Resuscitation plus最新文献

{"title":"Use of CPR feedback devices in resuscitation training: A systematic review and meta-analysis of randomized controlled trials","authors":"Yiqun Lin ,&nbsp;Andrew Lockey ,&nbsp;Aaron Donoghue ,&nbsp;Robert Greif ,&nbsp;Andrea Cortegiani ,&nbsp;Barbara Farquharson ,&nbsp;Fahad Javaid Siddiqui ,&nbsp;Arna Banerjee ,&nbsp;Tasuku Matsuyama ,&nbsp;Adam Cheng ,&nbsp;Education Implementation Team Task Force of the International Liaison Committee on Resuscitation ILCOR","doi":"10.1016/j.resplu.2025.100939","DOIUrl":"10.1016/j.resplu.2025.100939","url":null,"abstract":"<div><h3>Objectives</h3><div>The use of cardiopulmonary resuscitation (CPR) feedback devices during training is increasing. This review evaluates whether incorporating CPR feedback devices in training improves patient survival, CPR quality in actual resuscitation, skill acquisition and retention after training.</div></div><div><h3>Methods</h3><div>This systematic review was part of the continuous evidence evaluation process of the International Liaison Committee on Resuscitation (ILCOR). We searched MEDLINE, EMBASE, and SCOPUS databases from inception to September 30, 2024, including randomized controlled trials (RCTs) in all languages (with an English abstract) comparing CPR training with and without feedback devices. Outcome included patient survival, quality of clinical performance in resuscitation, and CPR skill acquisition and retention. Non-RCT studies, unpublished work without peer review or animal studies were excluded. Risk of bias was assessed using Cochrane tools, and certainty of evidence was graded using the Grading of Recommendations Assessment, development and Evaluation (GRADE) approach. Standardized mean difference (SMD) were calculated and pooled effects were analyzed using random-effects models. PROSPERO CRD42023488130.</div></div><div><h3>Results</h3><div>We identified 20 RCTs with 4579 participants. Risks of bias ranged from low to critical (low: 8, moderate: 9, and critical: 3). No studies evaluated the patient survival, clinical performance in resuscitation or cost-effectiveness. Compared to no feedback, using CPR feedback devices during training significantly improved key quality metrics. Pooled effect sizes were 0.76 (95%CI 0.02 – 1.50) for mean compression depth (15 studies), 0.98 (95%CI: 0.10 – 1.87) for depth compliance (16 studies), 0.29 (95%CI: 0.10 – 0.48) for mean rate (17 studies), 0.44 (95%CI: 0.23 – 0.66) for rate compliance (9 studies), and 0.53 (95%CI: 0.31 – 0.75) for recoil compliance (10 studies) in favour of using feedback devices during training. Heterogeneity was large (I² &gt; 50%) in all analyses. Planned subgroup analyses revealed no statistically significant interaction between healthcare professionals and laypersons. Using the GRADE approach, the certainty of evidence was downgraded for certain outcomes due to critical risk of bias for 3 studies and inconsistency but upgraded for strong association.</div></div><div><h3>Conclusion</h3><div>The use of CPR feedback devices during resuscitation training improves key quality metrics of CPR performance, with moderate to high certainty of evidence. However, further studies are needed to evaluate the impact on cost-effectiveness, clinical performance and patient outcomes.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"23 ","pages":"Article 100939"},"PeriodicalIF":2.1,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143734996","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":"Seasonal variation in bystander efforts and survival after out-of-hospital cardiac arrest","authors":"Niels Saaby Hald ,&nbsp;Harman Yonis ,&nbsp;Mathias Hindborg ,&nbsp;Helle Collatz Christensen ,&nbsp;Jannie Kristine Bang Gram ,&nbsp;Erika Frischknecht Christensen ,&nbsp;Fredrik Folke ,&nbsp;Gunnar Gislason ,&nbsp;Christian Torp-Pedersen ,&nbsp;Kristian Bundgaard Ringgren","doi":"10.1016/j.resplu.2025.100934","DOIUrl":"10.1016/j.resplu.2025.100934","url":null,"abstract":"<div><h3>Background</h3><div>This study investigated the hypothesis that out-of-hospital cardiac arrest (OHCA) incidence, public automated external defibrillator (PAD) utilization and outcome vary by season, with increased incidence and lower survival rates expected in winter. The aim was to provide insights that might optimize resuscitation efforts throughout the year.</div></div><div><h3>Methods</h3><div>Cases of OHCA from 2016 to 2021 were included from the Danish Cardiac Arrest Registry. Cases were stratified by season and month and analysed for frequency, witnessed status, location, bystander cardiopulmonary resuscitation (CPR), bystander PAD defibrillation and 30-day survival. The primary outcome was incidence of OHCA and variability in utilization of PADs by season. Secondary outcome was 30-day survival rates. Categorical variables were compared using Chi-square and multivariable analyses were conducted using Poisson regression.