Pub Date : 2025-12-05DOI: 10.1016/j.resplu.2025.101186
Sanna-Maria Pohjanpaju , Sirkku Heino , Sampsa Suvela , Antti Eranti , Stepani Bendel , Timo Nyyssönen , Sanna Uskela , Anu Taskinen , Sakari Syväoja , Marko Hoikka , Matti Reinikainen , Tuomas T. Rissanen
Introduction
Extracorporeal cardiopulmonary resuscitation (ECPR) using veno-arterial extracorporeal membrane oxygenation (VA-ECMO) is a treatment option for refractory cardiac arrest patients, but it has mostly been restricted to hospitals with on-site cardiothoracic surgery support. We report the implementation of the ECPR protocol in a rural hospital without on-site cardiothoracic surgery.
Methods
The ECPR protocol was initiated in June 2020 in North Karelia Central Hospital in Eastern Finland, in collaboration with the tertiary center, Kuopio University Hospital, where patients were transferred for further treatment. After successful initiation of the ECPR protocol, the emergency ECMO treatment was extended to patients with refractory cardiogenic shock or respiratory failure. We retrospectively analyzed patient outcomes.
Results
Between June 2020 and June 2024, 15 patients suffering from refractory cardiac arrest were treated with ECPR. The median age of the patients was 56 years [interquartile range (IQR) 46–63]. Ten (67 %) patients were treated because of out-of-hospital cardiac arrest and five (33 %) patients because of in-hospital cardiac arrest. The median time from cardiac arrest to VA-ECMO was 58 (IQR 37–65) min. At six months, three (20 %) ECPR patients were alive with a favorable neurological outcome. In addition, one patient with cardiogenic shock was treated successfully with VA-ECMO and one respiratory failure patient with VV-ECMO.
Conclusion
The ECPR protocol involving the initiation of emergency VA-ECMO in a hospital without on-site cardiac surgery and transfer to a tertiary center for further treatment is feasible and led to the survival of 20 % of the ECPR-treated patients and 25 % of all VA-ECMO-treated patients.
{"title":"Implementation of emergency extracorporeal membrane oxygenation in a hospital without on-site cardiothoracic surgery support","authors":"Sanna-Maria Pohjanpaju , Sirkku Heino , Sampsa Suvela , Antti Eranti , Stepani Bendel , Timo Nyyssönen , Sanna Uskela , Anu Taskinen , Sakari Syväoja , Marko Hoikka , Matti Reinikainen , Tuomas T. Rissanen","doi":"10.1016/j.resplu.2025.101186","DOIUrl":"10.1016/j.resplu.2025.101186","url":null,"abstract":"<div><h3>Introduction</h3><div>Extracorporeal cardiopulmonary resuscitation (ECPR) using veno-arterial extracorporeal membrane oxygenation (VA-ECMO) is a treatment option for refractory cardiac arrest patients, but it has mostly been restricted to hospitals with on-site cardiothoracic surgery support. We report the implementation of the ECPR protocol in a rural hospital without on-site cardiothoracic surgery.</div></div><div><h3>Methods</h3><div>The ECPR protocol was initiated in June 2020 in North Karelia Central Hospital in Eastern Finland, in collaboration with the tertiary center, Kuopio University Hospital, where patients were transferred for further treatment. After successful initiation of the ECPR protocol, the emergency ECMO treatment was extended to patients with refractory cardiogenic shock or respiratory failure. We retrospectively analyzed patient outcomes.</div></div><div><h3>Results</h3><div>Between June 2020 and June 2024, 15 patients suffering from refractory cardiac arrest were treated with ECPR. The median age of the patients was 56 years [interquartile range (IQR) 46–63]. Ten (67 %) patients were treated because of out-of-hospital cardiac arrest and five (33 %) patients because of in-hospital cardiac arrest. The median time from cardiac arrest to VA-ECMO was 58 (IQR 37–65) min. At six months, three (20 %) ECPR patients were alive with a favorable neurological outcome. In addition, one patient with cardiogenic shock was treated successfully with VA-ECMO and one respiratory failure patient with VV-ECMO.</div></div><div><h3>Conclusion</h3><div>The ECPR protocol involving the initiation of emergency VA-ECMO in a hospital without on-site cardiac surgery and transfer to a tertiary center for further treatment is feasible and led to the survival of 20 % of the ECPR-treated patients and 25 % of all VA-ECMO-treated patients.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"27 ","pages":"Article 101186"},"PeriodicalIF":2.4,"publicationDate":"2025-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145790608","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}
Pub Date : 2025-12-05DOI: 10.1016/j.resplu.2025.101187
Emilia Kortesuo , Joonas Tirkkonen , Matti Reinikainen , Pirkka T. Pekkarinen , Eeva Moilanen , Liisa Petäjä , Markus B Skrifvars , Johanna Hästbacka
Background and aim
Out-of-hospital cardiac arrest (OHCA) leads to an inflammatory response, including alterations in matrix metalloproteinase (MMP)-9 and tissue inhibitor of matrix metalloproteinase (TIMP)-1 concentrations. We investigated whether the MMP-9 and TIMP-1 plasma concentrations of OHCA patients are elevated and associated with outcome among OHCA patients.
