Resuscitation plus最新文献

{"title":"Evaluation of genetic-molecular causes of out-of-hospital cardiac arrest – from patients to families: the GenetiCA study","authors":"Arianna Morena ,&nbsp;Sara Bendotti ,&nbsp;Annapaola D’Ambrosio ,&nbsp;Gianluca Marconi ,&nbsp;Giuseppe Stirparo ,&nbsp;Catherine Klersy ,&nbsp;Alessia Currao ,&nbsp;Roberto Primi ,&nbsp;Leila UImanova ,&nbsp;Mario Urtis ,&nbsp;Enrico Contri ,&nbsp;Alessandra Palo ,&nbsp;Alessandro Vicentini ,&nbsp;Simone Savastano ,&nbsp;Maurizia Grasso ,&nbsp;Eloisa Arbustini ,&nbsp;Leonardo De Luca ,&nbsp;Enrico Baldi","doi":"10.1016/j.resplu.2026.101351","DOIUrl":"10.1016/j.resplu.2026.101351","url":null,"abstract":"<div><h3>Background</h3><div>Out-of-hospital cardiac arrest (OHCA) is a public health priority. In patients aged ≤50 years, inherited arrhythmogenic and structural heart diseases represent a leading etiology, yet existing evidence is largely derived from small, selected cohorts, and population-based estimates of genetic contribution to OHCA in young are still lacking.</div></div><div><h3>Methods</h3><div>A multicenter, prospective observational study enrolling all patients aged ≤50 years who experience a medically-caused OHCA in Lombardy Region (Italy). (<span><span>ClinicalTrials.gov</span><svg><path></path></svg></span> NCT06844851). Blood samples will be collected in the pre-hospital by Emergency Medical System during Advanced Life Support. Genetic analysis will be performed using Next-Generation Sequencing with a comprehensive multigene panel targeting inherited arrhythmogenic syndromes and cardiomyopathies. Pre-hospital clinical data, environmental air pollution data and clinical outcomes will be collected. Family members of probands carrying pathogenic (P), likely-pathogenic (LP), or uncertain variants will be offered genetic counseling and clinical evaluation. The primary outcome will be to determine the prevalence of inherited arrhythmogenic and structural cardiomyopathies among young OHCA cases in this geographic area. Secondary outcomes will assess regional variability, associations with initial rhythm, sex, environmental pollution, and survival according to genetic findings.</div></div><div><h3>Expected results</h3><div>Based on the regional OHCA registry (LombardiaCaRe), approximately 575 resuscitated young OHCA cases are expected annually. P/LP variants are anticipated in 15–25% of cases, corresponding to 86–144 individuals/year.</div></div><div><h3>Discussion</h3><div>GenetiCA study will provide the first population-based assessment of inherited cardiac diseases among young OHCA patients within an entire geographic region. It aims to clarify the genetic burden of OHCA, support targeted family screening with potential implications for public health policies.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"29 ","pages":"Article 101351"},"PeriodicalIF":2.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147945119","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":"Drone-delivery of defibrillators reduces time to defibrillation in a ski resort: a randomised simulation-based trial","authors":"Michiel J. van Veelen ,&nbsp;Tomas Dal Cappello ,&nbsp;Giovanni Vinetti ,&nbsp;Abraham Mejia-Aguilar ,&nbsp;Alexandre Tomasi ,&nbsp;Rosmarie Oberhammer ,&nbsp;Marika Falla ,&nbsp;Giacomo Strapazzon","doi":"10.1016/j.resplu.2026.101360","DOIUrl":"10.1016/j.resplu.2026.101360","url":null,"abstract":"<div><h3>Background</h3><div>Out-of-hospital cardiac arrest (OHCA) is the leading cause of sudden, non-traumatic death in ski resorts. Early defibrillation is essential, yet access to automated external defibrillators (AEDs) is often delayed. Drone-based AED delivery has shown promise in urban settings, but its feasibility and performance under winter alpine conditions remain largely unknown.