Resuscitation plus最新文献

{"title":"Glucagon-like peptide-1 receptor agonist use is associated with reduced risk of out-of-hospital cardiac arrest in women with type 2 diabetes: A nationwide nested case-control study","authors":"Talip E. Eroglu ,&nbsp;Ruben Coronel ,&nbsp;Fredrik Folke ,&nbsp;Gunnar Gislason","doi":"10.1016/j.resplu.2024.100821","DOIUrl":"10.1016/j.resplu.2024.100821","url":null,"abstract":"<div><h3>Objective</h3><div>Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) improve cardiovascular outcomes in patients with type 2 diabetes, but few studies have studied the risk of out-of-hospital cardiac arrest (OHCA). We investigated whether GLP-1 RA use reduce OHCA risk in type 2 diabetes when compared to dipeptidyl peptidase-4 inhibitor (DPP-4i) use.</div></div><div><h3>Methods</h3><div>We identified all patients having a redeemed prescription of a glucose-lowering drug between 1995 and 2019 and excluded patients with a first-time redeemed prescription consisting of insulin. Within this cohort, we nested a case-control population comprising all OHCA-cases from presumed cardiac causes between 2013 and 2019. OHCA-cases were matched 1:5 to non-OHCA controls of the same sex and age on the date of OHCA. The odds ratios (ORs) and corresponding 95% confidence intervals (95%-CIs) of OHCA were reported comparing GLP-1 RAs versus DPP-4is.</div></div><div><h3>Results</h3><div>We identified 3,618 OHCA-cases from presumed cardiac causes and matched them to 18,090 non-OHCA controls. GLP-1 RAs were used by 269 (7.44%) cases and 1297 (7.17%) controls, and conferred no increase in the overall odds of OHCA compared with DPP-4i use (OR:0.89, 95%-CI 0.74–1.07). However, stratification according to sex revealed that OHCA risk was significantly reduced in women (OR:0.59, 95%-CI 0.40–0.86) but not in men (OR:1.01, 95%-CI 0.82–1.26, P-value interaction:0.0093). The OR of OHCA did not vary significantly when stratifying for age, duration of diabetes, chronic kidney disease, or presence of cardiovascular disease.</div></div><div><h3>Conclusion</h3><div>Our findings indicate that GLP-1 RA use is not associated with a reduced risk of OHCA in Danish individuals with type 2 diabetes when compared to DPP-4is.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"20 ","pages":"Article 100821"},"PeriodicalIF":2.1,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142586763","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":"Impact of video-assisted neonatal resuscitation on newborns and resuscitators: A feasibility study","authors":"Hiroki Otsuka ,&nbsp;Eiji Hirakawa ,&nbsp;Asataro Yara ,&nbsp;Daisuke Saito ,&nbsp;Takuya Tokuhisa","doi":"10.1016/j.resplu.2024.100811","DOIUrl":"10.1016/j.resplu.2024.100811","url":null,"abstract":"<div><h3>Aim</h3><div>High-risk deliveries are still common due to the increased use of assisted reproductive technologies. In Japan, despite centralization of labor, about half of all deliveries are still carried out in obstetric clinics. Telemedicine support is important for neonatal resuscitation involving urgent, life-altering professional judgment in local deliveries. This feasibility study examined the effects of using medical communication software on the quality of neonatal resuscitation, and the physiological parameters of the newborn and stress of the resuscitators.</div></div><div><h3>Methods</h3><div>This observational study included cesarean births with ≥ 36 weeks gestational age at Kagoshima City Hospital between January 1, 2023 and 2024. A camera on the neonatal resuscitation table allowed a neonatologist to observe the resuscitation through a medical communication software and give instructions to the resuscitators. The midwife performing the resuscitation wore a communication microphone to interact with the neonatologist. Details of the neonatal resuscitation procedures, newborn physical findings, and neonatal intensive care unit (NICU) admission rates were collected from medical records. A midwife questionnaire was also administered. The primary endpoints were resuscitation findings, and the secondary endpoint was resuscitator stress before and after implementing the software.</div></div><div><h3>Results</h3><div>The intervention had no major adverse effects and no change in NICU admission rates; however, there were increases in post-resuscitation temperature and suctioning frequency. While the intervention caused stress to the resuscitators, it also contributed to an increased sense of security and learning.</div></div><div><h3>Conclusion</h3><div>Telemedicine support in neonatal resuscitation can be introduced without significant adverse effects.