Methods
This was a substudy of the prospective COMACARE trial (NCT02698917). We included 112 OHCA patients and measured MMP-9 and TIMP-1 concentrations at ICU admission, 24, 48 and at 72 h. Preoperative blood samples from 40 age- and sex-matched elective cardiac surgery patients were used as controls. We defined favourable outcome as a Cerebral Performance Category (CPC) 1–2 at six months.
Results
The median (interquartile range) MMP-9 concentrations at admission for OHCA patients and for controls were 369 (228–619) ng/mL and 66 (41–114) ng/mL, respectively, p < 0.001. The TIMP-1 concentrations for OHCA patients at admission and for controls were 137 (104–163) ng/mL and 79 (71–96) ng/mL, respectively, p < 0.001. The MMP-9 levels peaked at admission; 448 (241–700) ng/mL in patients with CPC ≥ 3 as compared with 340 (224–563) ng/mL in patients with CPC 1–2 (p = 0.103). TIMP-1 concentrations peaked at 48 h; 223 (174–323) ng/mL in patients with CPC ≥ 3 as compared with 201 (148–273) ng/mL in patients with CPC 1–2 (p = 0.104). In a logistic regression model, neither biomarker demonstrated association with outcome.
Conclusion
OHCA patients had higher plasma concentrations of MMP-9 and TIMP-1 than elective surgery patients. However, the concentrations showed no association with outcome.
{"title":"Association of MMP-9 and TIMP-1 concentration with neurological outcome after cardiac arrest and resuscitation – a substudy of the COMACARE trial","authors":"Emilia Kortesuo , Joonas Tirkkonen , Matti Reinikainen , Pirkka T. Pekkarinen , Eeva Moilanen , Liisa Petäjä , Markus B Skrifvars , Johanna Hästbacka","doi":"10.1016/j.resplu.2025.101187","DOIUrl":"10.1016/j.resplu.2025.101187","url":null,"abstract":"<div><h3>Background and aim</h3><div>Out-of-hospital cardiac arrest (OHCA) leads to an inflammatory response, including alterations in matrix metalloproteinase (MMP)-9 and tissue inhibitor of matrix metalloproteinase (TIMP)-1 concentrations. We investigated whether the MMP-9 and TIMP-1 plasma concentrations of OHCA patients are elevated and associated with outcome among OHCA patients.</div></div><div><h3>Methods</h3><div>This was a substudy of the prospective COMACARE trial (NCT02698917). We included 112 OHCA patients and measured MMP-9 and TIMP-1 concentrations at ICU admission, 24, 48 and at 72 h. Preoperative blood samples from 40 age- and sex-matched elective cardiac surgery patients were used as controls. We defined favourable outcome as a Cerebral Performance Category (CPC) 1–2 at six months.</div></div><div><h3>Results</h3><div>The median (interquartile range) MMP-9 concentrations at admission for OHCA patients and for controls were 369 (228–619) ng/mL and 66 (41–114) ng/mL, respectively, <em>p</em> < 0.001. The TIMP-1 concentrations for OHCA patients at admission and for controls were 137 (104–163) ng/mL and 79 (71–96) ng/mL, respectively, <em>p</em> < 0.001. The MMP-9 levels peaked at admission; 448 (241–700) ng/mL in patients with CPC ≥ 3 as compared with 340 (224–563) ng/mL in patients with CPC 1–2 (<em>p</em> = 0.103). TIMP-1 concentrations peaked at 48 h; 223 (174–323) ng/mL in patients with CPC ≥ 3 as compared with 201 (148–273) ng/mL in patients with CPC 1–2 (<em>p</em> = 0.104). In a logistic regression model, neither biomarker demonstrated association with outcome.</div></div><div><h3>Conclusion</h3><div>OHCA patients had higher plasma concentrations of MMP-9 and TIMP-1 than elective surgery patients. However, the concentrations showed no association with outcome.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"27 ","pages":"Article 101187"},"PeriodicalIF":2.4,"publicationDate":"2025-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145790607","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}
Pub Date : 2025-12-04DOI: 10.1016/j.resplu.2025.101184
Erin Stewart , Timothy T Tran , Kenji Tanabe , Amanda Hunt , Gregory Watson , Alexander Kaizer , Col Vikhyat Bebarta , Patrick C Ng , Ana Fernandez-Bustamante
Objective
Bedside point-of-care ultrasound (POCUS) is effective to assess patients with cardiopulmonary instability, but experienced personnel is unavailable in secluded locations. We tested whether remote guidance support and a focused POCUS education would allow the acquisition of sufficient diagnostic quality and interpretation of selected cardiopulmonary POCUS views by untrained personnel.
