pages":"Article 101060"},"PeriodicalIF":2.4,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144926498","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 quality of CPR delivered by EMS personnel wearing enhanced personal protective equipment during the COVID-19 pandemic: a retrospective cohort study from Perth, Australia","authors":"Milena Talikowska ,&nbsp;Jason Belcher ,&nbsp;Eleanor Golling ,&nbsp;David Majewski ,&nbsp;Stephen Ball ,&nbsp;Tanya Birnie ,&nbsp;Judith Finn","doi":"10.1016/j.resplu.2025.101062","DOIUrl":"10.1016/j.resplu.2025.101062","url":null,"abstract":"<div><h3>Purpose</h3><div>To measure the quality of cardiopulmonary resuscitation (CPR) provided by Emergency Medical Services (EMS) personnel wearing ‘enhanced’ personal protective equipment (PPE) during the COVID-19 pandemic in Perth, Australia.</div></div><div><h3>Methods</h3><div>We undertook a retrospective cohort study of adult, non-traumatic, non-EMS-witnessed out-of-hospital cardiac arrests (OHCA) with resuscitation attempted by St John (Ambulance) Western Australia (SJWA) between 16/03/2020–16/05/2021; corresponding to the first 14 months of the COVID-19 pandemic. We reported the median (interquartile range [IQR]) compression depth, rate and fraction across the cohort, along with the proportion of cases compliant with resuscitation guidelines issued by the Australian and New Zealand Committee on Resuscitation (ANZCOR). We also looked for evidence of rescuer fatigue by comparing CPR quality during the first 10 min of resuscitation to the remaining CPR effort.</div></div><div><h3>Results</h3><div>Of 659 adult, non-traumatic, non-EMS-witnessed OHCA with SJWA-attempted resuscitation, 467 cases (71 %) had usable CPR quality data. The median (IQR) compression depth was 5.9 (5.4, 6.5) cm; with 89.5 % of cases having an average depth ≥5 cm as stipulated by ANZCOR guidelines. The median (IQR) compression rate was 108 (106, 110) min⁻¹; with 99.8 % of cases having an average rate within the recommended range 100–120 min⁻¹. The median (IQR) compression fraction was 91 (87, 93) %; ANZCOR recommends minimizing interruptions to compressions. Among 369 cases of sufficient duration to compare the first 10 min of resuscitation to the remaining CPR effort, we found no significant deterioration in CPR quality.</div></div><div><h3>Conclusion</h3><div>EMS personnel in Perth delivered high quality CPR, without evidence of fatigue, despite wearing enhanced PPE during the initial stages of the COVID-19 pandemic.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"26 ","pages":"Article 101062"},"PeriodicalIF":2.4,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144902539","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":"Extracorporeal membrane oxygenation combined with prone ventilation for the treatment of high-dose metoprolol and amlodipine poisoning: A case report","authors":"Zhiwen Zhao ,&nbsp;Bo Wang ,&nbsp;Daiqiang Liu ,&nbsp;Wengtao Tao ,&nbsp;Haowen Tang ,&nbsp;Zeyu Wu ,&nbsp;Xiaolin Zhang ,&nbsp;Zhicheng Fang","doi":"10.1016/j.resplu.2025.101059","DOIUrl":"10.1016/j.resplu.2025.101059","url":null,"abstract":"<div><div>Extracorporeal life support (ECLS) represents the ultimate intervention for respiratory and circulatory failure. By maintaining hemodynamic stability, ECLS facilitates drug metabolism and organ recovery, thereby improving survival outcomes. We report a case of severe respiratory and circulatory failure resulting from the oral ingestion of 35 extended-release metoprolol tablets (25 mg each) and 100 extended-release amlodipine tablets (5 mg each). The patient responded favorably to venoarterial extracorporeal membrane oxygenation (VA-ECMO) combined with prone-position ventilation.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"26 ","pages":"Article 101059"},"PeriodicalIF":2.4,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144902540","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Leg-foot chest compressions: a scoping review","authors":"Nino Fijačko ,&nbsp;Kristina McShea ,&nbsp;Eva Dolenc Šparovec ,&nbsp;Špela Metličar ,&nbsp;Tomaž Horvat ,&nbsp;Vinay M. Nadkarni ,&nbsp;Robert Greif","doi":"10.1016/j.resplu.2025.101056","DOIUrl":"10.1016/j.resplu.2025.101056","url":null,"abstract":"<div><h3>Objectives</h3><div>High-quality chest compressions (CCs) are vital for the return of spontaneous circulation. When hand CCs are difficult, leg-foot CCs may offer an alternative. We reviewed existing studies to describe the current evidence and identify gaps in the literature regarding this technique and its impact on outcomes.