</div></div><div><h3>Methods</h3><div>In this randomised, simulation-based cross-over trial, three methods of AED delivery were compared: (1) automated drone delivery to bystanders, (2) snowmobile-equipped ski patrol, and (3) simulated helicopter emergency medical service (HEMS) flights. Thirty-six simulations involving 12 bystanders, 2 ski patrollers, and 2 physicians were planned. The simulations took place at distances of up to 2500 m at four locations at 2275 m altitude in a highly visited ski resort in the Alps. The primary outcome was time to defibrillation (TTD). Secondary outcomes included bystanders’ perceived workload, physical effort, and handling difficulty.</div></div><div><h3>Results</h3><div>Thirty (83%) simulations were completed; six (17%) were cancelled due to severe snowfall. Drone-delivered AEDs achieved significantly shorter TTD compared with snowmobile ski patrol [5.6 (95% CI 4.9–6.3) min vs. 6.7 (95% CI 6.1–7.3) min; <em>p</em> = 0.019] and compared with HEMS [15.3 (95% CI 14.6–16.0) min; <em>p</em> &lt; 0.001]. Bystanders correctly applied AED pads in all scenarios and reported low median workload (NASA-TLX 7.3/20) and low median handling difficulty and physical effort (VAS 13 and 22 mm on a 100-mm scale).</div></div><div><h3>Conclusions</h3><div>Automated drone delivery of AEDs in a mountainous ski resort is feasible under winter conditions and could reduce TTD compared with conventional rescue responses.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"29 ","pages":"Article 101360"},"PeriodicalIF":2.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147995218","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":"Computed tomography assessment after out-of-hospital cardiac arrest resuscitation","authors":"Saleem M. Halablab ,&nbsp;Frances Shofer ,&nbsp;Aarthi Kaviyarasu ,&nbsp;Oscar J.L. Mitchell ,&nbsp;William Reis ,&nbsp;Taylor Brothers ,&nbsp;David Fischer ,&nbsp;Benjamin S. Abella ,&nbsp;John Greenwood","doi":"10.1016/j.resplu.2026.101346","DOIUrl":"10.1016/j.resplu.2026.101346","url":null,"abstract":"<div><h3>Aims</h3><div>The present study aims to assess the incidence of causes of cardiac arrest and sequelae after resuscitation from OHCA (out-of-hospital cardiac arrest) identified on early, post-arrest Computed Tomography (CT).</div></div><div><h3>Methods</h3><div>This is an observational, registry study of adult OHCA patients admitted to three hospitals at the University of Pennsylvania Health System who achieved sustained return of spontaneous circulation between January 2019 and October 2020. Data collected encompassed demographics, arrest characteristics, basic metabolic profiles, CT imaging data, and clinical care notes. Primary outcome is survival to hospital discharge and secondary outcomes included neurologic outcome, CT findings and interventions, and IV contrast and kidney injury rates.</div></div><div><h3>Results</h3><div>Out of 161 patients, 117 received at least one CT in the ED after return of spontaneous circulation. The most common pathologies identified by post-arrest CT scans include cerebral oedema (30/117); pulmonary embolism (8/87); sternal fractures (9/87); pulmonary infiltrates (69/87) that included aspiration, pneumonia, or pneumonitis; deep venous thrombosis (4/64); pulmonary contusions (4/87); hematomas (2/87); flail chest (1/87).</div></div><div><h3>Conclusion</h3><div>Early CT imaging after ROSC from OHCA regularly identified potential causes of cardiac arrest and important sequelae of resuscitation efforts. Implementing larger scale prospective studies comparing such protocols and standard-of-care is important to determine impact on OHCA outcomes.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"29 ","pages":"Article 101346"},"PeriodicalIF":2.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147859064","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":"Rethinking intra-arrest thrombolysis: the role of patient selection and timing","authors":"Tao Wu","doi":"10.1016/j.resplu.2026.101361","DOIUrl":"10.1016/j.resplu.2026.101361","url":null,"abstract":"","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"29 ","pages":"Article 101361"},"PeriodicalIF":2.