Resuscitation plus最新文献

{"title":"The influence of preexisting coronary artery disease on long-term follow up and neurological outcome in patients receiving out of hospital extracorporeal membrane oxygenation","authors":"Andrea Stadlbauer,&nbsp;Alois Philipp,&nbsp;Maik Foltan,&nbsp;Christian Stadlbauer,&nbsp;Simon Schopka,&nbsp;Christof Schmid,&nbsp;Andreas Keyser","doi":"10.1016/j.resplu.2025.101033","DOIUrl":"10.1016/j.resplu.2025.101033","url":null,"abstract":"<div><h3>Background</h3><div>Pre-hospital extracorporeal cardiopulmonary resuscitation (ECPR) in out-of-hospital cardiac arrest is costly and resource-intensive. Low survival rates raise questions concerning efficacy of ECPR. We aimed to analyze survival and neurological outcome of these patients and the influence of underlying coronary artery disease as well as shockable heart rhythm leading to resuscitation.</div></div><div><h3>Methods</h3><div>Retrospective analysis of our ECMO database revealed 94 patients receiving ECPR for out-of-hospital cardiac arrest from September 2009 to May 2023. After exclusion of patients with pulmonary embolism, drowning or intoxication as confounders, 58 patients remained. Patients were divided into 2 groups depending on underlying coronary artery disease and initial heart rhythm. Primary outcome was survival to discharge and long-term survival, secondary outcome was neurological capacity analyzed with the cerebral performance category score (CPC).</div></div><div><h3>Results</h3><div>26 patients (44.8 %) survived to discharge; 6 patients died during a median follow-up time of 1057.5 days. There was no significant difference concerning survival to discharge between the groups. Numerically, more patients with shockable rhythm and without coronary artery disease survived. Kaplan-Meier analysis revealed a survival benefit for patients with shockable rhythm without coronary artery disease (<em>p</em> &lt; 0.007). 92.3 % of survivors had a CPC-Score of 1. CPC Score did not differ between the groups.</div></div><div><h3>Conclusion</h3><div>Though mortality in ECPR patients remains high with 55.2 %, long-term and neurological outcome with a CPC score of 1 is very good, especially of those with shockable rhythm and without coronary artery disease. Old age and duration of cardiopulmonary resuscitation pre-ECMO impair neurological outcome. Thus, on-site ECMO cannulation should be endorsed.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"25 ","pages":"Article 101033"},"PeriodicalIF":2.1,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144695331","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":"Pad size, orientation, and placement for defibrillation during basic life support: A systematic review","authors":"Giuseppe Ristagno ,&nbsp;Federico Semeraro ,&nbsp;Violetta Raffay ,&nbsp;Giuseppe Stirparo ,&nbsp;Ileana Lulic ,&nbsp;Charles D. Deakin ,&nbsp;Ian R. Drennan ,&nbsp;Jimena Del Castillo ,&nbsp;Jason Acworth ,&nbsp;Peter T. Morley ,&nbsp;Gavin D. Perkins ,&nbsp;Micheal Smith ,&nbsp;Theresa M. Olasveengen ,&nbsp;Janet E. Bray","doi":"10.1016/j.resplu.2025.101030","DOIUrl":"10.1016/j.resplu.2025.101030","url":null,"abstract":"<div><h3>Aim</h3><div>To evaluate the impact of defibrillation pad size, orientation, and position on clinical outcomes in adult and paediatric cardiac arrest with a shockable rhythm through a systematic review of available evidence.</div></div><div><h3>Methods</h3><div>A systematic review was registered with PROSPERO (CRD42024512443). Searches were performed across PubMed, EMBASE, and the Cochrane Library up to March 31st, 2025. Studies involving adults or children with cardiac arrest and comparing pad sizes or positions were included. Risk of bias was assessed using the RoB 2.0 and ROBINS-I tools, and the certainty of evidence was evaluated using GRADE methodology.</div></div><div><h3>Results</h3><div>Of 7855 screened studies, four met inclusion criteria, e.g. 1 randomized clinical trial (RCT) and 3 observational studies in adults, covering 1334 adult cardiac arrest patients. Evidence on pad size, deriving from an observational study enrolling 314 patients, was sparse and inconclusive, with no significant differences in defibrillation success between large and small pads (OR 0.82[0.42–1.60]). For pad orientation, no evidence was found. For pad placement, one RCT including 280 patients suggested a potential survival benefit from vector-change defibrillation using anterior-posterior (AP) pad placement in refractory ventricular fibrillation (VF), compared to the standard anterior-lateral (AL) placement (adj. RR 1.71[1.01–2.88]). Data from two observational studies including 739 patients were conflicting and limited by high risk of bias.