</div></div><div><h3>Results</h3><div>A total of 25,248 OHCA cases were included with a median age of 74 years [IQR 63–82] and 64% were male. Multivariable analyses revealed a lower incident rate ratio (IRR) of OHCA for most months (IRR 0.78 to 0.92 with 95%CI 0.72–0.98, all p-values &lt; 0.05), except March and December, using January as reference. Seasonal rates of bystander CPR (78.4%–79.4%, <em>p</em> = 0.414) and PAD shock (8.9%–9.8%, <em>p</em> = 0.266) remained consistent throughout the year. The proportion of residential OHCAs were higher during winter than in summer (79.4% vs 77.5%, respectively, <em>p</em> = 0.023). Crude 30-day survival rates showed significant seasonal variation with lower survival rates during winter (11.1%) compared to spring (12.4%), summer (13.4%) and fall (12.2%, <em>p</em> = 0.001). However, after adjusting for factors such as sex, comorbidities, and OHCA circumstances (witnessed status, bystander CPR, PAD shock), no significant seasonal variation in survival remained (all <em>p</em> &gt; 0.05).</div></div><div><h3>Conclusion</h3><div>Incidence of OHCA was higher in winter, but rates of bystander CPR and PAD shock remained consistent across seasons. Crude mortality rates were significantly lower during winter. However, multivariable regression analysis revealed no significant variation in survival rates by month.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"23 ","pages":"Article 100934"},"PeriodicalIF":2.1,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143734997","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":"Psychological impact on first responders dispatched to out-of-hospital cardiac arrest via smartphone alerting system: A longitudinal survey-based study","authors":"Julian Ganter ,&nbsp;Ariane-Catherina Ruf ,&nbsp;Stefan Bushuven ,&nbsp;Ute Nowotny-Behrens ,&nbsp;Michael Patick Müller ,&nbsp;Hans-Jörg Busch","doi":"10.1016/j.resplu.2025.100941","DOIUrl":"10.1016/j.resplu.2025.100941","url":null,"abstract":"<div><h3>Background</h3><div>Smartphone alerting systems designed to dispatch volunteer first responders to out-of-hospital cardiac arrest cases are progressing rapidly. Recently, growing attention has been given to understanding the impact of these operations on first responders, with a particular focus on safeguarding them from possible psychological challenges. This study investigates the psychological stress experienced by first responders following their involvement in an operation, analyzing specific stress factors to enhance opportunities for psychological support.</div></div><div><h3>Methods</h3><div><em>A</em> two-stage questionnaire (Q1 and Q2) survey was conducted, with surveys administered one and four weeks after dispatched first responder arrived at the scene between October 9, 2023, and January 23, 2024. Screening questions based on the FAUST study assessed psychological stress, with ≥4 positive responses indicating at-risk individuals. Personal and operational variables were analyzed for their correlation with stress levels for identifying affected first responder. The study was approved by the Freiburg Ethics Committee (DRKS00032958).</div></div><div><h3>Results</h3><div>The response rates for the triggered questionnaires were 190/324 (59%) for Q1 and 132/322 (41%) for Q2. Fewer than 1% answered ≥4 screening questions positively, indicating a low measured prevalence of psychological stress. Situations involving resuscitation or already deceased patients but also first responders’ feelings of insecurity were identified as significant factors of possible psychological stress, while regular CPR training appeared to significantly reduce the likelihood of stress.</div></div><div><h3>Conclusions</h3><div>First responders who volunteer for such roles frequently encounter challenging situations. However, psychological stress is rarely reported. Integrating mechanisms into smartphone alerting systems to identify stress indicators and provide accessible support is essential.