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148177687","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":"Anticipatory charging of the defibrillator: a systematic review","authors":"Ziad Nehme ,&nbsp;Helen Pocock ,&nbsp;Tatsuya Norii ,&nbsp;Theresa Olasveengen ,&nbsp;Ian R. Drennan ,&nbsp;Janet E. Bray","doi":"10.1016/j.resplu.2026.101349","DOIUrl":"10.1016/j.resplu.2026.101349","url":null,"abstract":"<div><h3>Aim</h3><div>To evaluate whether anticipatory charging of the defibrillator prior to rhythm analysis improves patient outcomes and resuscitation performance compared with charging the defibrillator after rhythm analysis.</div></div><div><h3>Methods</h3><div>We conducted a systematic review (PROSPERO CRD420251068149) through searching MEDLINE, EMBASE, and the Cochrane library from inception through November 24, 2025. Eligible studies included randomised controlled trials and observational studies comparing charging the defibrillator prior to rhythm analysis with charging after rhythm analysis. We excluded conference abstracts and unpublished literature. Risk of bias was assessed using Cochrane’s Risk of Bias-2 and QUIPS, and GRADE was used for outcome assessment. Due to significant heterogeneity, meta-analysis was not performed, and a narrative synthesis of the findings is provided.</div></div><div><h3>Results</h3><div>Eleven studies met inclusion criteria: five clinical observational studies and six simulation trials. Certainty of evidence was very low for all outcomes (high risk of bias and indirectness from simulation or bundled intervention studies). Observational studies showed mixed associations between anticipatory charging and survival or return of spontaneous circulation (ROSC), with some benefit when implemented in bundled interventions. Across clinical and simulation studies, anticipatory charging consistently reduced pre-shock and peri-shock pauses compared with standard charging after rhythm analysis. However, comparisons with the 2010 guideline charging method were inconsistent. Limited data from one small study of in-hospital cardiac arrests suggested similar rates of inadvertent shocks across charging strategies.</div></div><div><h3>Conclusion</h3><div>Anticipatory charging is feasible and associated with fewer interruptions in chest compressions compared with standard charging but may not be superior to the 2010 guideline charging method. Its impact on survival and neurological outcomes also remain uncertain.</div></div><div><h3>Registration</h3><div>PROSPERO CRD420251068149.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"29 ","pages":"Article 101349"},"PeriodicalIF":2.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147945177","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":"Dispatcher-led triage to reduce futile EMS transport for suspected out-of-hospital cardiac arrest in Japan: a narrative review and phased implementation framework","authors":"Yoshinori Ito ,&nbsp;Hideo Inaba","doi":"10.1016/j.resplu.2026.101353","DOIUrl":"10.1016/j.resplu.2026.101353","url":null,"abstract":"<div><div>Dispatcher-led triage for suspected out-of-hospital cardiac arrest (OHCA) may help reduce nonbeneficial emergency medical service (EMS) responses and transport by enabling conservative response modification in narrowly defined cases of obvious death (e.g., clear postmortem changes or catastrophic injury incompatible with life) or expected death (e.g., verifiable do-not-attempt-resuscitation/advance care planning documentation). In Japan, EMS generally initiates resuscitation and transports patients with suspected OHCA unless unequivocal signs of death are present. Drawing on international systems (e.g., the United Kingdom and Ontario) and recent evidence on dispatcher recognition accuracy, this narrative review summarizes practical safeguards relevant to call-stage triage, including high-sensitivity protocols, escalation rules when uncertainty persists, and structured