</div></div><div><h3>Methods</h3><div>Between November and December 2024, we conducted a scoping review, searching eight databases, two proceedings (Resuscitation 2024 and the Resuscitation Science Symposium 2024), a trial register, animal guidelines, citations, and reference lists. We included studies on leg-foot CCs performed on humans, animals, or manikins by laypersons, healthcare professionals, pre-licensure students, or duty-to-respond laypersons. The intervention was leg-foot CCs; the comparison was standard hand CCs. Outcomes were feasibility, acceptability, and effectiveness (rate, depth, recoil, location). Eligible designs included trials, non-randomised studies, case reports, and research letters with English abstracts from 1960 to 2024.</div></div><div><h3>Results</h3><div>Out of 1173 records, we identified 14 studies comparing leg-foot and hand CCs, all using manikins, mostly from Western countries (11/14 studies). No human studies were identified. Twelve compared depth, nine rate, six recoil, and eight location. Most studies found no significant subgroup differences, though some reported better performance in heavier participants or when using a balance aid. Several studies observed differences in rate, recoil, and location overall. Of five studies assessing fatigue, two favoured leg-foot CCs, one was mixed, and two favoured hand CCs.</div></div><div><h3>Conclusion</h3><div>No human studies of leg-foot CCS were identified. On manikins, leg-foot CCs are feasible and may reduce fatigue, but results vary. More research, including animal or human studies, is needed.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"26 ","pages":"Article 101056"},"PeriodicalIF":2.4,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144922419","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":"Mid-term (30- to 90-day) neurological changes in out-of-hospital cardiac arrest survivors receiving extracorporeal cardiopulmonary resuscitation: a nationwide retrospective study (the JAAM-OHCA registry)","authors":"Takashi Hongo ,&nbsp;Tetsuya Yumoto ,&nbsp;Tsuyoshi Nojima ,&nbsp;Takafumi Obara ,&nbsp;Yoshiyuki Ueda ,&nbsp;Takashi Yorifuji ,&nbsp;Atsunori Nakao ,&nbsp;Hiromichi Naito","doi":"10.1016/j.resplu.2025.101057","DOIUrl":"10.1016/j.resplu.2025.101057","url":null,"abstract":"<div><h3>Background</h3><div>Few studies have examined mid-term neurological changes in out-of-hospital cardiac arrest (OHCA) patients after receiving extracorporeal cardiopulmonary resuscitation (ECPR). This study aimed to evaluate neurological improvements between 30 and 90 days in OHCA patients treated with ECPR or conventional cardiopulmonary resuscitation (CCPR) using a large nationwide cohort.</div></div><div><h3>Methods</h3><div>This retrospective multicenter study used data from a Japanese nationwide OHCA registry. Participants were categorized into ECPR and CCPR groups based on the initial resuscitation method. Neurological changes between 30 and 90 days were assessed using Cerebral Performance Category (CPC) scores. The primary outcome was neurological improvement, defined as an improvement in CPC score during this period.</div></div><div><h3>Results</h3><div>A total of 4467 OHCA survivors at 30 days were included, 669 in the ECPR group and 3798 in the CCPR group. At 30 days, favorable neurological outcomes were observed in 318 ECPR patients (47.5 %) and 2103 CCPR patients (55.4 %). Neurological improvement between 30 and 90 days was more frequent in the ECPR group (83 [12.4 %] vs. 258 [6.7 %]). There was no significant difference in 90-day mortality between the two groups (82 [12.2 %] vs. 519 [13.6 %]). ECPR was independently associated with 30- to 90-day neurological improvement (adjusted odds ratio (OR) 2.01; 95 % confidence interval (CI), 1.38–2.93) but was not associated with 90-day mortality (adjusted OR 1.11; 95 % CI, 0.77–1.59).</div></div><div><h3>Conclusion</h3><div>ECPR was associated with a greater likelihood of neurological improvement between 30 and 90 days. By 90 days, mortality was nearly the same in both groups.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"25 ","pages":"Article 101057"},"PeriodicalIF":2.4,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144891950","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":"Association between base excess level at hospital arrival and neurological outcomes in adult out-of-hospital cardiac arrest: A multicentre cohort study","authors":"Ryuta Onodera ,&nbsp;Norihiro Nishioka ,&nbsp;Tomoki Yamada ,&nbsp;Shunichiro Nakao ,&nbsp;Kazuhisa Yoshiya ,&nbsp;Changhwi Park ,&nbsp;Tetsuro Nishimura ,&nbsp;Takuya Ishibe ,&nbsp;Kazuma Yamakawa ,&nbsp;Takeyuki Kiguchi ,&nbsp;Masafumi Kishimoto ,&nbsp;Kohei Ninomiya ,&nbsp;Yusuke Ito ,&nbsp;Taku Sogabe ,&nbsp;Takaya Morooka ,&nbsp;Haruko Sakamoto ,&nbsp;Yuki Hironaka ,&nbsp;Atsunori Onoe ,&nbsp;Tasuku Matsuyama ,&nbsp;Yohei Okada ,&nbsp;Taku Iwami","doi":"10.1016/j.resplu.2025.101055","DOIUrl":"10.1016/j.resplu.2025.101055","url":null,"abstract":"<div><h3>Aim</h3><div>We aimed to assess the association between base excess (BE) levels and neurological outcomes in patients with out-of-hospital cardiac arrest (OHCA), accounting for the time from cardiac arrest onset to blood sampling.