Resuscitation plus最新文献

{"title":"Effect of introduction of a rapid response system and increasing Medical Emergency Team (MET) activity on mortality over a 20-year period in a paediatric specialist hospital","authors":"Jason Acworth ,&nbsp;Connor Ryan ,&nbsp;Elliott Acworth ,&nbsp;Syeda Farah Zahir","doi":"10.1016/j.resplu.2024.100823","DOIUrl":"10.1016/j.resplu.2024.100823","url":null,"abstract":"<div><h3>Background</h3><div>Rapid Response Systems are hospital-wide patient-focused systems aiming to improve recognition of acute deterioration in patients and trigger a rapid response aimed at preventing potentially avoidable adverse events such as cardiac arrest and death. In 1994, the Royal Children’s Hospital in Brisbane, Australia, was one of the first institutions to adopt a paediatric rapid response system (RRS). The purpose of this study was to investigate the impacts of both introduction of a paediatric RRS and increasing RRS activations (MET dose) on hospital mortality.</div></div><div><h3>Methods</h3><div>Prospectively collected data from institutional databases at a specialist paediatric hospital was used to determine hospital mortality rate pre- and post- implementation of the RRS. An interrupted time series model using segmented regression was utilised to assess the pre-intervention trend, as well as immediate and sustained effects of RRS implementation on hospital mortality. Univariate linear regression examined potential effects of MET dose on mortality.</div></div><div><h3>Results</h3><div>Hospital mortality rate did not change significantly over 15 years before RRS implementation. In the first year after implementation, mortality rate fell significantly (−1.4; 95 %CI −2.27 to −0.52; p = 0.0027). For each year that passed after the intervention, there was no significant change in hospital mortality rate (Estimate: −0.08; 95 %CI −0.17 to 0.02; p = 0.11). Univariate linear regression modelling showed that with every unit increase in MET Dose, hospital mortality rate decreased by −0.13 (95 % CI: −0.27 to 0; p = 0.05).</div></div><div><h3>Conclusions</h3><div>Utilising data from one of the earliest and longest duration single-centre cohort of paediatric MET events, this study reaffirms the association between implementation of a paediatric RRS and decreased hospital mortality. The study also provides novel evidence of the impact of MET dose on patient outcome in the paediatric population. It is recommended that factors influencing the benefit of rapid response systems in paediatric populations are further identified so that this life saving initiative can be optimised.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"20 ","pages":"Article 100823"},"PeriodicalIF":2.1,"publicationDate":"2024-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142659655","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":"Prehospital ventilation strategies in out-of-hospital cardiac arrest: A protocol for a randomized controlled trial (PIVOT trial)","authors":"Cheng-Yi Fan ,&nbsp;Sih-Shiang Huang ,&nbsp;Chi-Hsin Chen ,&nbsp;Chih-Wei Sung ,&nbsp;Chin-Hao Chang ,&nbsp;Tung-Hsiu Hung ,&nbsp;Yen-Chen Liu ,&nbsp;Edward Pei-Chuan Huang","doi":"10.1016/j.resplu.2024.100827","DOIUrl":"10.1016/j.resplu.2024.100827","url":null,"abstract":"<div><h3>Aims</h3><div>The PIVOT trial evaluates the clinical outcomes and ventilatory quality of an automatic pneumatic ventilation method compared to a bag-valve-mask ventilation method in patients who have experienced out-of-hospital cardiac arrest and have had an advanced airway placed.</div></div><div><h3>Methods</h3><div>The PIVOT trial is a pragmatic, open-label, multicenter randomized controlled trial. It aims to recruit 514 patients in Hsinchu County, Taiwan. Adult, non-trauma patients who experience out-of-hospital cardiac arrest, are treated by emergency medical services, and have an advanced airway in place will be randomized. Biweekly cluster randomization will assign EMS teams to either the automatic pneumatic ventilation group or the bag-valve-mask group. Informed consent is waived. The primary outcome is the return of spontaneous circulation, either prehospital or in-hospital. Secondary outcomes include survival to discharge, neurological outcomes, prehospital ventilatory quality, and the content of prehospital resuscitation. Participants will be followed until they pass away or are discharged from the hospital.