</div></div><div><h3>Conclusion</h3><div>Evidence remains inconclusive to support the superiority of any specific pad size, orientation or position for improving survival or neurological outcomes in cardiac arrest. However, vector-change to the AP position may offer benefit in cases of refractory VF. High-quality RCTs are needed to further inform clinical practice.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"25 ","pages":"Article 101030"},"PeriodicalIF":2.1,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144695330","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":"Paramedic assessment of carotid artery pulsation using pre-recorded ultrasound videos: a comparative analysis of three ultrasound modes","authors":"C. Gaik,&nbsp;H. Wulf,&nbsp;B. Vojnar","doi":"10.1016/j.resplu.2025.101028","DOIUrl":"10.1016/j.resplu.2025.101028","url":null,"abstract":"<div><h3>Background</h3><div>This cross-sectional study aimed to determine whether paramedics with limited or no prior ultrasound experience can consistently identify the presence or absence of common carotid artery (CCA) pulsation, as a potential alternative to manual pulse checks during cardiopulmonary resuscitation.</div></div><div><h3>Methods</h3><div>Following a six-minute instructional video, paramedics assessed short pre-recorded ultrasound videos of the CCA acquired in B-mode, M−mode, and Color Doppler. Each of the 93 participants viewed 24 randomized 10-second videos and classified each as showing pulsation or no pulsation. To replicate clinical conditions where manual pulse checks may fail − such as post-resuscitation − videos were recorded during two distinct phases of cardiac surgery: (1) under controlled hypotension and (2) during complete circulatory standstill following aortic clamping.</div></div><div><h3>Results</h3><div>A total of 2232 assessments were analyzed. M−mode: Participants correctly identified CCA pulsation in 95 % (265/279) of assessments. In videos without CCA pulsation, the correct classification of ‘no pulsation present’ was achieved in 97 % (270/279). B-mode: The presence of CCA pulsation was correctly identified in 78 % (218/279), whereas in 22 % (61/279) of cases, participants incorrectly categorized the video as ‘no pulsation present’ despite pulsation being present. Conversely, the absence of CCA pulsation was accurately detected in 98 % (635/651) of cases. Color Doppler: CCA pulsation was correctly identified in 99 % (551/558) of assessments. Similarly, in videos without CCA pulsation, participants correctly classified 96 % (185/186) as ‘no pulsation present’.</div></div><div><h3>Conclusion</h3><div>Paramedics demonstrated a high level of diagnostic accuracy in identifying both the presence and absence of CCA pulsation using two-dimensional (2D) ultrasound across multiple imaging modes in a controlled study setting. The findings suggest that the combination of Color Doppler and, in particular, M−mode appears to be the most suitable approach for identifying CCA pulsation via ultrasound.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"25 ","pages":"Article 101028"},"PeriodicalIF":2.1,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144679497","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":"Comparative features and outcomes of cardiogenic shock in patients with and without prior resuscitated shockable cardiac arrest: Insight from the FRENSHOCK multicenter prospective registry","authors":"Hamid Merdji ,&nbsp;Vincent Bataille ,&nbsp;Anais Curtiaud ,&nbsp;Laurent Bonello ,&nbsp;François Roubille ,&nbsp;Bruno Levy ,&nbsp;Pascal Lim ,&nbsp;Jean-Claude Dib ,&nbsp;Julien Maizel ,&nbsp;Nicolas Brechot ,&nbsp;Marion Beuzelin ,&nbsp;Emmanuelle Fillippi ,&nbsp;Miloud Cherbi ,&nbsp;Julien Demiselle ,&nbsp;Grégoire Rangé ,&nbsp;Jérémie Joffre ,&nbsp;Marwan Yassine ,&nbsp;Caroline Biendel ,&nbsp;Fanny Bounes ,&nbsp;Guillaume Leurent ,&nbsp;Zogheib Elie","doi":"10.1016/j.resplu.2025.101024","DOIUrl":"10.1016/j.resplu.2025.101024","url":null,"abstract":"<div><h3>Aim</h3><div>Differences between cardiogenic shock (CS) with and without prior resuscitated cardiac arrest (CA) remain largely unexplored. We hypothesized that patients who experience shockable CA followed by CS are likely to have worse outcomes compared to CS without prior CA.</div></div><div><h3>Methods</h3><div>FRENSHOCK is a prospective multicenter observational registry conducted in French critical care units in 2016, which included CS from various etiologies. Patients admitted after resuscitation of a CA were included if they fulfilled previously defined CS criteria. Non-shockable rhythms at the time of medical intervention were considered exclusion criteria and were not recorded in the registry.