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"23 ","pages":"Article 100941"},"PeriodicalIF":2.1,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143716007","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":"Strengthening trauma resuscitation education and training in low-resource settings: A call for global inclusion","authors":"Ileana Lulic ,&nbsp;Carlos Mesquita ,&nbsp;Dinka Lulic ,&nbsp;Romeo Lages Simões ,&nbsp;Luís Ferreira ,&nbsp;Piotr Koleda ,&nbsp;Sérgio Baptista ,&nbsp;Henrique Alexandrino ,&nbsp;Thiago Rodrigues Calderan ,&nbsp;Vanessa Henriques Carvalho ,&nbsp;Vitor Favali Kruger ,&nbsp;Rodrigo Caselli Belem ,&nbsp;Fernando López-Mozos ,&nbsp;Carlos Yanez ,&nbsp;Jadranka Pavicic Saric ,&nbsp;Gustavo Pereira Fraga","doi":"10.1016/j.resplu.2025.100935","DOIUrl":"10.1016/j.resplu.2025.100935","url":null,"abstract":"<div><div>Trauma is a leading cause of preventable death worldwide, disproportionately affecting low-resource settings where access to specialized care is limited. Systemic barriers, including fragmented trauma networks and workforce shortages, contribute to poor outcomes. Strengthening trauma resuscitation through structured education and training is critical to improving survival and reducing disparities. However, traditional trauma training models often fail to address regional constraints, limiting their effectiveness. Brazil has developed a comprehensive trauma resuscitation education model by integrating public awareness campaigns, medical student-led initiatives, digital learning, simulation-based training, and telemedical support. A horizontal approach to trauma patient management, combined with hands-on immersive simulation training, has further enhanced this framework, emphasizing the team approach and non-technical skills essential for high-performance trauma care. This narrative review examines Brazil’s trauma resuscitation training strategies and explores their potential to serve as a template for low-resource settings. By analyzing key educational components, we identify cost-effective solutions to strengthen trauma system capacity. To bridge disparities, trauma education must extend beyond well-resourced environments. Faculty development, sustainable mentorship, and access to technology-driven education are critical to equipping providers with the skills needed to manage complex trauma scenarios. Mobile simulation units and telemedicine platforms expand training to remote regions, while scalable digital platforms enable real-time collaboration. Despite these advancements, funding constraints, logistical barriers, and the need for culturally tailored education hinder widespread implementation. Embedding trauma education into national health policies and disaster response systems is essential to ensuring sustainable, high-quality trauma care worldwide.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"23 ","pages":"Article 100935"},"PeriodicalIF":2.1,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143738768","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":"Physical, psychological, cognitive, social health outcomes, and health-related quality of life in out-of-hospital cardiac arrest survivors and their caregivers: Protocol of the quality cardiac arrest survivorship cohort study (QualiCAS)","authors":"Pin Pin Pek ,&nbsp;Megan Chua ,&nbsp;Le Xuan Liew ,&nbsp;Christina Chen ,&nbsp;Shir-Lynn Lim ,&nbsp;Felix Maverick Rubillar Uy ,&nbsp;Vui Kian Ho ,&nbsp;Yew Woon Chia ,&nbsp;Jia Min Chua ,&nbsp;Ee Ling Goh ,&nbsp;Lai Peng Tham ,&nbsp;Pei Lin Koh ,&nbsp;Kai Lee Woo ,&nbsp;Cheryl Ting Zhen Woo ,&nbsp;Iylia Muhammad Afiq ,&nbsp;Kexin Fang ,&nbsp;Han Nee Gan ,&nbsp;Benjamin Sieu-Hon Leong ,&nbsp;Desmond Ren-Hao Mao ,&nbsp;Nausheen Edwin Doctor ,&nbsp;Andrew Fu Wah Ho","doi":"10.1016/j.resplu.2025.100938","DOIUrl":"10.1016/j.resplu.2025.100938","url":null,"abstract":"<div><h3>Background</h3><div>Out-of-hospital cardiac arrest (OHCA) is an emergency with historically low survival rates. Advances in resuscitation and post-resuscitation care have improved survival, precipitating greater scientific interest in OHCA patients’ survivorship. However, there is insufficient high-quality population-based long-term survivorship data and limited research on the impact of OHCA sequelae on survivors’ caregivers.</div></div><div><h3>Objective</h3><div>Our primary aim is to determine neurological function, physical, psychological, cognitive, social outcomes, and health-related quality of life (HRQoL) of OHCA survivors in Singapore. Secondary aims are to quantify caregivers’ burden and its association with their HRQoL, and psychological well-being.</div></div><div><h3>Methods</h3><div>The Quality Cardiac Arrest Survivorship Cohort Study (QualiCAS) is a prospective population-based cohort study of OHCA survivors and their caregivers in Singapore. Participants aged ≥18 years and caregivers aged ≥21 years will be recruited from all public hospitals in Singapore. Health outcomes will be evaluated at 3, 6, and 12 months, and 3 and 5 years using the Hospital Anxiety and Depression Scale, PTSD Checklist for DSM-5, Fatigue Severity Scale, Montreal Cognitive Assessment Tool, EQ-5D-5L, Community Integration Questionnaire-Revised, Barthel Index, Lawton’s Instrumental Activities of Daily Living, Timed Up and Go Test, Handgrip strength assessment, and Zarit Burden Interview.