</div></div><div><h3>Conclusion</h3><div>The PIVOT trial will provide new insight on the clinical effectiveness of automatic pneumatic ventilation in patients experienced out-of-hospital cardiac arrest.</div><div><strong>Trial number</strong>: NCT06067204 in <span><span><em>clinicaltrial.gov</em></span><svg><path></path></svg></span></div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"20 ","pages":"Article 100827"},"PeriodicalIF":2.1,"publicationDate":"2024-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142659592","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":"Cardiopulmonary resuscitation in obese patients: A scoping review","authors":"Julie Considine ,&nbsp;Keith Couper ,&nbsp;Robert Greif ,&nbsp;Gene Yong-Kwang Ong ,&nbsp;Michael A. Smyth ,&nbsp;Kee Chong Ng ,&nbsp;Tracy Kidd ,&nbsp;Theresa Mariero Olasveengen ,&nbsp;Janet Bray ,&nbsp;on behalf of the International Liaison Committee on Resuscitation (ILCOR) Basic Life Support (BLS), Advanced Life Support (ALS), Paediatric Life Support (PLS), and Education, Implementation, Teams (EIT) Task Forces","doi":"10.1016/j.resplu.2024.100820","DOIUrl":"10.1016/j.resplu.2024.100820","url":null,"abstract":"<div><h3>Background</h3><div>Given the increasing global prevalence of obesity, the International Liaison Committee on Resuscitation (ILCOR) commissioned this scoping review to explore current evidence underpinning treatment and outcomes of obese patients (adult and children) in cardiac arrest.</div></div><div><h3>Methods</h3><div>This scoping review, conducted using Arksey and O’Malley’s framework and reported according to PRISMA-ScR guidelines, included studies of CPR in obese patients. ‘Obese’ was defined according to each individual study. Medline, EMBASE and Cochrane were searched from inception to 1 October 2024. Narrative synthesis was guided by Synthesis Without Meta-Analysis (SWiM) reporting guidelines.</div></div><div><h3>Results</h3><div>36 studies were included: 2 paediatric and 34 adult studies. Fourteen studies reported on out-of-hospital cardiac arrest (OHCA), 12 on in-hospital cardiac arrest (IHCA), eight on both OHCA and IHCA: cardiac arrest location was not reported in two studies. The most common outcomes were survival (n = 29), neurological outcome (n = 17) and ROSC (n = 7). In adults there were variable results in neurological outcome, survival to hospital discharge, longer term survival (months to years), and ROSC. In children, there were two studies suggesting that obese children had worse neurological outcomes, lower survival and lower ROSC than normal weight children. Few studies reported resuscitation quality indicators or techniques, and no studies reported adjustments to CPR techniques.</div></div><div><h3>Conclusion</h3><div>The variability in results does not suggest an urgent need to deviate from standard CPR protocols, however there was some evidence that CPR duration may be longer in obese adults, which may have staffing and resource implications.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"20 ","pages":"Article 100820"},"PeriodicalIF":2.1,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142659654","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":"Effect of chest compressions in addition to extracorporeal life support on carotid flow in an experimental model of refractory cardiac arrest in pigs","authors":"Sergey Gurevich ,&nbsp;Rajat Kalra ,&nbsp;Marinos Kosmopoulos ,&nbsp;Alexandra M Marquez ,&nbsp;Deborah Jaeger ,&nbsp;Mitchell Bemenderfer ,&nbsp;Danielle Burroughs ,&nbsp;Jason A Bartos ,&nbsp;Demetris Yannopoulos ,&nbsp;Sebastian Voicu","doi":"10.1016/j.resplu.2024.100826","DOIUrl":"10.1016/j.resplu.2024.100826","url":null,"abstract":"<div><h3>Background</h3><div>Extracorporeal life support (ECLS) provides organ perfusion in refractory cardiac arrest but during the initiation of ECLS mean arterial pressure (MAP) and carotid flow may be suboptimal due to hypotension and/or insufficient flow. We hypothesized that cardiopulmonary resuscitation (CPR) in addition to ECLS may increase carotid flow and MAP compared to ECLS alone.