</div></div><div><h3>Results</h3><div>Among the 771 enrolled patients (mean age 65.7 ± 14.9 years; 71.5 % male), 79 (10.2 %) had a resuscitated shockable cardiac arrest just before inclusion. Shockable CA patients had more respiratory support (78.5 % vs. 33.2 %, <em>p</em> &lt; 0.001), more mechanical circulatory support (35.4 % vs. 16.5 %, <em>p</em> &lt; 0.001), more coronary angiography performed (76 % vs. 48.8 %, <em>p</em> &lt; 0.001), finding more mono-troncular lesions (39 % vs. 16.9 %, <em>p</em> &lt; 0.001). Thirty-day and one-year survival were similar between groups. Among 30-day survivors, CS with an initial shockable CA exhibited significantly improved long-term survival compared to CS without prior resuscitated CA.</div></div><div><h3>Conclusion</h3><div>In a cohort of patients with cardiogenic shock from various etiologies, approximately 10% had experienced prior resuscitation following a cardiac arrest with shockable rhythms. Our findings suggest that selected cardiac arrest with a shockable rhythm leading to cardiogenic shock does not inherently confer a worse prognosis compared to other causes of cardiogenic shock.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"25 ","pages":"Article 101024"},"PeriodicalIF":2.1,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144703014","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":"Neurofilament, but not Alzheimer disease biomarkers in the acute phase correlate with cognitive performance after cardiac arrest","authors":"Johannes Lorentzson ,&nbsp;Gisela Lilja ,&nbsp;Erik Blennow Nordström ,&nbsp;Kaj Blennow ,&nbsp;Henrik Zetterberg ,&nbsp;Christian Hassager ,&nbsp;Matt P. Wise ,&nbsp;Andrea L. Benedet ,&nbsp;Tommaso Pellis ,&nbsp;Hans Friberg ,&nbsp;Nicholas Ashton ,&nbsp;Marion Moseby Knappe","doi":"10.1016/j.resplu.2025.101025","DOIUrl":"10.1016/j.resplu.2025.101025","url":null,"abstract":"<div><h3>Background</h3><div>Biomarkers serve as a quantitative measure of brain injury and may predict cognitive outcome after cardiac arrest. This study investigates the association and predictive accuracy of acute changes in Alzheimer disease-associated biomarkers to cognitive outcome in cardiac arrest survivors.</div></div><div><h3>Methods</h3><div>Retrospective study of the Target Temperature Management after Out-of-Hospital cardiac arrest trial. Serum from adult cardiac arrest survivors was sampled prospectively at 24, 48, and 72 h post-arrest and analyzed for peak-levels of Alzheimer disease markers (p-tau¹⁸¹, total tau, amyloid β [Aβ40 and Aβ42]), and the neurodegenerative biomarker neurofilament light (NfL). Cognitive outcome was evaluated blinded from biomarker results using four performance-based assessments at 6 months post-arrest. Spearman correlations were calculated. Area Under the Receiver Operating Characteristics curves (AUC) were calculated for biomarkers discriminatory ability for binary results of cognitive performance.</div></div><div><h3>Results</h3><div>206/342 (60 %) survivors from participating sites were included. Median was age 62 (IQR 53–69), 86 % male, 15 (7 %) had Mini-Mental State Examination (MMSE) scores &lt; 24. Alzheimer disease biomarkers exhibited at best small correlations to cognitive outcomes (rho = −0.22 to 0.18). The correlation between outcome instruments and NfL was rho = −0.32 to −0.20 (<em>p</em> &lt; 0.01). Discriminatory ability of cognitive impairment for acute changes in Alzheimer disease biomarkers was AUC 0.44–0.68 (95 % CI 0.29–0.82), and AUC 0.66–0.86 (95 % CI 0.59–0.95) for NfL.</div></div><div><h3>Conclusion</h3><div>In contrast to tau- and amyloid-related biomarkers, NfL could be more useful for predicting cognitive function in cardiac arrest survivors. Low participation by survivors with severe brain injury may have influenced results.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"25 ","pages":"Article 101025"},"PeriodicalIF":2.1,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144653758","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":"A chain of survival for drug overdose","authors":"Matthew Robert Dernbach ,&nbsp;Nabarun Dasgupta ,&nbsp;Adams L. Sibley ,&nbsp;Ida Tylleskar ,&nbsp;Arne Kristian Skulberg","doi":"10.1016/j.resplu.2025.101026","DOIUrl":"10.1016/j.resplu.2025.101026","url":null,"abstract":"<div><div>Drug overdose is a leading global cause of preventable morbidity and mortality and is closely associated with out-of-hospital cardiac arrest. While the American Heart Association’s “chain of survival” has improved outcomes in traditional cardiac arrest, it does not address the unique characteristics and challenges of overdose-related emergencies. In this article, we propose a novel “overdose chain of survival” to emphasize the importance of linking acute care with long-term prevention. This six-link framework