</div></div><div><h3>Methods</h3><div>This multicentre study was conducted in Osaka, Japan, and enrolled consecutive patients with OHCA who were transported to 16 medical centres between 2012 and 2021. Patients aged ≥ 18 years with witnessed OHCA and available BE measurements upon hospital arrival were examined. Patients were stratified into Q1 (BE ≤ −21.1 mmol/L), Q2 (−21.1 &lt; BE ≤ −15.7 mmol/L), Q3 (−15.7 &lt; BE ≤ −10.4 mmol/L) and Q4 (BE &gt; −10.4 mmol/L) groups based on BE levels. The primary outcome was 1-month survival with a favourable neurological outcome (Cerebral Performance Category scale score: 1 or 2).</div></div><div><h3>Results</h3><div>Among the 23,854 patients with OHCA, only 6066 were included in the final analysis. Approximately 3.2 %, 4.7 %, 9.9 % and 23.7 % of patients in the Q1, Q2, Q3 and Q4 groups, respectively, achieved favourable neurological outcomes at 1 month. Compared with Q4, the adjusted odds ratio for a favourable neurological outcome in Q1 was 0.13. Subgroup analysis revealed a significant interaction between prehospital return of spontaneous circulation (ROSC) and neurological outcomes; neurological outcomes worsened as BE decreased in patients with ROSC but not in those without ROSC.</div></div><div><h3>Conclusion</h3><div>Lower BE levels upon hospital arrival are associated with poorer neurological outcomes and may serve as prognostic indicators in patients with OHCA who achieved prehospital ROSC.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"25 ","pages":"Article 101055"},"PeriodicalIF":2.4,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144891951","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":"Conducting multicenter simulation-based experimental research: lessons drawn from the Quality CPR European project","authors":"Carla Sa-Couto ,&nbsp;Christoffer Ericsson ,&nbsp;Marc Lazarovici","doi":"10.1016/j.resplu.2025.101054","DOIUrl":"10.1016/j.resplu.2025.101054","url":null,"abstract":"<div><div>Multicenter research designs are widely recognized for enhancing the generalizability and real-world applicability of findings across diverse healthcare settings. However, conducting experimental studies across international sites presents substantial methodological, logistical, and operational challenges.</div><div>Quality CPR was a European multicenter simulation-based experimental study conducted across academic institutions in Portugal, Germany, and Finland. Using a randomized crossover design, the study investigated factors influencing chest compression quality and rescuer fatigue during simulated cardiopulmonary resuscitation.</div><div>Rather than serving as a methodological guide, this paper reflects on the practical experience of designing and implementing the Quality CPR study, highlighting twelve key lessons across the research lifecycle—planning, development, execution, and dissemination. These include collaborative protocol design, the development of a practical researcher guide to ensure cross-site harmonization, active support and real-time data monitoring during execution, and integrated dissemination strategies throughout the project lifecycle.</div><div>By documenting the enablers of success, this paper provides a practical reference for researchers planning similar international, multicenter studies. The insights offered aim to support the growing community of healthcare researchers engaged in cross-institutional initiatives.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"25 ","pages":"Article 101054"},"PeriodicalIF":2.4,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144867413","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":"Is the overdose chain of survival the missing link in reducing overdose deaths globally?","authors":"Jose Eric M. Lacsa","doi":"10.1016/j.resplu.2025.101051","DOIUrl":"10.1016/j.resplu.2025.101051","url":null,"abstract":"","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"25 ","pages":"Article 101051"},"PeriodicalIF":2.4,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144814022","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":"Challenges in resuscitation and survival factors of in-hospital cardiac arrest with suspected cardiovascular etiology: A multicenter retrospective study in Beijing, China","authors":"Ya Zhang ,&nbsp;Yao Ding ,&nbsp;Yang Yu ,&nbsp;Yuan Ma ,&nbsp;Ziyue Xiao ,&nbsp;Jianting Su ,&nbsp;Jing Wang ,&nbsp;Xiaojie Liu ,&nbsp;Jingcan Wang ,&nbsp;Zaihua Wei ,&nbsp;Hushan Ao","doi":"10.1016/j.resplu.2025.101053","DOIUrl":"10.1016/j.resplu.2025.101053","url":null,"abstract":"<div><h3>Background and Aim</h3><div>Cardiovascular disease affects both the elderly and younger populations, with cardiogenic arrest being the leading cause of in-hospital cardiac arrest (IHCA). The prognosis of IHCA related to cardiovascular diseases remains uncertain. This study aims to explore the characteristics, outcomes, and survival factors of IHCA with suspected cardiovascular etiology.