</div></div><div><h3>Discussion</h3><div>This study allows us to understand the natural history of OHCA survivorship and quantify the burdens on patients and their caregivers. Findings can guide clinical follow-up, identify high-risk patients, intervention targets, and inform rehabilitation strategies for OHCA sequelae.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"23 ","pages":"Article 100938"},"PeriodicalIF":2.1,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143767402","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":"Comparison of two respiratory function monitors for newborn mask ventilation: A randomised crossover study using simulation","authors":"C.M. Ní Chathasaigh ,&nbsp;A.E. Curley ,&nbsp;E. O Currain","doi":"10.1016/j.resplu.2025.100937","DOIUrl":"10.1016/j.resplu.2025.100937","url":null,"abstract":"<div><h3>Objectives</h3><div>Respiratory function monitors (RFM) provide objective feedback on respiratory parameters during face mask ventilation. While traditional RFMs display detailed waveforms, newer devices use simplified, colour-coded graphics. We aimed to compare three RFM feedback methods against a no-feedback approach, assessing ventilation parameters and user interpretation.</div></div><div><h3>Methods</h3><div>This simulation-based, crossover randomised study involved healthcare professionals at a tertiary neonatal centre, who received training on two RFMs: a “Coloured graphic” device (Monivent NeoTraining), offering monitor and sensor light feedback, and a “Flow curves” device (Respironics NM3). Participants performed positive pressure ventilation on a manikin across three phases: access to the “Coloured graphic” monitor and sensor light, “Light only”, and access to the “Flow curves” monitor, evaluated against a control phase with no feedback. An interpretation assessment followed. The primary outcome was the median difference in mask leak (%) between the control and the three intervention phases.</div></div><div><h3>Results</h3><div>Data from 51 participants were analysed. Compared to the control, the median (IQR) mask leak (%) was significantly lower in the “Coloured graphic” phase (11% [7%–26%]; median difference: −13 [95% CI: −26 to −2]). No significant differences were observed in the “Light only” phase (22% [8%–39%]); median difference: −10 [95% CI: −25 to 5]), or “Flow curves” phase (44% [6%–73%]; median difference: 8 [95% CI: −2 to 18]). Although more participants correctly interpreted the “Coloured graphic” feedback, only a minority selected appropriate corrective actions.</div></div><div><h3>Conclusions</h3><div>Objective feedback from the “Coloured graphic” RFM significantly reduced leak during mask ventilation.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"23 ","pages":"Article 100937"},"PeriodicalIF":2.1,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143824433","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":"Use of personal protective equipment and cognitive load during cardiopulmonary resuscitation – A randomized cross-over simulation-based study","authors":"Johannes Heymer ,&nbsp;Daniel Räpple ,&nbsp;Matthias Ott ,&nbsp;Florian Dengler ,&nbsp;Christina Jaki ,&nbsp;Daniel Bent ,&nbsp;Anna Hegar","doi":"10.1016/j.resplu.2025.100936","DOIUrl":"10.1016/j.resplu.2025.100936","url":null,"abstract":"<div><h3>Background</h3><div>The use of personal protective equipment (PPE) is essential during cardiopulmonary resuscitation (CPR) to prevent disease transmission, but its impact on rescuer fatigue and CPR quality remains debated.</div></div><div><h3>Aim</h3><div>To simultaneously evaluate the effect of PPE on cognitive load and resuscitation quality.</div></div><div><h3>Methods</h3><div>In a simulation-based trial at a German tertiary care hospital, 31 healthcare workers performed two 2-minute chest compression (CC) cycles on a manikin, once with PPE and once without. Compression quality (rate, depth, hand position, chest recoil) was assessed. Cognitive load was measured post-task using NASA- and Simulation Task Load Index (NASA- and SIM-TLX). Primary outcome was the difference in cognitive load with and without PPE, and secondary outcomes included differences in CC quality parameters.