Objective: This study investigated the effectiveness and accuracy of hands-free carotid ultrasound (CADFlow, Continuous Auto Doppler Flow, Sensus Medical, Suzhou, China) for monitoring carotid blood flow in assessing the return of spontaneous circulation (ROSC), in comparison to manual palpation of major arterial pulses.
Methods: A total of 341 adult patients with in-hospital cardiac arrest were enrolled from five affiliated teaching hospitals of medical universities. Chest compression rate and depth were monitored using the Prehospital Advanced Life Support Manual Cardiopulmonary Resuscitation (PALMCPR, SunLife Science, Suzhou, China) system. In the CADFlow group, hands-free carotid ultrasound was used to monitor carotid pulsation, while the control group relied on manual palpation of the carotid artery to assess ROSC. The groups were compared in terms of ROSC success rates, time to ROSC determination, and ROSC misjudgment rates. Additionally, the relationships between chest compression parameters (depth and rate) and carotid blood flow were analyzed.
Results: The ROSC success rate was non-significantly higher in the CADFlow group than in the control group (43% vs. 33%, P = 0.053), corresponding to a 10-percentage-point absolute increase The mean time required to assess carotid pulsation was significantly shorter in the CADFlow group (2.9 (SD 0.8) s vs. 7.2 (SD 1.3) s, P < 0.001). Strong correlations were observed between chest compression depth and CADFlow parameters, suggesting that the system can effectively assess Cardiopulmonary Resuscitation (CPR) compression quality.
Conclusions: The CADFlow hands-free carotid Doppler ultrasound system improves ROSC detection, shortens assessment time, and provides real-time feedback for CPR quality optimisation.
Trial registration: This clinical trial is registered with the Chinese Clinical Trial Registry (ChiCTR), with the registration number ChiCTR2200064633. The trial was registered on October 13, 2022. The full trial protocol is available upon request from the corresponding author.
目的：本研究探讨免持颈动脉超声（CADFlow, Continuous Auto Doppler Flow,Sensus Medical, Suzhou, China）监测颈动脉血流以评估自发循环（ROSC）的有效性和准确性，并将其与手动触诊主要动脉脉冲进行比较。方法：选取5所医科大学附属教学医院的341例院内心脏骤停成人患者。采用院前高级生命支持手册心肺复苏（PALMCPR,SunLife Science，苏州，中国）系统监测胸按压率和深度。CADFlow组采用免提颈动脉超声监测颈动脉搏动，对照组采用手触诊颈动脉评估ROSC。比较两组的ROSC成功率、ROSC测定时间和ROSC误判率。此外，还分析了胸按压参数（深度和频率）与颈动脉血流量的关系。结果：与对照组相比，CADFlow组的ROSC成功率无显著性提高（43% vs. 33%, P = 0.053），绝对增加了10个百分点。CADFlow组评估颈动脉脉动所需的平均时间明显缩短(2.9 （SD 0.8) s vs. 7.2 (SD 1.3) s, P < 0.001）。胸部按压深度与CADFlow参数之间存在较强相关性，提示该系统可有效评估心肺复苏按压质量。结论：CADFlow免提颈动脉多普勒超声系统提高了ROSC检测，缩短了评估时间，并为心肺复苏术质量优化提供了实时反馈。试验注册：本临床试验已在中国临床试验注册中心（ChiCTR）注册，注册号为ChiCTR2200064633。该试验于2022年10月13日注册。完整的试验方案可根据通讯作者的要求提供。
{"title":"Evaluating hands-free carotid Doppler ultrasound for real-time return of spontaneous circulation detection in in-hospital cardiac arrest: a multicenter randomized controlled study.","authors":"Yangyang Li, Miaorong Xie, Guoxing Wang, Shanshan Wu, Yuhong Mi, Jian Zhang, Zhen Han, Lianmei Pu, Haiyan Zhang, Zongfu Bi, Jiebin Li, Xiaoli Yuan, Shuo Wang, Chunsheng Li","doi":"10.1016/j.resuscitation.2026.111016","DOIUrl":"10.1016/j.resuscitation.2026.111016","url":null,"abstract":"<p><strong>Objective: </strong>This study investigated the effectiveness and accuracy of hands-free carotid ultrasound (CADFlow, Continuous Auto Doppler Flow, Sensus Medical, Suzhou, China) for monitoring carotid blood flow in assessing the return of spontaneous circulation (ROSC), in comparison to manual palpation of major arterial pulses.