quality assurance and quality improvement to detect false-negative decisions. It also proposes a phased implementation framework for Japan comprising (1) protocol refinement and monitoring of recognition accuracy, (2) legal and governance preparation with physician oversight, (3) simulation-based training and audit infrastructure, and (4) technology-supported triage (e.g., video) with prospective evaluation. Because direct evidence for dispatcher-stage triage in the specific form proposed for Japan remains limited, any transport-reduction policy should remain narrowly scoped and be supported by physician oversight, transparent auditing, and equity monitoring to ensure that efficiency gains do not come at the cost of missed potentially salvageable arrests.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"29 ","pages":"Article 101353"},"PeriodicalIF":2.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147945179","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":"External validation of the R-EDByUS score for neuroprognostication in out-of-hospital cardiac arrest","authors":"Chun-Hsiang Huang ,&nbsp;Cheng-Yi Fan ,&nbsp;Chien-Tai Huang ,&nbsp;Chi-Hsin Chen ,&nbsp;Ching-Yu Chen ,&nbsp;Yun-Chang Chen ,&nbsp;Wen-Chu Chiang ,&nbsp;Wei-Tien Chang ,&nbsp;Chien-Hua Huang ,&nbsp;Edward Pei-Chuan Huang ,&nbsp;Chih-Wei Sung","doi":"10.1016/j.resplu.2026.101339","DOIUrl":"10.1016/j.resplu.2026.101339","url":null,"abstract":"<div><h3>Background</h3><div>The R-EDByUS score predicts 1-month neurological outcomes for out-of-hospital cardiac arrest (OHCA) patients, considering prehospital return of spontaneous circulation (ROSC) and ongoing cardiopulmonary resuscitation (CPR). We aimed to externally validate the R-EDByUS scoring system in Taiwanese patients who experienced OHCA.</div></div><div><h3>Methods</h3><div>This multicenter retrospective cohort study was conducted at the National Taiwan University Hospital and its affiliated branches, including adult patients who experienced non-traumatic OHCA, from January 2016 to December 2023. We assessed the performance of the R-EDByUS scoring system in predicting unfavorable neurological outcomes (Cerebral Performance Category scores: 3–5) at hospital discharge. The area under the receiver operating characteristic curve (AUROC), sensitivity, specificity, and calibration curves were used to evaluate the model’s performance in the two cohorts.</div></div><div><h3>Results</h3><div>A total of 3417 patients were included and divided into prehospital ROSC (<em>n</em> = 170) and ongoing CPR (<em>n</em> = 3247) cohorts. In the prehospital ROSC cohort, the AUROC values were 0.79 (95% confidence interval (CI): 0.72–0.86) for the regression-based model and 0.73 (95% CI: 0.65–0.80) for the simplified model, indicating good predictive accuracy. In the ongoing CPR cohort, the AUROC values were 0.78 (95% CI: 0.74–0.81) and 0.77 (95% CI: 0.73–0.82), respectively. For ongoing CPR cohort, the calibration curve showed underestimation at low predicted probabilities but overestimation at high predicted probabilities.</div></div><div><h3>Conclusion</h3><div>With only prehospital variables, the R-EDByUS scoring system showed good performance in Taiwanese OHCA patients for prehospital ROSC group. However, further studies are warranted before the score can be applied clinically in the ongoing CPR cohort.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"29 ","pages":"Article 101339"},"PeriodicalIF":2.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147859073","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":"Determinants of bystander removal attempts in witnessed foreign body airway obstruction: a prospective nationwide multicenter observational study from the MOCHI registry","authors":"Yutaka Igarashi ,&nbsp;Tatsuya Norii ,&nbsp;Hatsumi Nakanishi ,&nbsp;Ryotaro Suga ,&nbsp;Ryuta Nakae ,&nbsp;Shoji Yokobori","doi":"10.1016/j.resplu.2026.101342","DOIUrl":"10.1016/j.resplu.2026.101342","url":null,"abstract":"<div><h3>Background</h3><div>Foreign body airway obstruction (FBAO) is a time-critical emergency. Although bystander removal maneuvers can improve outcomes, they are not consistently attempted even when events are witnessed. We aimed to identify patient-, witness-, and setting-related factors associated with the absence of bystander removal attempts in witnessed FBAO.