Resuscitation plus最新文献

{"title":"High-fidelity minute-level physiologic trajectories after ROSC from linked monitor-defibrillator recordings in out-of-hospital cardiac arrest.","authors":"Pieter Francsois Fouche, Emily Nehme, Sam Burton, Belinda Flanagan, Benjamin Meadley, David Anderson, Dion Stub, Ziad Nehme","doi":"10.1016/j.resplu.2026.101286","DOIUrl":"https://doi.org/10.1016/j.resplu.2026.101286","url":null,"abstract":"<p><strong>Background: </strong>Early post-ROSC physiology changes rapidly, but most studies rely on a single handover set of vital signs, which can miss trajectories and time spent hypotensive or hypoxemic. We aimed to describe minute-level early post-ROSC blood pressure and oxygenation and examine their association with outcomes.</p><p><strong>Methods: </strong>Retrospective cohort study of out-of-hospital cardiac arrest in Victoria, Australia (2019-2023). We linked the Victorian Ambulance Cardiac Arrest Registry to Zoll® monitor-defibrillator recordings, aligned measurements to recorded ROSC, aggregated readings into 1-min bins, and derived per-patient mean, minimum, and minutes below thresholds for SBP, MAP and SpO₂. Associations with outcomes were modelled using adjusted logistic regression. Primary outcome was survival to hospital discharge. Secondary outcome was good 12-month neurological outcome among survivors.</p><p><strong>Results: </strong>Among 3694 patients with sustained ROSC, 1444 survived. Median ROSC-to-arrival was 58 min. Median per patient was 36 blood pressure and 97 SpO₂ values. Compared with SBP 100 mm Hg, survival was lower at 80 mm Hg (aOR 0.87, 95% CI 0.79-0.95) and higher at 140 mm Hg (aOR 1.32, 95% CI 1.11-1.59). SpO₂ 90% versus 95% was associated with lower survival (aOR 0.70, 95% CI 0.63-0.79). Longer time with SBP <90 mm Hg, MAP <65 mm Hg, or SpO₂ <90% was associated with lower survival. Associations with good 12-month neurological outcome were smaller and mainly limited to blood pressure.</p><p><strong>Conclusions: </strong>Minute-level monitor-defibrillator data showed strong associations between early hypotension and hypoxaemia and survival after ROSC and allow cumulative exposure to be quantified.</p>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"28 ","pages":"101286"},"PeriodicalIF":2.4,"publicationDate":"2026-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12991840/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147476828","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CARDIS (Cardiac ARrest DIgital Support): study protocol for a randomised controlled trial of a web-based support intervention for cardiac arrest survivors","authors":"Annette Waldemar ,&nbsp;Johan Israelsson ,&nbsp;Katarina Heimburg ,&nbsp;Erik Blennow Nordström ,&nbsp;Per Nordberg ,&nbsp;Anders Bremer ,&nbsp;Kristofer Årestedt ,&nbsp;Ingela Thylén","doi":"10.1016/j.resplu.2026.101235","DOIUrl":"10.1016/j.resplu.2026.101235","url":null,"abstract":"<div><h3>Background</h3><div>Surviving sudden cardiac arrest often lead to long-term cognitive, emotional, and physical consequences. Although clinical guidelines recommend structured post-cardiac arrest follow-up, such follow-up is often lacking or inconsistent. Tailored digital interventions are scarce but may help address gaps in follow-up resources. The CARDIS trial evaluates the effects on patient-reported outcome measures of a co-created, web-based support programme designed to improve wellbeing, self management, and reintegration into everyday life for cardiac arrest survivors.</div></div><div><h3>Methods</h3><div>CARDIS is a multicentre, parallel-group, randomised controlled trial enrolling cardiac arrest survivors aged &gt;18 years. Participants will be randomised 1:1 to intervention or control. Both groups will receive standard post-cardiac arrest care, including a routine followup visit with screening and management of cognitive, physical and emotional health, as well as a printed booklet. The intervention group will additionally receive access to a webbased selfguided support programme for 3 months. After study completion, control participants will be offered the programme.