Resuscitation plus最新文献

{"title":"Innovative integration of wearable ECG monitoring vest and drone-delivered AED for high-rise for cardiac emergency rescue: a pilot study","authors":"Hong Jiang , Shouzheng Wang , Wenbin Ouyang , Mingbo Pan , Xiangbin Pan","doi":"10.1016/j.resplu.2025.101206","DOIUrl":"10.1016/j.resplu.2025.101206","url":null,"abstract":"","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"27 ","pages":"Article 101206"},"PeriodicalIF":2.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145924676","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":"Artesunate preserves post-resuscitation myocardial and neurologic function in a rat model of cardiac arrest and cardiopulmonary resuscitation","authors":"Hui Li ,&nbsp;Cheng Cheng ,&nbsp;Lian Liang ,&nbsp;Tao Jin ,&nbsp;Guozhen Zhang ,&nbsp;Mary Ann Peberdy ,&nbsp;Joseph P. Ornato ,&nbsp;Wanchun Tang ,&nbsp;Min Yang","doi":"10.1016/j.resplu.2025.101214","DOIUrl":"10.1016/j.resplu.2025.101214","url":null,"abstract":"<div><h3>Background</h3><div>To investigate the effects of Artesunate (Art) on post-resuscitation myocardial and neurologic function, survival duration, and the underlying mechanisms in a rat model of cardiac arrest (CA) and cardiopulmonary resuscitation (CPR).</div></div><div><h3>Methods</h3><div>Thirty healthy male Sprague-Dawley rats were randomly allocated into three groups: Sham, Control(CA/CPR + vehicle),and ART(CA/CPR + Art). The latter two groups were further divided into survival and non-survival subgroups. CA were induced via 6-minute ventricular fibrillation, followed by 8 min of CPR. After the return of spontaneous circulation (ROSC), rats in the respective groups received either a vehicle or Art injection at random. Electrocardiogram (ECG) and arterial pressure were continuously monitored. In non-survival subgroups (euthanized 4 h post-ROSC), serum and tissue samples were analyzed for inflammatory cytokine concentrations, oxidative stress indices, myocardial injury markers, phosphorylated p38 (pp38), and echocardiography was performed. In survival subgroups, neurological deficit scores (NDS) were assessed at 24, 48, and 72 h post-ROSC, along with monitoring the duration of survival.</div></div><div><h3>Results</h3><div>Art reduced the severity of post-resuscitation myocardial dysfunction compared to control group. It attenuated interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), and cardiac troponin I (cTnI) plasma levels 4 h after ROSC. In comparison with the control group, Art treatment led to a marked decrease in Thiobarbituric acid reactive species (TBARS) and 4-hydroxy-2-nonenal(4-HNE) expression, accompanied by upregulation of superoxide dismutases (SOD) activity in both heart and brain tissues. Art administration also downregulated the phosphorylation of p38. Post-resuscitation neurologic function and duration of survival were improved significantly in Art treated animals.</div></div><div><h3>Conclusions</h3><div>This study demonstrated that Art reduces the severity of post-resuscitation myocardial and neurologic dysfunction, improves survival duration in a rat model of CA. The underlying mechanism may be related to anti-inflammation, oxidative stress and may be associated with regulation of 4-HNE induced p38 Mitogen activated protein kinase (MAPK) pathway activation.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"27 ","pages":"Article 101214"},"PeriodicalIF":2.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145977157","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":"Extracorporeal cardiopulmonary resuscitation following cardiac surgery: a scoping review","authors":"Sho Takemoto ,&nbsp;Tomonari M. Shimoda ,&nbsp;Yuta Inoue ,&nbsp;Hirofumi Kanazawa ,&nbsp;Amir Sanatkar ,&nbsp;Asishana Osho ,&nbsp;Ryan Ruiyang Ling ,&nbsp;Kollengode Ramanathan ,&nbsp;Akira Shiose ,&nbsp;Yohei Okada","doi":"10.1016/j.resplu.2025.101210","DOIUrl":"10.1016/j.resplu.2025.101210","url":null,"abstract":"<div><h3>Background</h3><div>In-hospital cardiac arrest after cardiac surgery demands specific approaches, such as rapid resternotomy, internal cardiac massage and sequential defibrillation. Extracorporeal cardiopulmonary resuscitation (ECPR) is a viable option; however, it is not standardized. This scoping review summarizes current evidence and identifies knowledge gaps regarding ECPR after cardiac surgery.