</p><p><strong>Methods: </strong>A total of 341 adult patients with in-hospital cardiac arrest were enrolled from five affiliated teaching hospitals of medical universities. Chest compression rate and depth were monitored using the Prehospital Advanced Life Support Manual Cardiopulmonary Resuscitation (PALMCPR, SunLife Science, Suzhou, China) system. In the CADFlow group, hands-free carotid ultrasound was used to monitor carotid pulsation, while the control group relied on manual palpation of the carotid artery to assess ROSC. The groups were compared in terms of ROSC success rates, time to ROSC determination, and ROSC misjudgment rates. Additionally, the relationships between chest compression parameters (depth and rate) and carotid blood flow were analyzed.</p><p><strong>Results: </strong>The ROSC success rate was non-significantly higher in the CADFlow group than in the control group (43% vs. 33%, P = 0.053), corresponding to a 10-percentage-point absolute increase The mean time required to assess carotid pulsation was significantly shorter in the CADFlow group (2.9 (SD 0.8) s vs. 7.2 (SD 1.3) s, P < 0.001). Strong correlations were observed between chest compression depth and CADFlow parameters, suggesting that the system can effectively assess Cardiopulmonary Resuscitation (CPR) compression quality.</p><p><strong>Conclusions: </strong>The CADFlow hands-free carotid Doppler ultrasound system improves ROSC detection, shortens assessment time, and provides real-time feedback for CPR quality optimisation.</p><p><strong>Trial registration: </strong>This clinical trial is registered with the Chinese Clinical Trial Registry (ChiCTR), with the registration number ChiCTR2200064633. The trial was registered on October 13, 2022. The full trial protocol is available upon request from the corresponding author.</p>","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":" ","pages":"111016"},"PeriodicalIF":4.6,"publicationDate":"2026-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146258778","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-16DOI: 10.1016/j.resuscitation.2026.111018
Theerapon Jariyasakoolroj, Karen O’Connell, Thomas MacDonald, John Breslin, Jennifer Murphy, Crystal MacDonald, Tara Neubrand, Laura Rochford, Sage Myers, Benjamin Kerrey, Aaron Donoghue
To examine the association between tracheal intubation (TI) attempts and chest compression (CC) pauses on chest compression fraction (CCF) during pediatric CPR across a network of emergency departments.
{"title":"The Impact of Tracheal Intubation Attempts on Chest Compression Fraction During Pediatric CPR: A Report from the Videography In Pediatric Resuscitation (VIPER) Collaborative","authors":"Theerapon Jariyasakoolroj, Karen O’Connell, Thomas MacDonald, John Breslin, Jennifer Murphy, Crystal MacDonald, Tara Neubrand, Laura Rochford, Sage Myers, Benjamin Kerrey, Aaron Donoghue","doi":"10.1016/j.resuscitation.2026.111018","DOIUrl":"https://doi.org/10.1016/j.resuscitation.2026.111018","url":null,"abstract":"To examine the association between tracheal intubation (TI) attempts and chest compression (CC) pauses on chest compression fraction (CCF) during pediatric CPR across a network of emergency departments.","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":"238 1","pages":""},"PeriodicalIF":6.5,"publicationDate":"2026-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146209346","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-09DOI: 10.1016/j.resuscitation.2026.111007
Priscilla Yu, Sierra Foster, Lucas Zeida Haar, Xilong Li, Priya Bhaskar, Michael Morriss, Sumit Singh, Tyler Burr, Deepa Sirsi, Lakshmi Raman, Ron Reeder, Javier J. Lasa
Objective: Explore relationships between early post-extracorporeal cardiopulmonary resuscitation (ECPR) oxygenation, ventilation, and survival to hospital discharge (SHD) with favorable neurologic outcome in children with cardiac disease.