</div></div><div><h3>Outcomes</h3><div>Primary outcome is overall wellbeing and health (QWB) at 3 months. Secondary outcomes include self-reported cognitive problems, HRQoL, life satisfaction, symptoms of depression and anxiety, post-traumatic stress, fatigue, and sleep disturbances. A process evaluation will evaluate social selection bias, adherence and participants experiences.</div></div><div><h3>Discussion</h3><div>The CARDIS trial will investigate the use of more accessible and standardised follow-up pathways by complementing existing care structures, thereby enhancing equity in long-term recovery and quality-of-life without requiring additional healthcare resources. The process evaluation will provide data on adherence, social selection, and engagement, essential for future implementation.</div><div><strong>Trial registration:</strong> The trial is registered at <span><span>clinicaltrials.gov</span><svg><path></path></svg></span> (NCT07240714).</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"28 ","pages":"Article 101235"},"PeriodicalIF":2.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146168604","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":"Association between early arterial pH, base excess and lactate and 24-h mortality and neurological outcomes after cardiac arrest and cardiopulmonary resuscitation: a translational study","authors":"Francesca Callegari ,&nbsp;Daria De Giorgio ,&nbsp;Giulia Merigo ,&nbsp;Marianna Cerrato ,&nbsp;Ornella Tinelli ,&nbsp;Aurora Magliocca ,&nbsp;Elisa R. Zanier ,&nbsp;Giuseppe Ristagno ,&nbsp;Francesca Fumagalli","doi":"10.1016/j.resplu.2026.101228","DOIUrl":"10.1016/j.resplu.2026.101228","url":null,"abstract":"<div><h3>Aim</h3><div>We aimed to assess the translational relevance of blood gas-derived acid-base parameters measured in rat and pig models of cardiac arrest and cardiopulmonary resuscitation, evaluating their potential as predictors of mortality and poor neurological outcome.</div></div><div><h3>Methods</h3><div>Seventy-seven rats, 83 pigs and 61 patients who experienced cardiac arrest of proven or suspected cardiac origin were retrospectively analyzed<strong>.</strong> Blood gas analyses were performed 4 h after return of spontaneous circulation. Neurological recovery was assessed using Neurological Deficit Score in rats, overall performance category in pigs, and cerebral performance category in patients. Nonlinear associations between blood gas-derived acid-base parameters and outcomes were analyzed using a generalized additive model. Receiver operating characteristics curve analyses were performed.</div></div><div><h3>Results</h3><div>In a multivariate regression analysis area under the curve, considering pH, base excess and lactate, for prediction of mortality were respectively: 0.796 (95%CI: 0.635–0.956), 0.980 (95%CI: 0.946–1.000), 0.959 (95%CI: 0.896–1.000) in rats; 0.908 (95%CI: 0.826–0.990), 0.933 (95%CI: 0.863–1.000), 0.798 (95%CI: 0.588–1.000) in pigs; and 0.830 (95%CI: 0.724–0.936), 0.832 (95%CI: 0.731–0.933), 0.839 (95%CI: 0.738–0.940) in patients. Area under the curve, considering pH, base excess and lactate, for prediction of poor neurological outcome were respectively: 0.673 (95%CI: 0.515–0.831), 0.724 (95%CI: 0.576–0.872), 0.900 (95%CI: 0.760–1.000) in pigs; and 0.835 (95%CI: 0.734–0.937), 0.835 (95%CI: 0.735–0.936), 0.884 (95%CI: 0.793–0.945) in patients.</div></div><div><h3>Conclusion</h3><div>Arterial pH, base excess and lactate were early independent predictors of both 24-h mortality and neurological outcome following cardiac arrest in animal models and in humans. BE showed the highest predictive value for mortality, while lactate was the strongest predictor for poor neurological outcome.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"28 ","pages":"Article 101228"},"PeriodicalIF":2.