includes: (1) prevention, (2) recognition and activation of emergency services, (3) basic first aid, (4) emergency treatment, (5) post-overdose care, and (6) recovery and secondary prevention. Each link highlights opportunities for intervention and coordination across systems of care. The framework is intended to guide clinical care, policy development, education, and research. By viewing overdose through a structured and holistic lens, the overdose chain of survival seeks to improve outcomes in the immediate aftermath of an overdose and also to address systemic barriers to sustained recovery. This conceptual model is adaptable to evolving drug trends and highlights the need for integrated, patient-centered approaches to overdose response and prevention.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"25 ","pages":"Article 101026"},"PeriodicalIF":2.1,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144633255","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":"Integrating smartwatch-based out-of-hospital cardiac arrest detection into resuscitation systems: a focus group study of community responder perspectives","authors":"Marijn Eversdijk ,&nbsp;Babette J.W. van der Eerden ,&nbsp;Dick L. Willems ,&nbsp;Willem J. Kop ,&nbsp;Mirela Habibović ,&nbsp;Marieke A.R. Bak","doi":"10.1016/j.resplu.2025.101027","DOIUrl":"10.1016/j.resplu.2025.101027","url":null,"abstract":"<div><h3>Background</h3><div>Smartwatch-based solutions for out-of-hospital cardiac arrest (OHCA) detection are increasingly explored to enhance survival outcomes, especially in unwitnessed cases. However, the perspectives of community responders, who play a critical role in early responding to resuscitation alerts, are not yet known. Exploring their current experiences and perspectives on this new technology is important for successfully developing and integrating these innovations into existing resuscitation systems.</div></div><div><h3>Methods</h3><div>Four semi-structured focus group discussions (FGDs) were conducted with 15 community responders in the Netherlands, recruited through the national cardiac arrest emergency network. Each FGD comprised two discussion topics: (1) integrating smartwatch-based OHCA detection into the current resuscitation system and (2) mitigating the burden of this technology on community responders. Verbatim transcripts were inductively coded for recurring themes.</div></div><div><h3>Results</h3><div>The FGDs revealed 54 unique codes that were grouped into four themes: (1) Missing information about the cause of the alert; (2) decision-making regarding accepting the alert, (3) challenges in reaching the location and (4) availability of aftercare for community responders.</div></div><div><h3>Conclusion</h3><div>This study identifies target topics that require attention in order to optimise community responders involvement in the implementation of smartwatch-based OHCA detection. Community responders indicated communication with the emergency dispatch centre, training with smartwatch-initiated scenarios and opt-in functionalities for responding to potential impactful situations as key factors to enhance the acceptability and feasibility. These factors ultimately aim to facilitate faster and more effective resuscitation following smartwatch-initiated alerts.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"25 ","pages":"Article 101027"},"PeriodicalIF":2.1,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144633256","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":"Higher bilirubin on admission predicts better outcome in refractory cardiac arrest: A Prague OHCA trial analysis focused on the antioxidant effect of bilirubin","authors":"Jan Pudil ,&nbsp;Martin Leníček ,&nbsp;Petra Kaválková ,&nbsp;Daniel Rob ,&nbsp;Milan Dusík ,&nbsp;Ján Tvrdoň ,&nbsp;Jana Šmalcová ,&nbsp;Tomáš Kovárník ,&nbsp;Libor Vítek ,&nbsp;Jan Bělohlávek","doi":"10.1016/j.resplu.2025.101023","DOIUrl":"10.1016/j.resplu.2025.101023","url":null,"abstract":"<div><h3>Background</h3><div>Although bilirubin is a proven antioxidant substance and a protective factor against the development of various diseases, in emergency medicine, its increased concentration is considered solely a marker of organ damage and negative prognosis. However, clinical data on the role of bilirubin in cardiac arrest (CA) and reperfusion injury, are sparse. The presented study investigates the protective effects of increased serum bilirubin concentrations and genetic determinants (UGT1A1 promoter variations) on the outcomes of patients with refractory out-of-hospital CA (r-OHCA) in a randomized population.