{"title":"The Association Between Early Arterial Oxygen and Carbon Dioxide with Neurologic Outcomes after Pediatric ECPR in Children with Cardiac Disease","authors":"Priscilla Yu, Sierra Foster, Lucas Zeida Haar, Xilong Li, Priya Bhaskar, Michael Morriss, Sumit Singh, Tyler Burr, Deepa Sirsi, Lakshmi Raman, Ron Reeder, Javier J. Lasa","doi":"10.1016/j.resuscitation.2026.111007","DOIUrl":"https://doi.org/10.1016/j.resuscitation.2026.111007","url":null,"abstract":"Objective: Explore relationships between early post-extracorporeal cardiopulmonary resuscitation (ECPR) oxygenation, ventilation, and survival to hospital discharge (SHD) with favorable neurologic outcome in children with cardiac disease.","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":"93 1","pages":""},"PeriodicalIF":6.5,"publicationDate":"2026-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146146301","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-06DOI: 10.1016/j.resuscitation.2026.111006
Meena Thuccani, Gustaf Hellsén, Johan Herlitz, Christian Rylander, Araz Rawshani, Peter Lundgren
{"title":"Predicting recurrent cardiac arrest within one year after surviving In-Hospital Cardiac Arrest using a machine learning model","authors":"Meena Thuccani, Gustaf Hellsén, Johan Herlitz, Christian Rylander, Araz Rawshani, Peter Lundgren","doi":"10.1016/j.resuscitation.2026.111006","DOIUrl":"https://doi.org/10.1016/j.resuscitation.2026.111006","url":null,"abstract":"","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":"89 1","pages":""},"PeriodicalIF":6.5,"publicationDate":"2026-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146134127","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-04DOI: 10.1016/j.resuscitation.2026.110999
Gerrit Jansen, Charlotte Eickelmann, Julia Johanna Grannemann, Annika Hoyer, Lydia Johnson Kolaparambil Varghese
{"title":"Reply to: Why are volumes not adding up?","authors":"Gerrit Jansen, Charlotte Eickelmann, Julia Johanna Grannemann, Annika Hoyer, Lydia Johnson Kolaparambil Varghese","doi":"10.1016/j.resuscitation.2026.110999","DOIUrl":"https://doi.org/10.1016/j.resuscitation.2026.110999","url":null,"abstract":"","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":"41 1","pages":""},"PeriodicalIF":6.5,"publicationDate":"2026-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146109972","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-01Epub Date: 2026-01-06DOI: 10.1016/j.resuscitation.2026.110960
Demetris Yannopoulos , Deborah Jaeger , Rajat Kalra , Paul Rees , Charles Bruen , Alexandra Schick , Sergey Gurevich , Ganesh Raveendran , Adam Gottula , Jason Bartos
Extracorporeal cardiopulmonary resuscitation (ECPR) is the only therapy capable of rescuing patients from refractory cardiac arrest, but its effectiveness is critically dependent on time to reperfusion. The system proposed here, grounded in current physiologic and systems-level evidence, is designed to reliably achieve extracorporeal membrane oxygenation (ECMO) flow within approximately 45 min of collapse. This model emphasizes tightly organized, strike team–like ECPR units, parallel activation pathways, and predefined deployment and transport strategies independent of cannulation location. As ECPR systems evolve, integration of artificial intelligence–enabled dispatch and decision-support tools may further improve reliability, scalability, and equitable access to timely reperfusion.