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146080280","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":"Hemolysis correction factor in the reporting of serum neuron-specific enolase – Clinical utility in neuroprognostication after cardiac arrest","authors":"Christina Jungar ,&nbsp;Erik Alinder ,&nbsp;Charlotte Becker ,&nbsp;Marion Moseby-Knappe ,&nbsp;Anna Lybeck","doi":"10.1016/j.resplu.2025.101208","DOIUrl":"10.1016/j.resplu.2025.101208","url":null,"abstract":"<div><h3>Background</h3><div>Neuron-specific enolase (NSE) from 48 h after cardiac arrest is the only biomarker of brain injury with recommended cut-offs for use in neuroprognostication. Hemolysis elevates levels of NSE and may result in false outcome predictions.</div></div><div><h3>Methods</h3><div>A correction-factor for hemolysis in reporting of levels of NSE was established and evaluated in (1) incoming routine samples and (2) biobank samples from 48 h after cardiac arrest from the SweCrit biobank. Comparisons were made with three methods for handling hemolysis: Hemolysis Index (HI) 30 mg/dL or HI 50 mg/dL as the highest acceptable level of hemolysis, or a graded approach.</div></div><div><h3>Results</h3><div>Five-hundred and fifty-six routine samples and 263 biobank samples were analyzed. A correction factor of 0.33 µg/L per HI significantly increased the number of reported routine samples, when compared to the three other methods for handling hemolysis (HI 30 mg/dL or HI 50 mg/dL as the highest acceptable level of hemolysis, or a graded approach). Use of the correction factor did not affect the number of reported biobank samples. The prognostic accuracy of NSE was unaffected by use of the correction factor compared to the other tested methods for handling hemolysis: area under the curve (AUC) 0.88 (95 % Cl 0.84–0.92) vs 0.87 (95 % Cl 0.83–0.92) at HI ≤ 30 mg/dL, 0.87 (95 % Cl 0.83–0.92) at HI ≤ 50 mg/dL and 0.87 (95 % CI 0.83–0.92) with the graded approach. Levels of hemolysis were low in the biobank samples.</div></div><div><h3>Conclusion</h3><div>Due to the low levels of hemolysis in the biobank samples, the effects of a correction factor on neuroprognostication after cardiac arrest in routine samples remains uncertain. Clinical use of a correction factor may lead to more reported samples but risks over-correction.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"28 ","pages":"Article 101208"},"PeriodicalIF":2.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145969131","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":"Regional disparities and temporal trends in pre-hospital management of out-of-hospital cardiac arrest in Thailand: a multi-center retrospective cohort study (2017–2023)","authors":"Chanodom Piankusol ,&nbsp;Nutcha Charoenboon ,&nbsp;Natthanaphop Isaradech ,&nbsp;Borwon Wittayachamnankul ,&nbsp;Sattha Riyapan ,&nbsp;Jirapong Supasaovapak ,&nbsp;Robert Bonar ,&nbsp;Bryan McNally ,&nbsp;Wachiranun Sirikul","doi":"10.1016/j.resplu.2026.101226","DOIUrl":"10.1016/j.resplu.2026.101226","url":null,"abstract":"<div><h3>Background</h3><div>Out-of-hospital cardiac arrest remains a major public health concern in Thailand, where pre-hospital care and survival outcomes vary widely across regions. Furthermore, national-level data remains sparse and fragmented.</div></div><div><h3>Methods</h3><div>This retrospective, multicenter cohort study analyzed adult out-of-hospital cardiac arrest cases from 2017 to 2023 using standardized data from the Pan-Asian Resuscitation Outcomes Study registry. Patients were included if they received emergency medical services in the field, regardless of whether they were transported to hospital or not. The study involved three hospitals representing regional, suburban-capital, and urban-capital settings. The primary outcome was 30-day survival. A modified Poisson regression with robust error variance was performed to identify pre-hospital factors associated with survival.