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"20 ","pages":"Article 100811"},"PeriodicalIF":2.1,"publicationDate":"2024-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142578624","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":"Association of white blood cell count with one-year mortality after cardiac arrest","authors":"Asser M.J. Seppä ,&nbsp;Markus B. Skrifvars ,&nbsp;Heidi Vuopio ,&nbsp;Rahul Raj ,&nbsp;Matti Reinikainen ,&nbsp;Pirkka T. Pekkarinen","doi":"10.1016/j.resplu.2024.100816","DOIUrl":"10.1016/j.resplu.2024.100816","url":null,"abstract":"<div><h3>Introduction</h3><div>Post-resuscitation care of cardiac arrest patients may be complicated by systemic inflammation elicited in response to whole-body ischaemia–reperfusion injury. We assessed the association between early WBC with one-year mortality in a large, unselected population of cardiac arrest patients.</div></div><div><h3>Methods</h3><div>We collected a retrospective multicentre cohort of ICU-treated CA patients from the Finnish national ICU registry. We used locally estimated scatterplot smoothing (LOESS) curve to assess the association between the most abnormal WBC of the first 24 h in the ICU with the likelihood of death within a year. Multivariable logistic regression analyses were performed to assess the independent association between WBC and one-year mortality. In nested cohort analysis, we tested the association of delay from collapse to return of spontaneous circulation (ROSC) with WBC in linear regression models.</div></div><div><h3>Results</h3><div>The LOESS curve was U-shaped, with the lowest predicted mortality at 7.5 10⁹/L WBC. Based on this cut-off value, patients were divided into high (≥ 7.5 10⁹/L) and low (&lt; 7.5 10⁹/L) WBC groups. In 4229 patients with high WBC, higher WBC was independently associated with increased one-year mortality (adjusted odds ratio (OR) 1.03 per 10⁹/L, 95 % confidence interval (CI) 1.02–1.04, p &lt; 0.001). In 776 patients with low WBC, lower WBC was independently associated with increased one-year mortality (adjusted OR 0.88 per 10⁹/L, 95 % CI 0.80–0.96, p &lt; 0.001). In a nested cohort analysis, longer ROSC-delay was associated with higher WBC in patients with a shockable rhythm (β = 0.10, R² = 0.04, p &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>In this large retrospective cohort, WBC was independently associated with one-year mortality after CA. Mortality was lowest in patients with WBC close to the upper limit of the normal reference range. Although WBC is not useful for outcome prognostication in individual patients, our results support the concept of excess inflammation being a harmful component of the post-cardiac arrest syndrome.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"20 ","pages":"Article 100816"},"PeriodicalIF":2.1,"publicationDate":"2024-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142578625","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":"Spatio-temporal distribution, prediction and relationship of three major acute cardiovascular events: Out-of-hospital cardiac arrest, ST-elevation myocardial infarction and stroke","authors":"Angelo Auricchio ,&nbsp;Tommaso Scquizzato ,&nbsp;Federico Ravenda ,&nbsp;Ruggero Cresta ,&nbsp;Stefano Peluso ,&nbsp;Maria Luce Caputo ,&nbsp;Stefano Tonazzi ,&nbsp;Claudio Benvenuti ,&nbsp;Antonietta Mira","doi":"10.1016/j.resplu.2024.100810","DOIUrl":"10.1016/j.resplu.2024.100810","url":null,"abstract":"<div><h3>Background</h3><div>Predicting the incidence of time-sensitive cardiovascular diseases like out-of-hospital cardiac arrest (OHCA), ST-elevation myocardial infarction (STEMI), and stroke can reduce time to treatment and improve outcomes. This study analysed the spatio-temporal distribution of OHCAs, STEMIs, and strokes, their spatio-temporal correlation, and the performance of different prediction algorithms.</div></div><div><h3>Methods</h3><div>Adults who experienced an OHCA, STEMI, or stroke in Canton Ticino, Switzerland from 2005 to 2022 were included. Datasets were divided into training and validation samples. To estimate and predict the yearly per-capita population incidences of OHCA, STEMI, and stroke, the integrated nested Laplace approximation (INLA), machine learning meta model (MLMM), the Naïve prediction method, and the exponential moving average were employed and compared. The relationship between OHCA, STEMI, and stroke was assessed by predicting the incidence of one condition, considering the lagged incidence of the other two as explanatory variables.