Pub Date : 2025-12-25DOI: 10.1016/j.resuscitation.2025.110943
Inayah Hodžić, Brian Doelkahar, Janneke Horn, Anne-Fleur van Rootselaar
{"title":"A continuous convolutional neural network: very early EEG most predictive for poor neurological outcome in postanoxic coma","authors":"Inayah Hodžić, Brian Doelkahar, Janneke Horn, Anne-Fleur van Rootselaar","doi":"10.1016/j.resuscitation.2025.110943","DOIUrl":"https://doi.org/10.1016/j.resuscitation.2025.110943","url":null,"abstract":"","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":"10 1","pages":""},"PeriodicalIF":6.5,"publicationDate":"2025-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145823698","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}
{"title":"Prevalence and Efficacy of New Protocol for Out-of-Hospital Cardiac Arrest Patients with “Do Not Attempt Resuscitation” Orders in Japan","authors":"Takeshi Nishimura, Takuya Taira, Masafumi Suga, Shinichi Ijuin, Akihiko Inoue, Shigenari Matsuyama, Satoshi Ishihara","doi":"10.1016/j.resuscitation.2025.110944","DOIUrl":"https://doi.org/10.1016/j.resuscitation.2025.110944","url":null,"abstract":"","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":"1 1","pages":""},"PeriodicalIF":6.5,"publicationDate":"2025-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145823697","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 : 2025-12-25DOI: 10.1016/j.resuscitation.2025.110941
Peter JONES
{"title":"Atropine use during critical care intubation","authors":"Peter JONES","doi":"10.1016/j.resuscitation.2025.110941","DOIUrl":"https://doi.org/10.1016/j.resuscitation.2025.110941","url":null,"abstract":"","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":"2 1","pages":"110941"},"PeriodicalIF":6.5,"publicationDate":"2025-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145823695","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}
Timely recognition of cardiac arrest (CA) is often delayed because gasping, a frequent sign of CA, is misinterpreted as normal breathing. In a porcine model of untreated CA with frequent gasps, we tested whether transthoracic impedance (TTI), continuously measured through defibrillator pads, could capture gasping-related thoracic volume changes. Gasping-induced inspiratory efforts produced large, distinctive TTI fluctuations. This observation was then confirmed in a healthy human volunteer simulating gasping under open and closed airway conditions. These translational findings support automated, TTI-based gasping detection via automated external defibrillators as a feasible strategy to improve early CA recognition and accelerate bystander CPR initiation.
{"title":"Detection of gasping through transthoracic impedance: a new approach to early cardiac arrest recognition","authors":"Aurora Magliocca , Giulia Merigo , Chiara Crivellari , Emanuele Rezoagli , Giuseppe Ristagno","doi":"10.1016/j.resuscitation.2025.110945","DOIUrl":"10.1016/j.resuscitation.2025.110945","url":null,"abstract":"<div><div>Timely recognition of cardiac arrest (CA) is often delayed because gasping, a frequent sign of CA, is misinterpreted as normal breathing. In a porcine model of untreated CA with frequent gasps, we tested whether transthoracic impedance (TTI), continuously measured through defibrillator pads, could capture gasping-related thoracic volume changes. Gasping-induced inspiratory efforts produced large, distinctive TTI fluctuations. This observation was then confirmed in a healthy human volunteer simulating gasping under open and closed airway conditions. These translational findings support automated, TTI-based gasping detection via automated external defibrillators as a feasible strategy to improve early CA recognition and accelerate bystander CPR initiation.</div></div>","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":"219 ","pages":"Article 110945"},"PeriodicalIF":4.6,"publicationDate":"2025-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145822699","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 : 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":"2025-12-22","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 : 2025-12-22DOI: 10.1016/j.resuscitation.2025.110933
Robert Darnell, Julia Broomhall, Christopher Newell, Emma Gendall, David Harrison, Kathy Rowan, James Doidge, Paul Mouncey, Doug Gould, Matt Thomas
Cardiac arrest is frequently categorised by the event location, capturing differences in epidemiology, response and outcome. In the United Kingdom (UK) the National Cardiac Arrest Audit excludes arrests not attended by the resuscitation team, such as in many Intensive Care Units (ICU). Differences in staffing and skill mix within ICUs mean the risk of cardiac arrest occurring, the involvement (or not) of the resuscitation team, and the probability of return of spontaneous circulation (ROSC) are all likely to differ from other locations. This study aimed to determine the incidence proportion, risk factors and outcomes of in-hospital cardiac arrest (IHCA) in the ICU.