Methods
We recruited 22 volunteer adults with little to no POCUS experience. We asked participants to obtain six POCUS heart, lung and abdominal views on healthy volunteers: at baseline; with remote guidance; and independently after a 2-h POCUS training session. Expert sonographers scored the diagnostic image quality (0, 0.5, or 1). Last, participants interpreted 24 previously recorded POCUS images: 2 normal and 22 abnormal (cardiogenic shock, tamponade, intra-abdominal bleeding, pneumonia, pleural effusion).
Results
The image quality of all six POCUS views at baseline was inadequate for clinical use in >80 % of participants. Image quality of all views improved with remote guidance in >70 % of participants and 2-h training in >50 % of participants. Quality scores improved from baseline with remote guidance in all views, and with training in four views. Lung views had the highest quality improvement. Participants correctly identified as abnormal 72.8 % of images, but only 52.8 % of normal ones. Pneumonia was the condition most correctly identified after training.
Conclusions
Remote guidance, better than focused training, allowed novice sonographers to obtain selected POCUS views of sufficient diagnostic quality. Abnormal POCUS images were identified more reliably than normal ones. Education was most effective for acquiring lung POCUS views and pneumonia detection.
{"title":"Remote guidance and focused point-of-care ultrasound (POCUS) training for cardiopulmonary instability assessment by novice sonographers","authors":"Erin Stewart , Timothy T Tran , Kenji Tanabe , Amanda Hunt , Gregory Watson , Alexander Kaizer , Col Vikhyat Bebarta , Patrick C Ng , Ana Fernandez-Bustamante","doi":"10.1016/j.resplu.2025.101184","DOIUrl":"10.1016/j.resplu.2025.101184","url":null,"abstract":"<div><h3>Objective</h3><div>Bedside point-of-care ultrasound (POCUS) is effective to assess patients with cardiopulmonary instability, but experienced personnel is unavailable in secluded locations. We tested whether remote guidance support and a focused POCUS education would allow the acquisition of sufficient diagnostic quality and interpretation of selected cardiopulmonary POCUS views by untrained personnel.</div></div><div><h3>Methods</h3><div>We recruited 22 volunteer adults with little to no POCUS experience. We asked participants to obtain six POCUS heart, lung and abdominal views on healthy volunteers: at baseline; with remote guidance; and independently after a 2-h POCUS training session. Expert sonographers scored the diagnostic image quality (0, 0.5, or 1). Last, participants interpreted 24 previously recorded POCUS images: 2 normal and 22 abnormal (cardiogenic shock, tamponade, intra-abdominal bleeding, pneumonia, pleural effusion).</div></div><div><h3>Results</h3><div>The image quality of all six POCUS views at baseline was inadequate for clinical use in >80 % of participants. Image quality of all views improved with remote guidance in >70 % of participants and 2-h training in >50 % of participants. Quality scores improved from baseline with remote guidance in all views, and with training in four views. Lung views had the highest quality improvement. Participants correctly identified as abnormal 72.8 % of images, but only 52.8 % of normal ones. Pneumonia was the condition most correctly identified after training.</div></div><div><h3>Conclusions</h3><div>Remote guidance, better than focused training, allowed novice sonographers to obtain selected POCUS views of sufficient diagnostic quality. Abnormal POCUS images were identified more reliably than normal ones. Education was most effective for acquiring lung POCUS views and pneumonia detection.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"27 ","pages":"Article 101184"},"PeriodicalIF":2.4,"publicationDate":"2025-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145790606","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}
Pub Date : 2025-12-01DOI: 10.1016/j.resplu.2025.101183
Joan A. Sirigiri , Kaitland M. Byrd , Sofia Perez , Florian Schmitzberger , Thomas S. Valley , William Meurer , Elizabeth M. Viglianti
Background
Out-of-hospital cardiac arrests have high mortality and morbidity. Prognosticating neurological recovery for post-arrest patients is a significant challenge. Time-limited trials may be an appropriate strategy to implement in situations of prognostic uncertainty for patients. We sought to understand how clinicians considered time limited trials in the context of out-of-hospital cardiac arrests.