</div></div><div><h3>Results</h3><div>We included 3,906 OHCAs, 2,162 STEMIs, and 2,536 stroke patients. INLA and MLMM yearly predicted incidence OHCA, STEMI, and stroke at municipality level with very high accuracy, outperforming the Naïve forecasting and the exponential moving average. INLA exhibited errors of zero or one event in 82%, 87%, and 72% of municipalities for OHCA, STEMI, and stroke, respectively, whereas ML had errors in 81%, 89%, and 71% of municipalities for the same conditions. INLA had a prediction error of 0.87, 0.77, and 1.50 events per year per municipality for OHCA, STEMI and stroke, whereas MLMM of 0.70, 0.74, and 1.09 events, respectively. Including in the INLA model the lagged absolute values of the other conditions as covariates improved the prediction of OHCA and stroke but not STEMI. MLMM predictions were consistently the most accurate and did not benefit from the inclusion of the other conditions as covariates. All the three diseases showed a similar spatial pattern.</div></div><div><h3>Conclusions</h3><div>Prediction of incidence of OHCA, STEMI, and stroke is possible with very high accuracy using INLA and MLMM models. A robust spatio-temporal correlation between the 3 pathologies exists. Widespread implementation in clinical practice of prediction algorithms may allow to improve resource allocation, reduce treatment delays, and improve outcomes.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"20 ","pages":"Article 100810"},"PeriodicalIF":2.1,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142552856","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":"Evaluation of fatigue, load and the quality of chest compressions by bystanders in hot and humid environments","authors":"Haruka Takahashi ,&nbsp;Kensuke Suzuki ,&nbsp;Yohei Okada ,&nbsp;Satoshi Harada ,&nbsp;Hiroyuki Yokota ,&nbsp;Marcus Eng Hock Ong ,&nbsp;Satoo Ogawa","doi":"10.1016/j.resplu.2024.100818","DOIUrl":"10.1016/j.resplu.2024.100818","url":null,"abstract":"<div><h3>Background</h3><div>This study aimed to investigate the physiological load on bystanders during cardiopulmonary resuscitation (CPR) and the quality of chest compressions in hot and humid environments.</div></div><div><h3>Methods</h3><div>This prospective experimental study compared the physical load and quality of chest compressions among healthy volunteers who performed 10 min chest compression in a climate chamber under normal conditions (for Tokyo) (Wet Bulb Globe Temperature [WBGT] 21 °C) and hot and humid conditions (WBGT 31 °C). The primary outcome was the depth of chest compressions over a 10-minute period. Secondary outcomes included the volunteer’s heart rate (HR), core body temperature (BT), Borg scale for assessing fatigue, and blood lactate levels. Data were analyzed using two-way repeated measures analysis of variance (ANOVA) and paired t-tests.</div></div><div><h3>Results</h3><div>Out of 31 participants, 29 participants (mean [SD] age: 21[0.7], male: 21 [70.5 %]) were included in the analysis. For WBGT 21 °C and 31 °C, the mean chest compression depth at 10 min was not statistically difference (the depth of chest compression: 52.2 mm and 51.5 mm (p = 0.52)). At 10 min, heart rate and core temperature were 126 vs. 143 bpm, and 37.4℃ vs. 37.5℃ for WBGT 21℃ vs. WBGT 31℃ (mean differences: 17 bpm [95 % CI: 7.7–26.3], 0.1℃ [95 % CI: −0.1–0.3]). At the end, Borg scale was 16 vs. 18 and lactate levels were 3.9 vs. 5.1 mmol/L (mean differences: 2 [95 % CI: 1–3], 1.2 mmol/L [95 % CI: 0.1–2.3]).</div></div><div><h3>Conclusion</h3><div>there was no significant difference in the depth of chest compression of paramedic students under the conditions between WBGT 31℃ and WBGT 21℃. For secondary outcomes, the lactate and fatigue of bystanders increased under WBGT 31℃ compared to WBGT 21℃. Further research is needed on CPR in hot and humid environments.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"20 ","pages":"Article 100818"},"PeriodicalIF":2.1,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142552864","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":"Mirror, mirror, on the wall, who’s the fairest of them all?","authors":"Uri Adrian Prync Flato ,&nbsp;Ricardo Ferreira Mendes de Oliveira ,&nbsp;Lucas Kallas-Silva ,&nbsp;Maria Fernanda Dias Azevedo","doi":"10.1016/j.resplu.2024.100812","DOIUrl":"10.1016/j.resplu.2024.100812","url":null,"abstract":"","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"20 ","pages":"Article 100812"},"PeriodicalIF":2.1,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142552866","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":"Influence of rescuer position and arm angle on chest compression quality: An international multicentric randomized crossover simulation trial","authors":"Abel Nicolau ,&nbsp;Ingrid Bispo ,&nbsp;Marc Lazarovici ,&nbsp;Christoffer Ericsson ,&nbsp;Pedro Sa-Couto ,&nbsp;Inês Jorge ,&nbsp;Pedro Vieira-Marques ,&nbsp;Carla Sa-Couto","doi":"10.1016/j.resplu.2024.100815","DOIUrl":"10.1016/j.resplu.2024.100815","url":null,"abstract":"<div><h3>Background</h3><div>Success in resuscitation depends not only on the timeliness of the maneuvers but also on the quality of chest compressions. Factors such as the rescuer position and arm angle can significantly impact compression quality.