{"title":"Critical Illness Related Cardiac Arrest (CIRCA): a prospective investigation of the incidence and outcome of cardiac arrest within Intensive Care Units in the United Kingdom","authors":"Robert Darnell, Julia Broomhall, Christopher Newell, Emma Gendall, David Harrison, Kathy Rowan, James Doidge, Paul Mouncey, Doug Gould, Matt Thomas","doi":"10.1016/j.resuscitation.2025.110933","DOIUrl":"https://doi.org/10.1016/j.resuscitation.2025.110933","url":null,"abstract":"Cardiac arrest is frequently categorised by the event location, capturing differences in epidemiology, response and outcome. In the United Kingdom (UK) the National Cardiac Arrest Audit excludes arrests not attended by the resuscitation team, such as in many Intensive Care Units (ICU). Differences in staffing and skill mix within ICUs mean the risk of cardiac arrest occurring, the involvement (or not) of the resuscitation team, and the probability of return of spontaneous circulation (ROSC) are all likely to differ from other locations. This study aimed to determine the incidence proportion, risk factors and outcomes of in-hospital cardiac arrest (IHCA) in the ICU.","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":"8 1","pages":""},"PeriodicalIF":6.5,"publicationDate":"2025-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145813756","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 : 2025-12-22DOI: 10.1016/j.resuscitation.2025.110942
Yutaka Igarashi, Tatsuya Norii
{"title":"Choking “Witnessed but Untreated” Since 1880: Are We Still Missing It?","authors":"Yutaka Igarashi, Tatsuya Norii","doi":"10.1016/j.resuscitation.2025.110942","DOIUrl":"https://doi.org/10.1016/j.resuscitation.2025.110942","url":null,"abstract":"","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":"47 1","pages":""},"PeriodicalIF":6.5,"publicationDate":"2025-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145813752","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 : 2025-12-22DOI: 10.1016/j.resuscitation.2025.110934
Tanner Smida, Joshua M. Kimbrell, Judah A. Kreinbrook, Gabriel H. Gan, Wesley Odom, Tom Bouthillet, Brooks Walsh, Michael Shukis, James Scheidler, P.S. Martin, Ari Moskowitz, Catherine R. Counts, James Bardes
Transcutaneous pacing (TCP) is used to treat bradycardia with hemodynamic compromise. Prior data suggested that electrical capture was uncommon during prehospital TCP. We aimed to determine the prevalence of sustained electrical capture and identify associated factors in a multicenter cohort.
{"title":"The prevalence of sustained electrical capture during prehospital transcutaneous pacing: a multicenter observational study","authors":"Tanner Smida, Joshua M. Kimbrell, Judah A. Kreinbrook, Gabriel H. Gan, Wesley Odom, Tom Bouthillet, Brooks Walsh, Michael Shukis, James Scheidler, P.S. Martin, Ari Moskowitz, Catherine R. Counts, James Bardes","doi":"10.1016/j.resuscitation.2025.110934","DOIUrl":"https://doi.org/10.1016/j.resuscitation.2025.110934","url":null,"abstract":"Transcutaneous pacing (TCP) is used to treat bradycardia with hemodynamic compromise. Prior data suggested that electrical capture was uncommon during prehospital TCP. We aimed to determine the prevalence of sustained electrical capture and identify associated factors in a multicenter cohort.","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":"15 1","pages":""},"PeriodicalIF":6.5,"publicationDate":"2025-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145813778","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 : 2025-12-22DOI: 10.1016/j.resuscitation.2025.110936
Stephen Gyung Won Lee , Tae Han Kim , Dong Hyun Choi , Min Woo Kim , Ki Jeong Hong , Young Sun Ro , Kyoung Jun Song , Sang Do Shin
Introduction
Cardiac arrest recognition by emergency medical dispatch (EMD) is essential for initiation of telephone CPR that could lead to bystander CPR before emergency medical service (EMS) arrival. Video-assisted cardiac arrest recognition protocol was developed and implemented for better recognition of cardiac arrest suspected calls that recognition was uncertain under conventional audio-call dispatch. We tested the performance of video-assisted protocol after pilot implementation in a metropolitan dispatch center.
Methods
All emergency medical dispatch calls received by Seoul emergency dispatch center that used video-assisted cardiac arrest recognition protocol from June 2020 to December 2020 were enrolled. The primary outcome was the presence of cardiac arrest upon EMS arrival evaluated by EMS providers arrived at the scene. The predictive performance measure of video-assisted protocol was calculated including sensitivity and specificity with 95 % confidence intervals (CIs).