</div></div><div><h3>Methods</h3><div>We searched PubMed, Web of Science, Cochrane Library, and Ichushi-Web (a Japanese medical database) from July 29, 2024 through March 20, 2025. Studies reporting outcomes in patients received ECPR after cardiac surgery were included, without restrictions on study design or language.</div></div><div><h3>Results</h3><div>Of 3963 unique articles, 49 studies were included. Among these, 3 adult and 17 pediatric studies reported ≥20 identifiable post–cardiac surgery ECPR cases (91 adult cases and 1464 pediatric cases). Across the included adult literature, only two ventricular assist device cases and no minimally invasive cardiac surgery cases were found. Adult post-cardiac surgery ECPR outcomes showed 33–35 % of overall survival and 23–29 % of survival with favorable neurological outcome. Pediatric outcomes were variable, with 10–70 % of overall survival and 10–40 % survival with favorable neurological outcome. Chest compression duration ranged from 31 to 36 min in adult post-cardiac surgery ECPR and from 27 to 60 min in pediatrics, where this metric was frequently available only from mixed surgical/non-surgical cohorts.</div></div><div><h3>Conclusion</h3><div>Both adult and pediatric groups demonstrated variable but relatively high overall survival and survival with favorable neurological outcome following ECPR. Pediatric studies highlighted prolonged chest compressions. Further research is needed to explore the role of ECPR following minimally invasive and ventricular assist device surgery.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"27 ","pages":"Article 101210"},"PeriodicalIF":2.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145977160","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":"Detection of return of spontaneous circulation during cardiopulmonary resuscitation using continuous carotid artery Doppler blood flow monitored by AI in an animal model","authors":"Raghava Vinaykanth Mushunuri ,&nbsp;Bjorn Ove Faldaas ,&nbsp;Frank Lindseth ,&nbsp;Charlotte Bjork Ingul ,&nbsp;Gabriel Kiss","doi":"10.1016/j.resplu.2025.101207","DOIUrl":"10.1016/j.resplu.2025.101207","url":null,"abstract":"<div><h3>Background</h3><div>Manual pulse checks during cardiopulmonary resuscitation (CPR) to confirm return of spontaneous circulation (ROSC) are often unreliable and time- consuming. To address this, a novel RescueDoppler device has been developed, consisting of a small ultrasound probe that attaches to the neck and continuously monitors potential blood flow in the carotid artery.</div></div><div><h3>Aim</h3><div>To provide automatic real-time feedback on ROSC using RescueDoppler carotid blood flow during cardiac arrest by employing advanced deep-learning techniques.</div></div><div><h3>Method</h3><div>We conducted two experiments using carotid blood flow velocity recordings from 9 pigs, with ventricular fibrillation induced via an implantable defibrillator. Experiment 1 included 2610 annotated heart cycles and used a simple classifier to distinguish compression (only manual) from ROSC signals. Experiment 2 involved 5140 cycles and employed a two- stage classifier: the first stage replicated Experiment 1, while the second further separated compression-only from compression with intrinsic cardiac activity. Two- second spectral signals were extracted, normalized, and artificial neural networks are trained for classifying the signals by using State-of-the-art deep learning models as feature extractors. Grad-CAM, an explainable AI (XAI) method, highlighted key regions which contributed most to the model’s predictions.</div></div><div><h3>Results</h3><div>Our model achieved mean sensitivity of 98 %, specificity of 97 %, positive predictive value of 97 %, and negative predictive value of 100 %. XAI heatmaps highlighted features important for the model’s predictions.</div></div><div><h3>Conclusion</h3><div>In a porcine model of cardiac arrest, we demonstrated that deep learning techniques can harness the potential of AI to identify the compressions with intrinsic cardiac activity and ROSC during CPR, achieving highly accurate results.