</div></div><div><h3>Methods</h3><div>We analyzed a prospective, nationwide, multicenter cohort from the MOCHI registry in Japan, including patients with witnessed FBAO. The primary outcome was absence of a bystander removal attempt. Multivariable logistic regression with multiple imputation for missing data was used to examine associations with patient age, sex, eating function, location (home, care facility, public), and witness/bystander age and sex.</div></div><div><h3>Results</h3><div>Among 325 witnessed FBAO events, 193 (59%) involved a removal attempt and 132 (41%) did not. The median patient age was 81 years. Attempt rates varied by location: 82% in care facilities, 52% at home, 43% in public places. Witnesses/bystanders were significantly older in events without an attempt (median 60 vs. 50 years). Older witness/bystander age was independently associated with higher odds of no attempt (OR 1.39 per 10-year increase; 95% CI 1.14–1.70). Compared with home, no attempt was less frequent in care facilities (OR 0.43; 95% CI 0.20–0.93) and more frequent in public places (OR 2.11; 95% CI 1.08–4.10).</div></div><div><h3>Conclusions</h3><div>In witnessed FBAO, removal attempts were less likely when witnesses were older and when events occurred in public places. These findings may help inform age-tailored and setting-specific first-aid strategies to increase bystander intervention.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"29 ","pages":"Article 101342"},"PeriodicalIF":2.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147859063","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":"Potential return of spontaneous circulation in Japanese out-of-hospital cardiac arrest patients with pseudo–pulseless electrical activity: a post hoc analysis of a prospective multicentric study","authors":"Yuichi Horikoshi ,&nbsp;Jun Hamaguchi ,&nbsp;Ryo Ishizawa ,&nbsp;Takahiro Yamanaka ,&nbsp;Keiki Shimizu ,&nbsp;Nobuya Kitamura ,&nbsp;Yosuke Homma ,&nbsp;Hiraku Funakoshi ,&nbsp;Takashi Tagami ,&nbsp;Hideo Yasunaga ,&nbsp;Munekazu Takeda ,&nbsp;Shotaro Aso","doi":"10.1016/j.resplu.2026.101327","DOIUrl":"10.1016/j.resplu.2026.101327","url":null,"abstract":"<div><h3>Introduction</h3><div>As of yet, there are few studies of Asian patients with pseudo-pulseless electrical activity (PEA). Japanese patients with out-of-hospital cardiac arrest (OHCA) tend to be elderly, experience cardiac arrest while at home, and present with severe illness. The present study evaluated the prognostic implications of pseudo-PEA in a Japanese cohort with a high risk of OHCA.</div></div><div><h3>Methods</h3><div>The present study is a post hoc analysis of SOS-KANTO 2017, a prospective, multicentric study which included OHCA patients with PEA on hospital arrival who underwent echocardiographic assessment during resuscitation. The patients were categorized into a pseudo-PEA and a true PEA group. The primary outcome was the return of spontaneous circulation (ROSC). The secondary outcomes included survival to hospital admission, 30-day survival, and a favorable neurological status at discharge. Logistic regression was performed with cardiac activity as the primary predictor after adjusting for covariates.</div></div><div><h3>Results</h3><div>Of 894 eligible patients, 345 had pseudo-PEA, and 549 had true PEA. In total, 49.3% achieved ROSC. The pseudo-PEA group had a significantly higher rate of ROSC (87.2% vs. 25.5%; <em>p</em> &lt; 0.01). On multivariable logistic regression, the pseudo-PEA group was independently associated with a high ROSC rate (odds ratio [OR]: 22.1; 95% confidence interval [CI]: 14.2–34.3), survival to hospital admission (OR: 17.8; 95% CI: 11.2–28.2), 30-day survival (OR: 51.9; 95% CI: 7.33–367), and favorable neurological outcome at discharge (OR: 14.3; 95% CI: 1.62–125).