</div></div><div><h3>Methods</h3><div>Between March 1, 2013, and October 25, 2020, 256 randomized Prague OHCA patients with r-OHCA were evaluated for inclusion and categorized as having increased (&gt;10 µmol/l) or low/normal serum bilirubin concentrations on hospital arrival and present or absent genetic variations for mild hyperbilirubinemia. The primary outcome was survival with a good neurological outcome (defined as cerebral performance category 1–2) 180 days after randomization.</div></div><div><h3>Results</h3><div>Finally, 164 patients were included in the bilirubin concentration analysis. Favorable neurological survival after 180 days occurred in 50 of 99 patients (50.5 %) in the group with higher initial serum bilirubin concentrations and 18 of 65 patients (27.7 %) in the low-bilirubin group (absolute difference 22.8 [8.1–37.5]; <em>P</em> = 0.006). The effect persisted also in multivariable analysis (OR for favorable outcome = 3.02 [95 % CI = 1.16–7.84]; <em>P</em> = 0.023). Genetic predisposition for mild hyperbilirubinemia was not associated with any patient outcomes.</div></div><div><h3>Conclusions</h3><div>A higher initial serum bilirubin concentration predicts better outcomes in patients with refractory OHCA regardless of the treatment used. <em>UGT1A1</em> gene promotor variations are not associated with refractory OHCA patient outcomes.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"25 ","pages":"Article 101023"},"PeriodicalIF":2.1,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144633161","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":"Factors for good neurological outcome in adult OHCA with initial shockable rhythm: a retrospective multicenter cohort study from the German Resuscitation Registry","authors":"Stephan Katzenschlager ,&nbsp;Nikolai Kaltschmidt ,&nbsp;Simon Orlob ,&nbsp;Frank Weilbacher ,&nbsp;Matthias Huck ,&nbsp;Stephan Seewald ,&nbsp;Lisa Rück ,&nbsp;Hanna Hoffmann ,&nbsp;Erik Popp ,&nbsp;Jan-Thorsten Gräsner ,&nbsp;Jan Wnent","doi":"10.1016/j.resplu.2025.101022","DOIUrl":"10.1016/j.resplu.2025.101022","url":null,"abstract":"<div><h3>Study aim</h3><div>This study examined defibrillation attempts during out-of-hospital cardiac arrest (OHCA) with shockable rhythm and survival outcomes, focusing on good neurological outcome at discharge. It aimed to identify predictors of favorable outcomes and guide future trials for alternative defibrillation strategies.</div></div><div><h3>Methods</h3><div>In this retrospective, multicenter cohort study, data were extracted from the German Resuscitation Registry for adult patients (≥18 years) who experienced OHCA with an initial shockable rhythm between January 2007 and December 2023. Only cases from good data quality centers were included. Patients were categorized according to the number of defibrillations received (1, 2–3, 4–6, and ≥7). Multivariable logistic regression was performed to identify independent predictors of favorable neurological outcomes.</div></div><div><h3>Results</h3><div>Out of 332,001 OHCA records, 15,284 met the inclusion criteria. Survival endpoints, including any return of spontaneous circulation, hospital admission with ROSC, 24-h survival, and survival to discharge, significantly declined with an increasing number of defibrillation attempts. In the regression analysis, EMS-witnessed arrests were strongly associated with favorable outcomes (OR 3.8; 95 % Confidence Interval 3.1–4.7). More defibrillations, prolonged ambulance response times, and older age were independently associated with lower odds of achieving a favorable neurological outcome.</div></div><div><h3>Conclusion</h3><div>An increasing number of defibrillations is independently linked to reduced survival and worse neurological outcomes in adults experiencing out-of-hospital cardiac arrest with an initial shockable rhythm. These results underscore the urgent need for alternative management strategies for multiple defibrillation attempts. These compelling observations warrant a reevaluation of defibrillation protocols to improve patient outcomes.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"25 ","pages":"Article 101022"},"PeriodicalIF":2.1,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144605988","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":"Philanthropy through income tax donations: advancing education in adult basic life support and accessibility of automated external defibrillators","authors":"Nino Fijačko,&nbsp;Kristin Alm-Kruse,&nbsp;Sergio Cazorla-Calderón,&nbsp;Rosario Losiggio,&nbsp;Robert Greif","doi":"10.1016/j.resplu.2025.101021","DOIUrl":"10.1016/j.resplu.2025.101021","url":null,"abstract":"","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"25 ","pages":"Article 101021"},"PeriodicalIF":2.1,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144605989","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}