Result
During the study period, video-assisted protocol was used in 115 emergency calls that dispatchers were uncertain based on the initial audio call. In 15 cases the dispatcher additionally recognized the case as cardiac arrest under video-assistance. Of recognized cases, 14 (93.3 %) cases were confirmed as cardiac arrest upon EMS arrival. The sensitivity (95 % CI) and the specificity (95 % CI) of the video-assisted protocol were 66.7 % (43.0–85.4) and 98.9 % (94.2–100) respectively.
Conclusion
Use of video-assisted cardiac arrest recognition protocol helped recognize additional cardiac arrest cases that could not be recognized with the audio-call in the dispatch center. Technological and operational improvement should be continuously studied for better cardiac arrest recognition using video-assisted protocol during emergency call taking.
{"title":"Diagnostic performance of a video-assisted cardiac arrest recognition protocol by emergency medical dispatcher in out-of-hospital cardiac arrest","authors":"Stephen Gyung Won Lee , Tae Han Kim , Dong Hyun Choi , Min Woo Kim , Ki Jeong Hong , Young Sun Ro , Kyoung Jun Song , Sang Do Shin","doi":"10.1016/j.resuscitation.2025.110936","DOIUrl":"10.1016/j.resuscitation.2025.110936","url":null,"abstract":"<div><h3>Introduction</h3><div>Cardiac arrest recognition by emergency medical dispatch (EMD) is essential for initiation of telephone CPR that could lead to bystander CPR before emergency medical service (EMS) arrival. Video-assisted cardiac arrest recognition protocol was developed and implemented for better recognition of cardiac arrest suspected calls that recognition was uncertain under conventional audio-call dispatch. We tested the performance of video-assisted protocol after pilot implementation in a metropolitan dispatch center.</div></div><div><h3>Methods</h3><div>All emergency medical dispatch calls received by Seoul emergency dispatch center that used video-assisted cardiac arrest recognition protocol from June 2020 to December 2020 were enrolled. The primary outcome was the presence of cardiac arrest upon EMS arrival evaluated by EMS providers arrived at the scene. The predictive performance measure of video-assisted protocol was calculated including sensitivity and specificity with 95 % confidence intervals (CIs).</div></div><div><h3>Result</h3><div>During the study period, video-assisted protocol was used in 115 emergency calls that dispatchers were uncertain based on the initial audio call. In 15 cases the dispatcher additionally recognized the case as cardiac arrest under video-assistance. Of recognized cases, 14 (93.3 %) cases were confirmed as cardiac arrest upon EMS arrival. The sensitivity (95 % CI) and the specificity (95 % CI) of the video-assisted protocol were 66.7 % (43.0–85.4) and 98.9 % (94.2–100) respectively.</div></div><div><h3>Conclusion</h3><div>Use of video-assisted cardiac arrest recognition protocol helped recognize additional cardiac arrest cases that could not be recognized with the audio-call in the dispatch center. Technological and operational improvement should be continuously studied for better cardiac arrest recognition using video-assisted protocol during emergency call taking.</div></div>","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":"219 ","pages":"Article 110936"},"PeriodicalIF":4.6,"publicationDate":"2025-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145813753","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}
The physiological patterns and clinical implications of body temperature variability following targeted temperature management (TTM) in patients undergoing extracorporeal cardiopulmonary resuscitation (ECPR) remain poorly understood. This study aimed to evaluate the association between post-rewarming temperature trajectories and survival outcomes, as well as neurological prognosis, in ECPR-treated out-of-hospital cardiac arrest (OHCA) patients.
{"title":"Impact of Differential Temperature Trajectories Following Targeted Temperature Management on Outcomes in Out-of-Hospital Cardiac Arrest Patients Receiving ECPR: A Multicenter, Retrospective Study with Prospective Validation","authors":"Xian Zhang, Lifei Chen, Fang Wang, Yueming Wu, Jia Chen, Fujin Chen, Renhua Sun, JunLong Xu, Yongan Xu, Yinghe Xu, Xuwei He","doi":"10.1016/j.resuscitation.2025.110932","DOIUrl":"https://doi.org/10.1016/j.resuscitation.2025.110932","url":null,"abstract":"The physiological patterns and clinical implications of body temperature variability following targeted temperature management (TTM) in patients undergoing extracorporeal cardiopulmonary resuscitation (ECPR) remain poorly understood. This study aimed to evaluate the association between post-rewarming temperature trajectories and survival outcomes, as well as neurological prognosis, in ECPR-treated out-of-hospital cardiac arrest (OHCA) patients.","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":"56 1","pages":""},"PeriodicalIF":6.5,"publicationDate":"2025-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145813755","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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