</div></div><div><h3>Conclusion</h3><div>Pseudo-PEA may be associated with a higher rate of ROSC and favorable, short and middle-term outcomes in Japanese patients with OHCA. Early echocardiographic assessment of cardiac activity may help prognostication and guide resuscitation even in high-risk populations.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"29 ","pages":"Article 101327"},"PeriodicalIF":2.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147803198","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 use of supplemental oxygen during cardiopulmonary resuscitation – a systematic review of the literature","authors":"M.B. Skrifvars ,&nbsp;S. D’Arrigo ,&nbsp;S. Ohshimo ,&nbsp;B. Grunau ,&nbsp;T. Scquizzato ,&nbsp;C. Crowley ,&nbsp;J.C. Jakobsen ,&nbsp;J.J. Petersen ,&nbsp;C.D.B. Sillassen ,&nbsp;C.B. Kamp ,&nbsp;G.B. Madsen ,&nbsp;P.B. Andersen ,&nbsp;V.H. Niemelä ,&nbsp;M. Mäkinen ,&nbsp;I.R. Drennan ,&nbsp;A. Moskowitz ,&nbsp;K. Berg ,&nbsp;J. Soar","doi":"10.1016/j.resplu.2026.101333","DOIUrl":"10.1016/j.resplu.2026.101333","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate whether the use of supplemental oxygen during cardiopulmonary resuscitation (CPR) improves outcomes after cardiac arrest.</div></div><div><h3>Methods</h3><div>We conducted a systematic review and registered the protocol PROSPERO (CRD420251243123). We searched 12 databases from inception to 27 October 2025 to identify studies evaluating supplemental oxygen use during CPR. Outcomes included return of spontaneous circulation (ROSC), survival, and survival with favorable neurological or functional outcome. Risk of bias was assessed using the Risk Of Bias In Non-randomized Studies of Interventions (ROBINS-I) tool. Evidence was synthesized narratively without meta-analysis. Hyperoxaemia was defined as PaO₂ &gt;300 mmHg (&gt;40 kPa), normoxaemia as PaO₂ 60–300 mmHg (8–40 kPa), and hypoxaemia as PaO₂ &lt;60 mmHg (&lt;8 kPa).</div></div><div><h3>Results</h3><div>Six studies met the inclusion criteria; all were observational. Five studies included out-of-hospital cardiac arrest patients, and one included in-hospital cardiac arrest patients. No study compared different inspired oxygen concentrations during CPR. The included studies provided indirect evidence as patients received an inspired oxygen fraction of 100%, and oxygen exposure was assessed using arterial blood gas measurements obtained during CPR. All studies were judged to be at critical risk of bias. Across studies, the prevalence of hyperoxaemia during CPR ranged from 2% to 21%, whereas hypoxaemia was more common, occurring in 20–72% of patients. Descriptively, patients with hyperoxaemia compared with patients with hypoxaemia had higher reported rates of ROSC (50–100% versus 21–58%), survival to hospital discharge (10–56% versus 1–16%), and favorable neurological or functional outcome (5–23% versus 0.5–3%).</div></div><div><h3>Conclusions</h3><div>No studies directly comparing different supplemental oxygen strategies during CPR were identified. Very low-certainty indirect evidence from observational studies suggests an association between higher measured arterial oxygen levels during CPR and improved outcomes. These findings support current guideline recommendations to deliver the highest feasible inspired oxygen concentration during CPR, and highlight the need for randomized trials to evaluate oxygen strategies during CPR.</div><div>Review registration: CRD420251243123 (<span><span>https://www.crd.york.ac.uk/PROSPERO/view/CRD420251243123</span><svg><path></path></svg></span>)</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"29 ","pages":"Article 101333"},"PeriodicalIF":2.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147859020","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}