</div></div><div><h3>Methods</h3><div>Observational pilot study comparing hemodynamic parameters before and after CPR cessation in pigs supported by ECLS for experimental refractory cardiac arrest. Pigs were anesthetized, ventricular fibrillation was induced for 3 min, automated CPR performed for 30 min, ECLS was initiated then CPR stopped.</div><div>Variables averaged over 3 s were compared between the last 3 s of CPR + ECLS and 3, 6, 30 s, and 5 and 10 min of ECLS alone. Data are expressed as medians (25–75 interquartile range) and compared using paired samples Wilcoxon test.</div></div><div><h3>Results</h3><div>Nine pigs were included, ECLS was initiated at 2.7 (2.3–2.8) L/min. MAP during CPR + ECLS was 56(53.0–59.2) mmHg, <em>versus</em> 50(45–57)mmHg, 52(46–59)mmHg, 61(50–63)mmHg, 57 (54–66)mmHg, 54 (47–58)mmHg of ECLS alone, p = 0.50, 0.61, 0.70, 0.44, 0.73 respectively. Carotid flow was 113(78–119) ml/min during CPR + ECLS <em>versus</em> 99(79–110)ml/min, 100(81–110)ml/min, 96(60–122)ml/min, 118 (101–130)ml/min, 124 (110–141)ml/min, p = 0.41, 0.52, 0.73, 0.33, 0.20 respectively. When ECLS was initiated at lower flow, 1.5 L/min (one pig), MAP decreased from 59 to 45 mmHg, and carotid flow from 78.2 to 32.5 ml/min after 3 s of ECLS alone.</div></div><div><h3>Conclusion</h3><div>Stopping CPR after effective ECLS initiation does not decrease MAP or carotid flow. Future studies may evaluate augmenting low flow ECLS with CPR.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"20 ","pages":"Article 100826"},"PeriodicalIF":2.1,"publicationDate":"2024-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142659590","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":"Monocyte programmed death-ligand 1 upregulation in early post-out-of-hospital cardiac arrest is associated with increased risk of acute respiratory distress syndrome","authors":"Le An ,&nbsp;Rui Shao ,&nbsp;Chenchen Hang ,&nbsp;Xingsheng Wang ,&nbsp;Luying Zhang ,&nbsp;Hao Cui ,&nbsp;Jingfei Yu ,&nbsp;Zhenyu Shan ,&nbsp;Ziren Tang","doi":"10.1016/j.resplu.2024.100822","DOIUrl":"10.1016/j.resplu.2024.100822","url":null,"abstract":"<div><h3>Background</h3><div>Out-of-hospital cardiac arrest (OHCA) is a major public health problem. Acute respiratory distress syndrome (ARDS) is a common condition in OHCA patients. We investigated the relationship between the expression of programmed death-1 (PD-1) related molecules and the development and prognosis of ARDS.</div></div><div><h3>Methods</h3><div>Between January 2021 and December 2023, post-resuscitated patients were screened for eligibility in the study. PD-1 related molecules expression was measured by flow cytometry at 48 h of admission in patients with OHCA. The prognostic variables were the development of ARDS during hospitalization and the 28-day patient mortality rate. We analyzed the relationship between the expression of PD-1-related molecules and the development of secondary ARDS in OHCA patients, and assessed the correlation of this expression with the prognosis of ARDS patients.</div></div><div><h3>Results</h3><div>In total, 107 consecutive OHCA patients were enrolled in this study. The median age of the enrolled patients was 60 years, with an age range of 53 to 67 years, and 71 % were male. Among the cardiac arrest patients, 44.8 % had a cardiac etiology, 30.8 % were witnessed, 17.8 % received bystander CPR, and 66.4 % had an initial rhythm of asystole. Our results showed that only monocyte ligand programmed death ligand-1 (PD-L1) expression was significantly elevated in the ARDS group of OHCA patients (P &lt; 0.001). Among patients with ARDS, the expression of PD-L1 on monocytes in non-survivors was significantly higher than in survivors (P &lt; 0.05). The Receiver operating characteristic curves analysis demonstrates that monocyte PD-L1 expression has predictive potential for the development and prognosis of ARDS. Multivariate logistic regression analysis showed that monocyte PD-L1 expression was an independent predictor of mortality in OHCA patients with ARDS.