{"title":"Survival on the clock: rethinking where and how we deliver ECPR","authors":"Demetris Yannopoulos , Deborah Jaeger , Rajat Kalra , Paul Rees , Charles Bruen , Alexandra Schick , Sergey Gurevich , Ganesh Raveendran , Adam Gottula , Jason Bartos","doi":"10.1016/j.resuscitation.2026.110960","DOIUrl":"10.1016/j.resuscitation.2026.110960","url":null,"abstract":"<div><div>Extracorporeal cardiopulmonary resuscitation (ECPR) is the only therapy capable of rescuing patients from refractory cardiac arrest, but its effectiveness is critically dependent on time to reperfusion. The system proposed here, grounded in current physiologic and systems-level evidence, is designed to reliably achieve extracorporeal membrane oxygenation (ECMO) flow within approximately 45 min of collapse. This model emphasizes tightly organized, strike team–like ECPR units, parallel activation pathways, and predefined deployment and transport strategies independent of cannulation location. As ECPR systems evolve, integration of artificial intelligence–enabled dispatch and decision-support tools may further improve reliability, scalability, and equitable access to timely reperfusion.</div></div>","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":"219 ","pages":"Article 110960"},"PeriodicalIF":4.6,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145934570","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-01Epub Date: 2026-01-07DOI: 10.1016/j.resuscitation.2026.110956
Jerry P. Nolan, Claudio Sandroni, Markus B. Skrifvars
{"title":"Reply to: Post-resuscitation care: myocardial dysfunction is the main cause of haemodynamic instability, not vasodilation","authors":"Jerry P. Nolan, Claudio Sandroni, Markus B. Skrifvars","doi":"10.1016/j.resuscitation.2026.110956","DOIUrl":"10.1016/j.resuscitation.2026.110956","url":null,"abstract":"","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":"219 ","pages":"Article 110956"},"PeriodicalIF":4.6,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145945697","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-01Epub Date: 2025-12-27DOI: 10.1016/j.resuscitation.2025.110950
Michael D. April , Steven G. Schauer
{"title":"In-hospital cardiac arrest: lessons from CIRCA on associations with incidence and survival","authors":"Michael D. April , Steven G. Schauer","doi":"10.1016/j.resuscitation.2025.110950","DOIUrl":"10.1016/j.resuscitation.2025.110950","url":null,"abstract":"","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":"219 ","pages":"Article 110950"},"PeriodicalIF":4.6,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145844822","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-01Epub Date: 2025-12-22DOI: 10.1016/j.resuscitation.2025.110939
Kristin Alm-Kruse , Tommaso Scquizzato , Matteo Di Mauro , Junling Fu , Arianna Gazzato , Maria Vargas , Maria Caterina Pace , Giacomo Monti , Elena De Momi , Giovanni Landoni , Anna Mara Scandroglio , Alberto Zangrillo
Background
Videos of out-of-hospital cardiac arrests (OHCA) publicly shared online provide a rare source to investigate the features and circumstances before and after collapse. They also shape public understanding and attitudes, potentially influencing lay responses and expectations after cardiac arrest. We aimed to collect and analyse videos of out-of-hospital cardiac arrest shared online.
Methods
We conducted a descriptive analysis of publicly available OHCA videos identified through a systematic search of YouTube and Google (November 2024–April 2025). Videos were eligible if they depicted a real-life OHCA. Cardiac arrest features and characteristics were extracted and summarized descriptively.
Results
We identified and analysed 127 videos depicting 145 unique OHCAs from all continents between 1984 and 2025. Most recordings (51 %) originated from closed-circuit television cameras. Victims were male in 87 % of cases, and 53 % had an age greater than 40 years. Prodromal signs were visible in 98 % of cases, lasting a median of 3 s (IQR 2–5), and included slowing or pausing activity (49 %), altered head/arm movements (32 %), and reaching for support (28 %). Post-collapse signs were observed in two-thirds of assessable cases, including seizure-like movements (36 %) and agonal breathing (22 %). Bystanders noticed the collapse after a median of 1 (IQR 1–2) second and approached the victim after 2 (IQR 1–4) seconds.
Conclusions
Publicly available videos of OHCA offer a rare view into the earliest moments of collapse, highlighting consistent recognition cues, frequent misinterpreted signs, and an action gap between recognition and intervention. These insights may inform education, training, and development of novel strategies aimed at improving recognition and response.