</div></div><div><h3>Results</h3><div>Among 2259 eligible cases, 30-day survival was low, with notable variation across hospital settings. Bystander cardiopulmonary resuscitation was most frequent in the suburban-capital hospital (47.2%) and lowest in the regional hospital (23.7%). Family members were the most common providers of bystander cardiopulmonary resuscitation across all sites, though healthcare professionals were more frequently involved in the regional hospital. Multivariable analysis showed that bystander cardiopulmonary resuscitation and shorter emergency medical services response time were significantly associated with improved survival, while advanced airway management and transport time were not.</div></div><div><h3>Conclusion</h3><div>This study confirmed the importance of bystander cardiopulmonary resuscitation and services response time in patient survival in Thailand and highlighted regional disparities. A coordinated national registry is urgently needed for targeted improvements. Lack of standardized and comprehensive data, especially neurologic outcomes and long-term survival, hinders performance evaluation and evidence-based reform.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"28 ","pages":"Article 101226"},"PeriodicalIF":2.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146039235","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":"Case report: Survival after an unwitnessed deep and long avalanche burial","authors":"Andreas Bregenzer ,&nbsp;Emilis Simeliunas ,&nbsp;Benjamin Zweifel ,&nbsp;Peter Fiala ,&nbsp;Peter Paal ,&nbsp;Oliver Reisten ,&nbsp;John Ellerton ,&nbsp;Evelien Cools","doi":"10.1016/j.resplu.2026.101224","DOIUrl":"10.1016/j.resplu.2026.101224","url":null,"abstract":"","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"28 ","pages":"Article 101224"},"PeriodicalIF":2.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146039301","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":"Underuse of bystander defibrillation on females during out-of-hospital cardiac arrest: a retrospective observational study in Aotearoa New Zealand","authors":"Verity F. Todd ,&nbsp;Heather Hutchinson ,&nbsp;Vinuli Withanarachchie ,&nbsp;Andy Swain ,&nbsp;Sarah Maessen ,&nbsp;Aroha Brett ,&nbsp;Bridget Dicker","doi":"10.1016/j.resplu.2026.101252","DOIUrl":"10.1016/j.resplu.2026.101252","url":null,"abstract":"<div><h3>Introduction</h3><div>Early bystander CPR and defibrillation improve cardiac arrest survival. International studies show women receive fewer bystander interventions after out-of-hospital cardiac arrest (OHCA) than men. We investigated associations between sex and bystander interventions in OHCA in Aotearoa New Zealand.</div></div><div><h3>Methods</h3><div>Retrospective cohort study of adult OHCA with attempted resuscitation (January 2019–December 2023). Variables included demographics, ethnicity, socioeconomic deprivation, rurality, location type, and witness status. Logistic regression assessed associations between sex and bystander CPR and bystander defibrillation (shock delivered), adjusting for covariates.</div></div><div><h3>Results</h3><div>Of 9377 OHCA events, 29.6% occurred in females. Bystander CPR rates were similar between females (75.7%) and males (77.3%) (AOR 1.06, 95% CI: 0.94–1.18, <em>p</em> = 0.36). However, bystander defibrillation occurred in only 1.9% of females versus 5.4% of males. Females had 65% lower odds of receiving bystander defibrillation in unadjusted analysis (UOR 0.35, 95% CI: 0.26–0.47, <em>p</em> &lt; 0.001) and 39% lower odds after adjustment (AOR 0.61, 95% CI: 0.44–0.84, <em>p</em> = 0.002). Among shockable rhythm cases, sex disparity was not significant (AOR 0.83, 95% CI: 0.59–1.15, <em>p</em> = 0.26).</div></div><div><h3>Conclusion</h3><div>Despite equitable bystander CPR rates, females had significantly lower odds of receiving bystander defibrillation. In shockable rhythm cases, the disparity was not significant after adjustment for covariates, suggesting that patient and event characteristics mediate rather than confound this relationship. Findings highlight the need for targeted interventions addressing strategies to improve bystander defibrillation for females in cardiac arrest.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"28 ","pages":"Article 101252"},"PeriodicalIF":2.