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"27 ","pages":"Article 101207"},"PeriodicalIF":2.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145924675","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":"Intubation during in-hospital cardiac arrest: an instrumental variable analysis","authors":"Mathias J. Holmberg ,&nbsp;Asger Granfeldt ,&nbsp;Lars W. Andersen","doi":"10.1016/j.resplu.2025.101202","DOIUrl":"10.1016/j.resplu.2025.101202","url":null,"abstract":"<div><h3>Introduction</h3><div>Tracheal intubation is commonly performed during in-hospital cardiac arrest, but the evidence for a survival benefit remains uncertain.</div></div><div><h3>Methods</h3><div>This was an observational study using data from the Get With The Guidelines registry. Adult patients with an in-hospital cardiac arrest between January 2013 and December 2021 were included. Instrumental variable analyses were conducted using two-stage least squares regression in an attempt to account for unmeasured confounding. Two instrumental variables were predefined as (1) tracheal intubation during the previous cardiac arrest and (2) the proportion of intubated cardiac arrest patients within the past year at a given hospital. The primary outcome was survival to hospital discharge. Secondary outcomes included return of spontaneous circulation and favorable neurological status.</div></div><div><h3>Results</h3><div>A total of 210,115 cardiac arrests were included. The median age was 67 years, 59 % of patients were male, and 85 % of patients had an initial non-shockable rhythm. Intubation was performed in 85 % of patients. For the first and second instrumental variables, tracheal intubation was associated with absolute risk differences in survival of −11 % (95 % CI, −16 % to −5.6 %) and −12 % (95 % CI, −16 % to −8.2 %), respectively. Similar results were observed for the secondary outcomes.</div></div><div><h3>Conclusions</h3><div>Tracheal intubation during in-hospital cardiac arrest was associated with reduced survival, although point estimates were implausibly large, and the results should be interpreted cautiously. Preference-based instrumental variables may not adequately address confounding in this setting. Randomized clinical trials are needed to inform advanced airway management during in-hospital cardiac arrest.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"27 ","pages":"Article 101202"},"PeriodicalIF":2.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145924814","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":"Incidence and prognostic impact of delirium after cardiac arrest: a systematic review and meta-analysis","authors":"Saeed Khayat Kakhki ,&nbsp;Majid Daneshfar ,&nbsp;Mehrdad Yousefnezhad ,&nbsp;Alireza NamaeiQasemnia","doi":"10.1016/j.resplu.2025.101195","DOIUrl":"10.1016/j.resplu.2025.101195","url":null,"abstract":"<div><h3>Background</h3><div>Delirium is common after ROSC, yet reported incidence varies widely across studies that differ in instruments, assessment windows, and post-arrest care. We aimed to quantify the incidence of delirium among adult post-ROSC ICU survivors and evaluate its association with short-term mortality.</div></div><div><h3>Methods</h3><div>The review was reported according to PRISMA guidelines and registered on PROSPERO (CRD420251160097). PubMed, Embase, Scopus, and Web of Science were searched from 2000 to 30 Sep 2025 without language restrictions. Eligible studies enrolled adults (≥18 years) with ROSC admitted to ICU and reported ICU-period delirium using validated tools (CAM-ICU, ICDSC, DSM-based diagnosis) or structured screening scales. Proportions were pooled on the logit scale using random-effects models with Hartung–Knapp adjustment. Prespecified sensitivity analyses included validated tools only, exclusion of non-validated instruments, and binomial–normal GLMM.