{"title":"Features and circumstances of out-of-hospital cardiac arrests caught on camera: an analysis of publicly available online videos","authors":"Kristin Alm-Kruse , Tommaso Scquizzato , Matteo Di Mauro , Junling Fu , Arianna Gazzato , Maria Vargas , Maria Caterina Pace , Giacomo Monti , Elena De Momi , Giovanni Landoni , Anna Mara Scandroglio , Alberto Zangrillo","doi":"10.1016/j.resuscitation.2025.110939","DOIUrl":"10.1016/j.resuscitation.2025.110939","url":null,"abstract":"<div><h3>Background</h3><div>Videos of out-of-hospital cardiac arrests (OHCA) publicly shared online provide a rare source to investigate the features and circumstances before and after collapse. They also shape public understanding and attitudes, potentially influencing lay responses and expectations after cardiac arrest. We aimed to collect and analyse videos of out-of-hospital cardiac arrest shared online.</div></div><div><h3>Methods</h3><div>We conducted a descriptive analysis of publicly available OHCA videos identified through a systematic search of YouTube and Google (November 2024–April 2025). Videos were eligible if they depicted a real-life OHCA. Cardiac arrest features and characteristics were extracted and summarized descriptively.</div></div><div><h3>Results</h3><div>We identified and analysed 127 videos depicting 145 unique OHCAs from all continents between 1984 and 2025. Most recordings (51 %) originated from closed-circuit television cameras. Victims were male in 87 % of cases, and 53 % had an age greater than 40 years. Prodromal signs were visible in 98 % of cases, lasting a median of 3 s (IQR 2–5), and included slowing or pausing activity (49 %), altered head/arm movements (32 %), and reaching for support (28 %). Post-collapse signs were observed in two-thirds of assessable cases, including seizure-like movements (36 %) and agonal breathing (22 %). Bystanders noticed the collapse after a median of 1 (IQR 1–2) second and approached the victim after 2 (IQR 1–4) seconds.</div></div><div><h3>Conclusions</h3><div>Publicly available videos of OHCA offer a rare view into the earliest moments of collapse, highlighting consistent recognition cues, frequent misinterpreted signs, and an action gap between recognition and intervention. These insights may inform education, training, and development of novel strategies aimed at improving recognition and response.</div></div>","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":"219 ","pages":"Article 110939"},"PeriodicalIF":4.6,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145813750","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-01Epub Date: 2026-01-20DOI: 10.1016/j.resuscitation.2026.110971
Evelien Cools , Robert Blasco , Peter Paal , Delphine S. Courvoisier , Ken Zafren , Hermann Brugger , Simon Rauch , Beat Walpoth
Background
Defibrillation often fails in patients in hypothermic cardiac arrest with shockable rhythms. In patients with core temperatures (Tc) ≤30°C the success rate, optimal number, timing of defibrillations, and factors including rewarming associated with successful defibrillation are not well known.
Aims
To determine the success rate of defibrillation in patients in hypothermic cardiac arrest with shockable rhythms. We studied Tc at defibrillation attempt, number of shocks, and factors facilitating defibrillation.
Methods
This was a retrospective observational study from the International Hypothermia Registry of patients with hypothermic cardiac arrest (Tc ≤30°C) and shockable rhythms undergoing defibrillation attempts before and during rewarming with or without extracorporeal life support. We performed multivariate binomial logistic regression to analyse the probability of defibrillation success according to the defibrillation temperature and ECLS rewarming.
Results
Thirty-seven patients with cardiac arrest, shockable rhythm, and Tc ≤30°C were included. Defibrillation was attempted in 20 patients before rewarming and in 17 during rewarming. The overall success rate was 22/37 (59%). Both the success rate of defibrillation (100% [17/17] vs. 25% [5/20]; P < 0.001) and Tc at the time of the defibrillation attempt (29.0°C [28.0–30.0°C] vs 25.8°C [24.0–26.2°C]; P < 0.001) were higher if defibrillation was performed during rewarming. No defibrillation attempt was successful at Tc <24.8°C.