</div></div><div><h3>Conclusions</h3><div>This study indicates that patients with increased PD-L1 on monocytes after OHCA may be more likely to develop ARDS. The expression of PD-L1 on monocytes was an independent predictive factor for the incidence of ARDS and mortality rate in OHCA patients.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"20 ","pages":"Article 100822"},"PeriodicalIF":2.1,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142659656","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":"Hemoglobin vesicles improve neurological outcomes after cardiac arrest in rats","authors":"Keisuke Tsuruta ,&nbsp;Hidetada Fukushima ,&nbsp;Hiromi Sakai","doi":"10.1016/j.resplu.2024.100819","DOIUrl":"10.1016/j.resplu.2024.100819","url":null,"abstract":"<div><h3>Aim</h3><div>To investigate the effects of hemoglobin vesicles (HbVs) in preventing hypoxic brain injury after cardiac arrest in a rat model of asphyxia-related cardiac arrest.</div></div><div><h3>Methods</h3><div>Male Wistar rats were divided into three groups: HbVs (n = 18), control (n = 29), and sham (n = 7). Respiratory arrest was induced using muscle relaxants under ventilation. Cardiac arrest occurred 3–4 min later. After 8 min, HbVs or saline (5 ml/kg), adrenaline, and sodium bicarbonate were administered, followed by chest compressions and ventilation. Resuscitation was deemed successful with a mean arterial pressure &gt; 60 mmHg sustained for at least 5 min. Behavioral and histopathological evaluations were performed 7 days later.</div></div><div><h3>Results</h3><div>Survival rates were 39 % and 24 % in the HbVs and control groups, respectively (P = 0.308). Motor activity scores and spatial memory were significantly higher in the HbVs group (P &lt; 0.001). Hippocampal CA1 region staining indicated significantly less neuropathy in the HbVs group (P &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>The administration of HbVs during resuscitation was effective in mitigating brain damage after whole-brain ischemia in rats, as demonstrated by improved histopathological and neurological outcomes. This suggests potential neurological benefits for patients during resuscitation, although further research in larger animal models is required to validate these findings.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"20 ","pages":"Article 100819"},"PeriodicalIF":2.1,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142659649","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":"Ventilation practices and preparedness of healthcare providers in term newborn resuscitation: A comprehensive survey study in Austrian hospitals","authors":"Eva M. Schwindt ,&nbsp;Reinhold Stockenhuber ,&nbsp;Jens Christian Schwindt","doi":"10.1016/j.resplu.2024.100817","DOIUrl":"10.1016/j.resplu.2024.100817","url":null,"abstract":"<div><h3>Aim of the study</h3><div>Although neonatal resuscitation is rare, and high-risk births usually occur in specialised centres, unexpected resuscitation measures may be necessary during births that are initially considered low-risk. This survey assessed the practices of healthcare providers in Austrian hospitals for postnatal resuscitation and evaluated their self-assessed airway management skills for newborns.</div></div><div><h3>Methods</h3><div>An online survey was distributed to all staff members responsible for the postnatal care of newborns in hospitals with obstetrics in Austria through the heads of departments (paediatrics, obstetrics, and anaesthesiology). The results are presented in terms of hospital care level and birth volume.</div></div><div><h3>Results</h3><div>In total, 79.5 % of all hospitals with maternity units in Austria participated in the survey. Preparedness was found to be improved with the level of care provided by the hospital. Overall, 50.4 % of the respondents did not feel adequately prepared for neonatal emergencies, and 35.0 % rated their face mask ventilation skills as insufficient. According to the survey results in 61.3 % of included hospitals or 52.5 % of births in Austria, safe endotracheal intubation cannot be provided.