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147278140","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":"Cardiac Arrest Recovery Enablement and Supported Self-management (CARESS): a study protocol for the feasibility testing of an online psychosocial and exercise rehabilitation programme for cardiac arrest survivors and co-survivors","authors":"N.A. Pearson ,&nbsp;G. McGregor ,&nbsp;H. Sandhu ,&nbsp;K. Couper ,&nbsp;J. Bruce ,&nbsp;P. Swindell ,&nbsp;S. Menzies ,&nbsp;D.R. Ellard ,&nbsp;R. Kandiyali ,&nbsp;S. Ennis ,&nbsp;S. Patel ,&nbsp;A. Hossain ,&nbsp;K.L. Haywood","doi":"10.1016/j.resplu.2026.101270","DOIUrl":"10.1016/j.resplu.2026.101270","url":null,"abstract":"<div><h3>Aim</h3><div>Little is known about how best to deliver support for the long-term recovery of cardiac arrest survivors, their family and close friends (co-survivors), or whether providing structured support is feasible. Working collaboratively, we have co-produced two online psychosocial and exercise rehabilitation care pathways for adult survivors and co-survivors – the Cardiac Arrest Recovery Enablement and Supported Self-management (CARESS) intervention. This study assesses the feasibility and acceptability of patient identification, recruitment, intervention delivery and outcomes assessment.</div></div><div><h3>Method</h3><div>A single arm, multi-centre feasibility study with an embedded process evaluation. We will test the acceptability and delivery of a new rehabilitation intervention in the NHS setting. We will recruit 30 cardiac arrest survivors discharged to home, and 30 co-survivors.</div><div>The CARESS rehabilitation intervention consists of three components delivered in real-time by video-call:<ul><li><span>1.</span><span><div>One-to-one consultation with a CARESS facilitator (week 1): a one-hour conversation to discuss motivation and set goals.</div></span></li><li><span>2.</span><span><div>Facilitator-led group support sessions (weeks 2–8; 1-h): provided weekly, separately for survivors <em>or</em> co-survivors to develop their knowledge, skills, understanding and establish connections with peers.</div></span></li><li><span>3.</span><span><div>Supervised group exercise rehabilitation sessions (weeks 3–8; up to 45 min): provided weekly, for survivors to build confidence and fitness.</div></span></li></ul>Recruitment, retention, and completion of outcome measures will be evaluated. Exploratory outcomes will include health-related quality of life (PROPr 29+2), emotional wellbeing (HADS, WEMWBS), and fatigue (FACIT-f), measured at baseline (week 0) and post-intervention (week 11) to assess suitability for a randomised controlled trial. Interviews to explore participant and facilitator perspectives will inform the process evaluation.</div></div><div><h3>Discussion</h3><div>This study assesses the feasibility of online delivery and findings will inform a future multi-centre randomised trial.</div><div><strong>Trial registration:</strong> ISRCTN16382742, prospectively registered 28/01/2025.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"28 ","pages":"Article 101270"},"PeriodicalIF":2.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147380223","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":"Impact of dispatcher-assisted cardiopulmonary resuscitation, advanced life support training, and physician experience on out-of-hospital cardiac arrest outcomes in Mostar: a 10-year retrospective cohort study","authors":"Igor Maslać ,&nbsp;Benjamin Palić ,&nbsp;Maja Kljakić ,&nbsp;Marin Puljić ,&nbsp;Marija Opančar ,&nbsp;Marko Kljakić ,&nbsp;Boris Opančar","doi":"10.1016/j.resplu.2026.101253","DOIUrl":"10.1016/j.resplu.2026.101253","url":null,"abstract":"<div><h3>Background</h3><div>Out-of-hospital cardiac arrest (OHCA) is a major public health challenge, with survival to hospital discharge rarely exceeding 10%. This study evaluated the association of dispatcher-assisted CPR (DA-CPR), advanced life support (ALS) training, and physician experience with OHCA outcomes in Mostar, Bosnia and Herzegovina, a resource-limited emergency medical service (EMS) system.