Conclusions
Defibrillation attempts can be successful before rewarming at Tc ≤30°C. The success rate is higher during rewarming and at a higher Tc. Tc is a strong and independent predictor of defibrillation success. Defibrillation at Tc <25°C is unlikely. These findings require confirmation in larger studies.
背景低温心脏骤停伴震荡心律的患者除颤常常失败。对于中心温度(Tc)≤30°C的患者，除颤成功率、最佳次数、除颤时间以及与除颤成功相关的复温等因素尚不清楚。目的探讨伴有震荡节律的低温心脏骤停患者除颤的成功率。我们研究了除颤次数、电击次数和促进除颤的因素。方法：这是一项来自国际低温登记的回顾性观察研究，研究对象是低温性心脏骤停（Tc≤30°C）和震荡性心律患者，在加或不加体外生命支持的复温之前和期间进行除颤尝试。我们根据除颤温度和ECLS复温进行多变量二项logistic回归分析除颤成功的概率。结果共纳入37例心脏骤停、震荡性心律、Tc≤30°C患者。20例患者在复温前尝试除颤，17例患者在复温中尝试除颤。总成功率为22/37（59%）。除颤的成功率（100%[17/17]对25% [5/20]；P < 0.001）和尝试除颤时的Tc（29.0°C[28.0-30.0°C]对25.8°C[24.0-26.2°C]; P < 0.001）如果在复温期间进行除颤，则更高。在Tc <；24.8°C时无除颤尝试成功。结论在Tc≤30°C再温前除颤可以成功。在复温和温度较高时，成功率较高。Tc是除颤成功的一个强有力且独立的预测指标。25°C的除颤是不可能的。这些发现需要在更大规模的研究中得到证实。
{"title":"Defibrillation in patients with accidental hypothermia and core temperatures ≤30°C – A retrospective observational study","authors":"Evelien Cools , Robert Blasco , Peter Paal , Delphine S. Courvoisier , Ken Zafren , Hermann Brugger , Simon Rauch , Beat Walpoth","doi":"10.1016/j.resuscitation.2026.110971","DOIUrl":"10.1016/j.resuscitation.2026.110971","url":null,"abstract":"<div><h3>Background</h3><div>Defibrillation often fails in patients in hypothermic cardiac arrest with shockable rhythms. In patients with core temperatures (Tc) ≤30°C the success rate, optimal number, timing of defibrillations, and factors including rewarming associated with successful defibrillation are not well known.</div></div><div><h3>Aims</h3><div>To determine the success rate of defibrillation in patients in hypothermic cardiac arrest with shockable rhythms. We studied Tc at defibrillation attempt, number of shocks, and factors facilitating defibrillation.</div></div><div><h3>Methods</h3><div>This was a retrospective observational study from the International Hypothermia Registry of patients with hypothermic cardiac arrest (Tc ≤30°C) and shockable rhythms undergoing defibrillation attempts before and during rewarming with or without extracorporeal life support. We performed multivariate binomial logistic regression to analyse the probability of defibrillation success according to the defibrillation temperature and ECLS rewarming.</div></div><div><h3>Results</h3><div>Thirty-seven patients with cardiac arrest, shockable rhythm, and Tc ≤30°C were included. Defibrillation was attempted in 20 patients before rewarming and in 17 during rewarming. The overall success rate was 22/37 (59%). Both the success rate of defibrillation (100% [17/17] vs. 25% [5/20]; <em>P</em> < 0.001) and Tc at the time of the defibrillation attempt (29.0°C [28.0–30.0°C] vs 25.8°C [24.0–26.2°C]; <em>P</em> < 0.001) were higher if defibrillation was performed during rewarming. No defibrillation attempt was successful at Tc <24.8°C.</div></div><div><h3>Conclusions</h3><div>Defibrillation attempts can be successful before rewarming at Tc ≤30°C. The success rate is higher during rewarming and at a higher Tc. Tc is a strong and independent predictor of defibrillation success. Defibrillation at Tc <25°C is unlikely. These findings require confirmation in larger studies.</div></div>","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":"219 ","pages":"Article 110971"},"PeriodicalIF":4.6,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146014390","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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