</div></div><div><h3>Results</h3><div>SIM-TLX identified a significant impact of PPE on task complexity and perceptual strain, while situational stress, distractions, task control, and NASA-TLX parameters (mental, physical, temporal demand, frustration, effort, performance) showed no significant differences. No significant differences were found in compression rate (113 bpm without PPE vs. 109 bpm with PPE), depth (61 mm without vs. 62 mm with PPE), correct hand position (81% without vs. 78% with PPE), and complete chest recoil (94% without vs. 84% with PPE). However not significant, PPE use showed more negative outliers in hand position and chest recoil.</div></div><div><h3>Conclusion</h3><div>PPE increases values on two subscales of the SIM-TLX (task complexity and perceptual strain), but does not significantly impact chest compression quality in CPR simulations.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"23 ","pages":"Article 100936"},"PeriodicalIF":2.1,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143716110","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":"Postresuscitation pleth variability index-guided hemodynamic management of out-of-hospital cardiac arrest survivors: A randomised controlled trial","authors":"Stefano Malinverni ,&nbsp;Paul Dumay ,&nbsp;Pierre Domont ,&nbsp;Marc Claus ,&nbsp;Antoine Herpain ,&nbsp;Jolan Grignard ,&nbsp;Silvia Matta ,&nbsp;Fatima Zohra Bouazza ,&nbsp;Queitan Ochogavia","doi":"10.1016/j.resplu.2025.100933","DOIUrl":"10.1016/j.resplu.2025.100933","url":null,"abstract":"<div><h3>Background and purpose</h3><div>Hypotension and shock after return of spontaneous circulation is harmful. Goal-directed post-resuscitation care aims at maintaining adequate perfusion pressure, but evidence.</div><div>on strategies to achieve this goal is limited. This study aimed to compare outcomes of pleth variability index (PVi) supported hemodynamic management during early hospital admission with those of standard hemodynamic management.</div></div><div><h3>Methods and trial design</h3><div>From March 2019 to August 2023, all mechanically ventilated patients adults admitted alive after a non-traumatic out-of-hospital cardiac arrest (OHCA) to the emergency department of Saint-Pierre University Hospital in Brussels, were screened for inclusion in this prospective, parallel, randomised, single-blind study. We enrolled patients with signs of tissue hypoperfusion after cardiac arrest. Patients were randomly allocated (1:1) to undergo hemodynamic treatment based on the PVi (intervention) or standard monitoring (control). Hemodynamic interventions targeted mean blood pressure above 70 mmHg, a capillary refill time below 3 s and urine output above 0.5 ml/kg/minute. The primary outcome was lactate clearance at 3 h. We hypothesized that PVi guided hemodynamic management would result in a faster lactate clearance at 3 h.</div></div><div><h3>Results</h3><div>96 patients underwent randomization. Due to non-consent and loss to follow-up 82 patients were included in the analysis, 39 in the intervention and 43 in the control group. The median lactate clearance 3 h after inclusion was not different between groups (57.4% [Interquartile range (IQR): 27.7–75.8%] in the control group versus 61.5% [IQR: 39.3–74.7%] in the intervention group), with a mean difference of 4.9% (95% CI, −7.5–17.2; <em>p</em> = 0.44) between the two groups. No side effects were observed.</div></div><div><h3>Conclusion</h3><div>A pleth variability index-based protocol did not significantly improve the lactate clearance compared with standard care (NCT03841708).</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"23 ","pages":"Article 100933"},"PeriodicalIF":2.1,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143716112","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":"Implementation of a specialized neuroprognostication consultation program and associated provider attitudes: A survey-based study","authors":"David Fischer ,&nbsp;Sahily Reyes-Esteves ,&nbsp;Connor Law ,&nbsp;Alice Ford ,&nbsp;Peter Schwab ,&nbsp;Benjamin S. Abella ,&nbsp;Andrea L.C. Schneider ,&nbsp;Monisha A. Kumar","doi":"10.1016/j.resplu.2025.100932","DOIUrl":"10.1016/j.resplu.2025.100932","url":null,"abstract":"<div><h3>Introduction</h3><div>Neuroprognostication for disorders of consciousness, particularly after cardiac arrest, is critical. However rapidly evolving research has translated little to clinical practice, with neuroprognostication frequently deviating from evidence and clinical guidelines. We implemented a novel program that provides specialized, interdisciplinary, and longitudinal care to improve the practice of neuroprognostication. The objective of this study was to evaluate the impact of this program on provider attitudes and satisfaction towards neuroprognostication after cardiac arrest.