</div></div><div><h3>Results</h3><div>Eleven studies (<em>n</em> = 1799) met inclusion criteria. The pooled ICU-period incidence of delirium was 0.43 (95 % CI 0.16–0.75) with a wide prediction interval (≈0.01–0.98), reflecting substantial heterogeneity largely driven by assessment instrument and ICU ascertainment window rather than patient factors. Findings were robust in binomial–normal GLMM analyses and in influence/sensitivity analyses. Delirium was consistently associated with greater resource use (longer ICU and hospital length of stay) and, in the two post-ROSC cohorts reporting adjusted models, signaled higher short-term mortality; larger CICU/AMI cohorts provided concordant mortality signals.</div></div><div><h3>Conclusions</h3><div>Delirium affects roughly two in five ICU survivors after ROSC and its measured incidence depends strongly on how and when it is assessed. Standardizing to validated tools and a common ICU window could narrow heterogeneity and improve comparability. These results support routine delirium screening and prevention as core elements of post-arrest care.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"27 ","pages":"Article 101195"},"PeriodicalIF":2.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145924812","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":"Wolf Creek XVIII Part 2: optimizing time intervals in cardiac arrest care","authors":"Theresa M. Olasveengen ,&nbsp;Haruka Takahashi ,&nbsp;Rudolph W. Koster ,&nbsp;Gavin D. Perkins ,&nbsp;Robert W. Neumar","doi":"10.1016/j.resplu.2025.101197","DOIUrl":"10.1016/j.resplu.2025.101197","url":null,"abstract":"<div><div>Optimizing time intervals in cardiac arrest care was a featured topic at the 50th Anniversary Wolf Creek Conference (Wolf Creek XVIII) hosted by the Max Harry Weil Institute for Critical Care Research and Innovation in Ann Arbor, Michigan, USA on June 19–21, 2025. This narrative review summarizes the presentations and discussion of the topic by invited panelist and conference participants made up of international academic and industry scientists as well as thought leaders in the field of cardiac arrest resuscitation. The proceedings highlighted the limitations of binary proportion-based resuscitation metrics (e.g. “bystander CPR—yes/no”) in driving improvements in cardiac arrest outcomes and called for a paradigm shift—placing time intervals to key cardiac arrest interventions and responses to therapy at the center of benchmarking quality improvement and research. In addition to an overview of the current state and vision for the future state, we detail knowledge gaps and barriers to translation, and propose research priorities that include standardizing interval measurement, harmonizing reporting, and validating interval metrics for system performance and proximal outcomes. Making treatment and response intervals core metrics for systems-of-care, registries, and clinical trials could shift the field’s focus toward the goal of faster restoration of perfusion resulting in improved survival and better neurologic recovery.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"27 ","pages":"Article 101197"},"PeriodicalIF":2.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145924981","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":"2025-12-24","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":"Comparison of Negative Pressure Performance Between Certified and Counterfeit Suction-based Devices","authors":"Nino Fijačko ,&nbsp;Špela Metličar ,&nbsp;Inja Dokl ,&nbsp;Aleš Fajmut","doi":"10.1016/j.resplu.2025.101203","DOIUrl":"10.1016/j.resplu.2025.101203","url":null,"abstract":"","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"27 ","pages":"Article 101203"},"PeriodicalIF":2.4,"publicationDate":"2025-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145924679","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":"Terminology Matters: Distinguishing Bystanders from First Responders in Resuscitation Science","authors":"Sergio Cazorla-Calderón ,&nbsp;Nino Fijačko ,&nbsp;Robert Greif","doi":"10.1016/j.resplu.2025.101201","DOIUrl":"10.1016/j.resplu.2025.101201","url":null,"abstract":"","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"27 ","pages":"Article 101201"},"PeriodicalIF":2.4,"publicationDate":"2025-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145924680","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}