</div></div><div><h3>Aim</h3><div>This study explores the influence of rescuer positioning and arm angle on the quality of chest compressions among healthcare professionals experienced in cardiopulmonary resuscitation.</div></div><div><h3>Methods</h3><div>In this international, multicentric, randomized crossover simulation trial with independent groups, healthcare professionals were assigned to one of four positions: kneeling on the floor, standing, standing on a step stool, and kneeling on the bed. Participants performed two 3-minute trials of uninterrupted chest compressions at arm angles of 90° and 105°. Compression quality was assessed, using manikin derived data.</div></div><div><h3>Results</h3><div>A total of 76 participants entered the study. Those using a 90° arm angle exhibited higher compression scores than those at a 105° angle. Rescuers standing on a step stool maintained higher scores over time when compared to other groups. In contrast, rescuers kneeling on the bed consistently scored below 75% throughout the trial, with particularly low scores at the 105° angle.</div></div><div><h3>Conclusion</h3><div>Rescuer position and arm angle significantly influence CPR quality, with a 90° arm angle and elevated positioning optimizing compression depth and effectiveness. The results recommend against kneeling on the bed due to its negative impact on chest compression quality.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"20 ","pages":"Article 100815"},"PeriodicalIF":2.1,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142552865","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":"Impact of endotracheal intubation versus laryngeal tube on gasometry and lactate at emergency department admission after out-of-hospital cardiac arrest","authors":"Olaf Aretz ,&nbsp;Jana Vienna Rödler ,&nbsp;Athina Gavriil ,&nbsp;Marc Deussen ,&nbsp;Emmanuel Chorianopoulos ,&nbsp;Sebastian Bergrath","doi":"10.1016/j.resplu.2024.100813","DOIUrl":"10.1016/j.resplu.2024.100813","url":null,"abstract":"<div><h3>Aim</h3><div>Guidelines recommend supraglottic airways (e.g. laryngeal tube, LT) for out-of-hospital cardiac arrest (OHCA) if providers are not skilled in endotracheal intubation (ETI). In prolonged cardiopulmonary resuscitation (CPR) LT led to asphyxial physiology. Therefore we evaluated the impact of LT vs. ETI on gasometry and lactate at admission.</div></div><div><h3>Methods</h3><div>All patients from 1 January 2020 to 30 April 2023 with return of spontaneous circulation (ROSC) or ongoing CPR (no ROSC) were included in this retrospective cohort study.</div><div>Continuous data were analysed using the Mann-Whitney-U-Test.</div></div><div><h3>Results</h3><div>Overall, 147 patients were included: ETI, n = 104; LT, n = 33; other airways, n = 10. ROSC, n = 86; no ROSC, n = 61. ETI vs. LT (median) for all patients showed: arterial blood gas analyses (BGA) (n = 62 vs. n = 20): pH 7.01 vs. 7.07, p = 0.83; pCO₂ 64.5 vs. 66.6 mmHg, p = 0.62; lactate 10.1 vs. 9.5 mmol/l, p = 0.68. Venous BGA (n = 37 vs. n = 11): pH 6.91 vs. 7.12, p = 0.15; pCO₂ 77.4 vs. 66.0 mmHg, p = 0.19; lactate 11.5 vs. 8.6 mmol/l, p = 0.24. ROSC, arterial BGA (n = 39 vs. n = 12): pH 7.09 vs. 7.14, p = 0.36; pCO₂ 60.3 vs. 56.4 mmHg, p = 0.84; lactate 8.95 vs. 7.0 mmol/l, p = 0.35. No ROSC, arterial BGA (n = 23 vs. n = 8): pH 6.9 vs. 6.8, p = 0.03; pCO₂ 80.7 vs. 85.6 mmHg, p = 0.64; lactate 13.0 vs. 14.6 mmol/l, p = 0.62.</div></div><div><h3>Conclusion</h3><div>The prehospital airway strategy had no impact on gasometry in this OHCA collective except a better pH with ETI in no ROSC. Due to small numbers and non-existent data about the exact prehospital ventilation parameters, further prospective studies are needed to evaluate this question.