</div></div><div><h3>Conclusion</h3><div>A significant proportion of healthcare workers in Austria responsible for postnatal newborn care do not feel adequately prepared for newborn emergencies.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"20 ","pages":"Article 100817"},"PeriodicalIF":2.1,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142659591","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":"Feasibility of real-time compression frequency and compression depth assessment in CPR using a “machine-learning” artificial intelligence tool","authors":"Hannes Ecker ,&nbsp;Niels-Benjamin Adams ,&nbsp;Michael Schmitz ,&nbsp;Wolfgang A. Wetsch","doi":"10.1016/j.resplu.2024.100825","DOIUrl":"10.1016/j.resplu.2024.100825","url":null,"abstract":"<div><h3>Background</h3><div>Video assisted cardiopulmonary resuscitation (V-CPR) has demonstrated to be efficient in improving CPR quality and patient outcomes, as Emergency Medical Service (EMS) dispatchers can use the video stream of a caller for diagnostic purposes and give instructions in a CPR scenario. However, the new challenges faced by EMS dispatchers during video-guided CPR (V-CPR)—such as analyzing the video stream, providing feedback to the caller, and managing stress—demand innovative solutions. This study explores the feasibility of incorporating an open-source “machine-learning” tool (artificial intelligence – AI), to evaluate the feasibility and accuracy in correctly detecting the actual compression frequency and compression depth in video footage of a simulated CPR.</div></div><div><h3>Design</h3><div>MediaPipe Pose Landmark Detection (Google LLC, Mountain View, CA, USA), an open-source AI software using “machine-learning” models to detect human bodies in images and videos, was programmed to assess compression frequency an depth in nine videos, showing CPR on a resuscitation manikin. Compression frequency and depth were assessed from compression to compression with AI software and were compared to the manikin’s internal software (QCPR, Laerdal, Stavanger, Norway). After testing for Gaussian distribution, means of non-gaussian data were compared using Wilcoxon matched-pairs signed rank test and the Bland Altman method.</div></div><div><h3>Main results</h3><div>MediaPipe Pose Landmark Detection successfully identified and tracked the person performing CPR in all nine video sequences. There were high levels of agreement between compression frequencies derived from AI and manikin’s software. However, the precision of compression depth showed major inaccuracies and was overall not accurate.</div></div><div><h3>Conclusions</h3><div>This feasibility study demonstrates the potential of open-source “machine-learning” tools in providing real-time feedback on V-CPR video sequences. In this pilot study, an open-source landmark detection AI software was able to assess CPR compression frequency with high agreement to actual frequency derived from the CPR manikin. For compression depth, its performance was not accurate, suggesting the need for adjustment. Since the software used is currently not intended for medical use, further development is necessary before the technology can be evaluated in real CPR.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"20 ","pages":"Article 100825"},"PeriodicalIF":2.1,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142587356","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":"Glucagon-like peptide-1 receptor agonist use is associated with reduced risk of out-of-hospital cardiac arrest in women with type 2 diabetes: A nationwide nested case-control study","authors":"Talip E. Eroglu ,&nbsp;Ruben Coronel ,&nbsp;Fredrik Folke ,&nbsp;Gunnar Gislason","doi":"10.1016/j.resplu.2024.100821","DOIUrl":"10.1016/j.resplu.2024.100821","url":null,"abstract":"<div><h3>Objective</h3><div>Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) improve cardiovascular outcomes in patients with type 2 diabetes, but few studies have studied the risk of out-of-hospital cardiac arrest (OHCA). We investigated whether GLP-1 RA use reduce OHCA risk in type 2 diabetes when compared to dipeptidyl peptidase-4 inhibitor (DPP-4i) use.