</div></div><div><h3>Methods and Results</h3><div>This retrospective study investigated IHCA suspected to be of cardiovascular origin among adult patients across multiple hospitals in Beijing, China, from January 2022 to December 2023. A total of 791 arrests were recorded, with a median age of 70 years (IQR 61–79), and 65.1 % were male. Ventricular fibrillation/pulseless ventricular tachycardia was the initial rhythm in 46.8 % of cases. Of the 791 patients, 394 (49.8 %) achieved return of spontaneous circulation (ROSC), and 302 (38.2 %) had more than one arrest during hospitalization. Ultimately, 130 patients (16.4 %) survived to hospital discharge. Multivariable Cox regression showed that ROSC without mechanical circulatory support (HR: 2.68; 95 % CI 1.58–4.56), shockable initial rhythm (HR: 1.52; 95 % CI 1.06–2.17), and a duration of cardiopulmonary resuscitation (CPR) of ≤ 30 min (HR: 1.82; 95 % CI 1.13–2.93) were independently associated with a higher likelihood of survival to discharge. In contrast, multiple CPR episodes (HR: 0.53; 95 % CI 0.36–0.76), prolonged hospital stays (HR: 0.90; 95 % CI 0.88–0.93), and IHCA in urban centers (HR: 0.60; 95 % CI 0.42–0.87) were linked to poorer survival.</div></div><div><h3>Conclusions</h3><div>Among patients with suspected cardiovascular-related IHCA, both the proportion of shockable initial rhythms and ROSC rates were high; however, survival to discharge remained low.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"25 ","pages":"Article 101053"},"PeriodicalIF":2.4,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144842286","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":"Out of hospital cardiac arrest in STEMI patients: A six-year review of an Irish tertiary referral centre","authors":"Gregory Offiah ,&nbsp;Darren Dahly ,&nbsp;Adel Shelfah ,&nbsp;Martin O. Quinn ,&nbsp;Siobhan Masterson ,&nbsp;Peter Kearney ,&nbsp;Conor Deasy","doi":"10.1016/j.resplu.2025.101052","DOIUrl":"10.1016/j.resplu.2025.101052","url":null,"abstract":"<div><h3>Background and objectives</h3><div>Out of hospital cardiac arrest (OHCA) can complicate ST segment elevation myocardial infarction (STEMI), with a tenfold increase in mortality compared to those presenting without cardiac arrest. This study aimed to characterise STEMI patients presenting with OHCA to a single centre and to investigate the factors affecting their outcomes.</div></div><div><h3>Methods</h3><div>A retrospective analysis was performed on all patients on the National Out of Hospital Cardiac Arrest Register that presented over a six-year period with OHCA. The hospital’s electronic health record was used to collect data on baseline characteristics, STEMI diagnosis, treatment and outcomes.</div></div><div><h3>Results</h3><div>There were 478 OHCA presentations; 75 (16 %) were diagnosed with STEMI. Mortality rates were significantly lower amongst the STEMI patients (23 % vs 87 %). There was no significant difference in the characteristics of STEMI patients transferred directly to the coronary catheterisation lab (CCL) and initially treated in ED. Over 90 % of STEMI patients were successfully treated with PCI. Mortality was higher in STEMI patients that were initially transferred to ED, with this factor identified as an independent predictor of mortality. However, transfer to CCL after two hours was not associated with increased mortality, when compared to those transferred within an hour of hospital arrival.</div></div><div><h3>Conclusion</h3><div>Mortality rates amongst studied STEMI patients presenting with OHCA were high. Although transfer to ED was associated with increased mortality, this finding may be explained by confounding factors, including more profound haemodynamic instability precluding STEMI diagnosis, and/or requiring transfer to ED for stabilisation.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"25 ","pages":"Article 101052"},"PeriodicalIF":2.4,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144830135","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}