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"20 ","pages":"Article 100813"},"PeriodicalIF":2.1,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142537661","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":"The relationship between race and emergency medical services resuscitation intensity for those in refractory-arrest","authors":"Justin Yap ,&nbsp;Jacob Hutton ,&nbsp;Marina Del Rios ,&nbsp;Frank Scheuermeyer ,&nbsp;Malini Nair ,&nbsp;Laiba Khan ,&nbsp;Emad Awad ,&nbsp;Takahisa Kawano ,&nbsp;Valerie Mok ,&nbsp;Jim Christenson ,&nbsp;Brian Grunau","doi":"10.1016/j.resplu.2024.100806","DOIUrl":"10.1016/j.resplu.2024.100806","url":null,"abstract":"<div><h3>Background</h3><div>Previous studies have reported race-based health disparities in North America. It is unknown if emergency medical service (EMS) treatment of out-of-hospital cardiac arrest (OHCA) varies based on race. We sought to compare markers of resuscitation intensity among different racial groups.</div></div><div><h3>Methods</h3><div>Using data of adult EMS-treated OHCAs from the Trial of Continuous or Interrupted Chest Compressions During CPR, we analyzed data from participants for whom on-scene return of spontaneous circulation (ROSC) was not achieved. We fit multivariate regression models using a generalized estimating equation, to estimate the association between patient race (White vs. Black vs. “Other”) and the following markers for resuscitation intensity: (1) resuscitation attempt duration; (2) intra-arrest transport; (3) number of epinephrine doses; (4) EMS arrival-to-CPR interval, and (5) 9–1–1 to first shock.</div></div><div><h3>Results</h3><div>From our study cohort of 5370 cases, the median age was 65 years old (IQR: 53–78), 2077 (39 %) were women, 2121 (39 %) were Black, 596 (11 %) were “Other race”, 2653 (49 %) were White, and 4715 (88 %) occurred in a private location. With reference to White race, Black race was associated with a longer resuscitation attempt duration and a lower number of epinephrine doses; Black and “Other” race were both associated with a lower odds of intra-arrest transport.</div></div><div><h3>Conclusion</h3><div>We identified race-based differences in EMS resuscitation intensity for OHCA within a North American cohort, although 40% of race data was missing from this dataset. Future research investigating race-based differences in OHCA management may be warranted.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"20 ","pages":"Article 100806"},"PeriodicalIF":2.1,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142537364","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 neurological outcomes in patients experiencing out-of-hospital cardiac arrest and severe acidaemia: retrospective analysis of a nation-wide registry","authors":"Makoto Watanabe ,&nbsp;Tetsuhisa Kitamura ,&nbsp;Bon Ohta ,&nbsp;Tasuku Matsuyama","doi":"10.1016/j.resplu.2024.100809","DOIUrl":"10.1016/j.resplu.2024.100809","url":null,"abstract":"<div><h3>Background and objective</h3><div>Acidaemia is common among individuals who experience out-of-hospital cardiac arrest (OHCA). While severe acidaemia is a strong predictor of unfavourable outcomes, a subset of patients exhibits dramatic recovery. Despite these conflicting outcomes, little is known about the factors associated with neurological outcomes in those who experience OHCA with severe acidaemia.</div></div><div><h3>Methods</h3><div>This retrospective analysis used data from a Japanese multicentre nationwide database, the Japanese Association for Acute Medicine OHCA Registry. The analysis included data from adult patients with OHCA for whom blood pH data were available upon arrival to hospital. The primary outcome was 30-day survival with favourable neurological outcomes, defined as a Glasgow-Pittsburgh cerebral performance category score of 1 or 2. Patients were categorised with severe acidaemia if their blood pH was ≤ 6.8. Factors associated with favourable outcomes were investigated using multiple logistic regression analysis.</div></div><div><h3>Results</h3><div>Data from 49,044 patients were included in the analysis, of whom 16,620 exhibited severe acidaemia with a median pH of 6.70 (interquartile range [IQR] 6.61–6.76], and 0.5% (86/16,620) experienced a neurologically favourable outcome. After adjustment for important prognostic factors, witnessed status exhibited a strong association with favourable neurological outcome (adjusted odds ratio [aOR] 6.46 [95% confidence interval (CI) 2.64–15.8]), while initial blood pH exhibited no significant association (aOR 0.90 with every 0.1 unit increase [95% CI 0.71–1.14]).</div></div><div><h3>Conclusion</h3><div>Although the number is small, a notable number of patients with severe acidaemia exhibited good neurological recovery. Witness status was critical for the prognosis of these patients.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"20 ","pages":"Article 100809"},"PeriodicalIF":2.1,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142537660","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}