</div></div><div><h3>Methods</h3><div>We conducted a retrospective cohort study encompassing all OHCA cases recorded in the Mostar region between 2013 and 2022. Dispatcher-assisted CPR was formally implemented in early 2018. Accordingly, patients were stratified into two groups: the pre-implementation period (2013–2017) and the post-implementation period (2018–2022). The primary outcome was return of spontaneous circulation (ROSC) and the secondary outcome was survival to hospital discharge.</div></div><div><h3>Results</h3><div>A total of 308 OHCA cases were included. ROSC was achieved in 88 patients (28.6%)<strong>,</strong> and 14 patients (4.5%) survived to hospital discharge. Following DA-CPR implementation, ROSC increased from 22.7% to 33.5%. In adjusted logistic regression DA-CPR (OR = 1.857, 95% CI 1.075–3.208) and ALS-trained physician involvement (OR = 1.802, 95% CI 1.045–3.105) were independently associated with ROSC. Physician experience was not associated with ROSC or survival to hospital discharge, and no examined exposures were associated with survival to hospital discharge.</div></div><div><h3>Conclusions</h3><div>Dispatcher-assisted CPR and ALS-trained physician involvement were associated with higher odds of ROSC, while none of the examined variables showed an association with survival to hospital discharge. Early resuscitation gains did not translate into final outcomes in this resource-limited EMS system. Improving survival will require coordinated system strengthening, particularly public-access defibrillation and standardized post-resuscitation care.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"28 ","pages":"Article 101253"},"PeriodicalIF":2.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147421646","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":"Applying randomized control trial criteria to an ECPR cohort","authors":"Yigal Helviz ,&nbsp;Frederic Shmuel Zimmerman ,&nbsp;Amir Orlev ,&nbsp;Michael Glikson ,&nbsp;David Shimony ,&nbsp;Daniel Fink ,&nbsp;Refael Strugo ,&nbsp;Elad Asher ,&nbsp;Tomer Kaplan ,&nbsp;Reem Naimy ,&nbsp;Ofer Merin ,&nbsp;Phillip D. Levin","doi":"10.1016/j.resplu.2026.101269","DOIUrl":"10.1016/j.resplu.2026.101269","url":null,"abstract":"<div><h3>Objective</h3><div>To assess how inclusion criteria from major randomized controlled trials (RCTs) of extracorporeal cardiopulmonary resuscitation (ECPR) apply within a cannulated ECPR cohort and to benchmark observed outcomes against published trial results.</div></div><div><h3>Methods</h3><div>We conducted a single-center retrospective cohort study at a 1,000-bed tertiary medical center of adults who underwent ECPR for out of hospital cardiac arrest. Inclusion criteria from the ARREST, PRAGUE, and INCEPTION trials were retrospectively applied. Analyses were restricted to cannulated patients, with survival evaluated overall and stratified by trial eligibility, and descriptively compared with published RCT outcomes.</div></div><div><h3>Results</h3><div>Sixty-six patients underwent ECPR, including 25 (38%) with a non-shockable initial rhythm. Overall survival to hospital discharge was 14% (9/66; 95% CI 6.4–24.3%), with favorable neurological outcome in 5/9 survivors. Survival was numerically higher among patients meeting trial inclusion criteria, but differences were not statistically significant. Survival was comparable to PRAGUE and INCEPTION and lower than ARREST.</div></div><div><h3>Conclusions</h3><div>Within this program level, cannulated ECPR cohort, RCT-derived inclusion criteria did not clearly distinguish survivors from non-survivors, and survival occurred among patients not meeting one or more trial eligibility thresholds. Rigid application of trial criteria at the point of cannulation may therefore exclude some patients with potential for meaningful recovery.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"28 ","pages":"Article 101269"},"PeriodicalIF":2.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147421668","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}