</div></div><div><h3>Methods</h3><div>We disseminated surveys across our health system to critical care providers and neurologists in the years before (2021, 2022) and after (2023) implementation of the program. The surveys assessed perceptions of, and satisfaction with, neuroprognostication after cardiac arrest. We used Fisher exact tests to compare program-exposed respondents to historical controls (2021 and 2022 respondents) and contemporary controls (2023 respondents without program exposure).</div></div><div><h3>Results</h3><div>We received 545 responses from neurologists and critical care providers, including nurses, trainees, and attendings. Program-exposed respondents, relative to historical and contemporary controls respectively, reported greater usefulness of neuroprognostication (94% reporting often or always useful, versus 69% [<em>p</em> &lt; 0.01]) and 68% [<em>p</em> &lt; 0.01]), comprehensiveness of neuroprognostication (94% reporting often or always comprehensive, versus 76% [<em>p</em> = 0.02] and 66% [<em>p</em> &lt; 0.01]), and greater satisfaction with neuroprognostication, particularly in comparison to the conventional model (63% reporting the program was “much better”).</div></div><div><h3>Conclusion</h3><div>Implementation of a specialized neuroprognostication program was associated with largely favorable attitudes towards neuroprognostication among providers. These findings encourage further study of this paradigm, and consideration of broader adoption to improve the practice of neuroprognostication.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"23 ","pages":"Article 100932"},"PeriodicalIF":2.1,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143767404","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":"Serum glial fibrillary acidic protein and protein gene product 9.5 for predicting neurological outcomes in cardiac arrest patients with cortical response to somatosensory evoked potentials","authors":"Chenchen Hang ,&nbsp;Rui Shao ,&nbsp;Xingsheng Wang,&nbsp;Luying Zhang,&nbsp;Weijie Cheng,&nbsp;Zihao Jiang,&nbsp;Ziqi Zhong,&nbsp;Le An,&nbsp;Ziren Tang","doi":"10.1016/j.resplu.2025.100931","DOIUrl":"10.1016/j.resplu.2025.100931","url":null,"abstract":"<div><h3>Aim</h3><div>Predicting neurological prognosis after cardiac arrest remains challenging. Somatosensory evoked potential N20 absence is highly specific but lacks sensitivity. Glial fibrillary acidic protein and protein gene product 9.5 are potential biomarkers for brain injury, yet their roles in cardiac arrest patients with preserved somatosensory evoked potential N20 remain underexplored.</div></div><div><h3>Methods</h3><div>From January 2023 to December 2024, 69 cardiac arrest patients were enrolled, of whom 46 had preserved somatosensory evoked potential N20 responses. Serum glial fibrillary acidic protein, protein gene product 9.5 and neuron-specific enolase levels were measured at 72 h post-resuscitation. Patients were evaluated for neurological outcomes at 3 months using the Glasgow-Pittsburgh Classification of Cerebral Function scale. Receiver operating characteristic analysis determined biomarker thresholds for poor prognosis.</div></div><div><h3>Results</h3><div>In patients with preserved somatosensory evoked potential N20 responses, glial fibrillary acidic protein and protein gene product 9.5 levels were significantly higher in those with poor outcomes (<em>P</em> &lt; 0.001). Glial fibrillary acidic protein (area under the curve = 0.908) had an optimal cutoff of 64.1 pg/mL (sensitivity 87.5%, specificity 82.4%) and a 100% specificity threshold of 149 pg/mL. Protein gene product 9.5 (area under the curve = 0.864) had an optimal cutoff of 448.4 pg/mL (sensitivity 87.5%, specificity 70.6%) and a 100% specificity threshold of 1253 pg/mL. The prognostic significance of combining serum glial fibrillary acidic protein, protein gene product 9.5, or neuron-specific enolase levels was explored, with glial fibrillary acidic protein + neuron-specific enolase achieving the highest area under the curve of 0.949 (0.882–1.000).</div></div><div><h3>Conclusions</h3><div>Serum glial fibrillary acidic protein and protein gene product 9.5 could be valuable predictors of poor neurological outcomes in cardiac arrest patients with cortical response to somatosensory evoked potential, though further studies are required to validate these findings.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"23 ","pages":"Article 100931"},"PeriodicalIF":2.1,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143697285","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}