</div></div><div><h3>Methods</h3><div>We identified all patients having a redeemed prescription of a glucose-lowering drug between 1995 and 2019 and excluded patients with a first-time redeemed prescription consisting of insulin. Within this cohort, we nested a case-control population comprising all OHCA-cases from presumed cardiac causes between 2013 and 2019. OHCA-cases were matched 1:5 to non-OHCA controls of the same sex and age on the date of OHCA. The odds ratios (ORs) and corresponding 95% confidence intervals (95%-CIs) of OHCA were reported comparing GLP-1 RAs versus DPP-4is.</div></div><div><h3>Results</h3><div>We identified 3,618 OHCA-cases from presumed cardiac causes and matched them to 18,090 non-OHCA controls. GLP-1 RAs were used by 269 (7.44%) cases and 1297 (7.17%) controls, and conferred no increase in the overall odds of OHCA compared with DPP-4i use (OR:0.89, 95%-CI 0.74–1.07). However, stratification according to sex revealed that OHCA risk was significantly reduced in women (OR:0.59, 95%-CI 0.40–0.86) but not in men (OR:1.01, 95%-CI 0.82–1.26, P-value interaction:0.0093). The OR of OHCA did not vary significantly when stratifying for age, duration of diabetes, chronic kidney disease, or presence of cardiovascular disease.</div></div><div><h3>Conclusion</h3><div>Our findings indicate that GLP-1 RA use is not associated with a reduced risk of OHCA in Danish individuals with type 2 diabetes when compared to DPP-4is.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"20 ","pages":"Article 100821"},"PeriodicalIF":2.1,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142586763","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":"Impact of video-assisted neonatal resuscitation on newborns and resuscitators: A feasibility study","authors":"Hiroki Otsuka ,&nbsp;Eiji Hirakawa ,&nbsp;Asataro Yara ,&nbsp;Daisuke Saito ,&nbsp;Takuya Tokuhisa","doi":"10.1016/j.resplu.2024.100811","DOIUrl":"10.1016/j.resplu.2024.100811","url":null,"abstract":"<div><h3>Aim</h3><div>High-risk deliveries are still common due to the increased use of assisted reproductive technologies. In Japan, despite centralization of labor, about half of all deliveries are still carried out in obstetric clinics. Telemedicine support is important for neonatal resuscitation involving urgent, life-altering professional judgment in local deliveries. This feasibility study examined the effects of using medical communication software on the quality of neonatal resuscitation, and the physiological parameters of the newborn and stress of the resuscitators.</div></div><div><h3>Methods</h3><div>This observational study included cesarean births with ≥ 36 weeks gestational age at Kagoshima City Hospital between January 1, 2023 and 2024. A camera on the neonatal resuscitation table allowed a neonatologist to observe the resuscitation through a medical communication software and give instructions to the resuscitators. The midwife performing the resuscitation wore a communication microphone to interact with the neonatologist. Details of the neonatal resuscitation procedures, newborn physical findings, and neonatal intensive care unit (NICU) admission rates were collected from medical records. A midwife questionnaire was also administered. The primary endpoints were resuscitation findings, and the secondary endpoint was resuscitator stress before and after implementing the software.</div></div><div><h3>Results</h3><div>The intervention had no major adverse effects and no change in NICU admission rates; however, there were increases in post-resuscitation temperature and suctioning frequency. While the intervention caused stress to the resuscitators, it also contributed to an increased sense of security and learning.</div></div><div><h3>Conclusion</h3><div>Telemedicine support in neonatal resuscitation can be introduced without significant adverse effects.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"20 ","pages":"Article 100811"},"PeriodicalIF":2.1,"publicationDate":"2024-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142578624","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}