Methods
Between 2021 and 2024, clinicians engaged in the Influence of Cooling duration on Efficacy in Cardiac Arrest Patients trial were invited to participate in an embedded qualitative study. Semi-structured interviews were conducted where clinicians were provided the definition of time limited trials and asked to reflect on their awareness and application of them for out-of-hospital cardiac arrest patients. We used inductive and deductive thematic content analysis.
Results
Within the sample of 20 clinicians from 11 hospitals, 14 were physicians, 13 were from academic medical centers, and 12 were men. Clinicians in this study reported an awareness of time-limited trials aligning with established definitions. They were considered appropriate when there was clinical uncertainty and to achieve goal concordant care. Perceived barriers were resource scarcity and the ethical challenge of balancing the ability to continue life sustaining therapies with unclear benefits. They were considered useful in situations of provider-decision maker misalignment, which is a novel finding in our study.
Conclusions
Time limited trials in out-of-hospital cardiac arrests can align medical therapies with patients’ wishes and help address the ethical dilemmas clinicians encounter when caring for patients. Further research should explore standardizing the use of time-limited trials in clinical practice.
{"title":"Clinician perspectives on utilizing time-limited trials among patients with an out-of-hospital cardiac arrest: A qualitative study","authors":"Joan A. Sirigiri , Kaitland M. Byrd , Sofia Perez , Florian Schmitzberger , Thomas S. Valley , William Meurer , Elizabeth M. Viglianti","doi":"10.1016/j.resplu.2025.101183","DOIUrl":"10.1016/j.resplu.2025.101183","url":null,"abstract":"<div><h3>Background</h3><div>Out-of-hospital cardiac arrests have high mortality and morbidity. Prognosticating neurological recovery for post-arrest patients is a significant challenge. Time-limited trials may be an appropriate strategy to implement in situations of prognostic uncertainty for patients. We sought to understand how clinicians considered time limited trials in the context of out-of-hospital cardiac arrests.</div></div><div><h3>Methods</h3><div>Between 2021 and 2024, clinicians engaged in the Influence of Cooling duration on Efficacy in Cardiac Arrest Patients trial were invited to participate in an embedded qualitative study. Semi-structured interviews were conducted where clinicians were provided the definition of time limited trials and asked to reflect on their awareness and application of them for out-of-hospital cardiac arrest patients. We used inductive and deductive thematic content analysis.</div></div><div><h3>Results</h3><div>Within the sample of 20 clinicians from 11 hospitals, 14 were physicians, 13 were from academic medical centers, and 12 were men. Clinicians in this study reported an awareness of time-limited trials aligning with established definitions. They were considered appropriate when there was clinical uncertainty and to achieve goal concordant care. Perceived barriers were resource scarcity and the ethical challenge of balancing the ability to continue life sustaining therapies with unclear benefits. They were considered useful in situations of provider-decision maker misalignment, which is a novel finding in our study.</div></div><div><h3>Conclusions</h3><div>Time limited trials in out-of-hospital cardiac arrests can align medical therapies with patients’ wishes and help address the ethical dilemmas clinicians encounter when caring for patients. Further research should explore standardizing the use of time-limited trials in clinical practice.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"27 ","pages":"Article 101183"},"PeriodicalIF":2.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145737550","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}
Pub Date : 2025-11-25DOI: 10.1016/j.resplu.2025.101179
Pin Pin Pek , Kexin Fang , Shir Lynn Lim , Felix Maverick Rubillar Uy , Vui Kian Ho , Yew Woon Chia , Jia Min Chua , Ee Ling Goh , Le Xuan Liew , Christina Chen , Nan Luo , Kai Yi Lee , Han Nee Gan , Benjamin Sieu-Hon Leong , Desmond Ren-Hao Mao , Nausheen Edwin Doctor , Wei Ming Ng , Ying Zi Oh , Kah Hua Peck , Michael Yih-Chong Chia , Andrew Fuwah Ho
Background
Survivors and co-survivors of out-of-hospital cardiac arrest (OHCA) experience disruptions in returning to normality. There is limited understanding of OHCA-related sequelae and their impact on co-survivors. This study describes the 3-month post-discharge health outcomes among OHCA survivors and co-survivors in the Quality Cardiac Arrest Survivorship cohort study (QualiCAS).
Methods
We conducted a prospective, population-based cohort study, enrolling subjects from 1 February 2023 to 30 November 2024. Physical, psychological, cognitive, and social health, health-related quality of life (HRQoL), and caregiver burden were described separately for survivors and co-survivors. HRQoL of survivors and co-survivors was compared against age-, sex-, and ethnicity-adjusted Singapore population norm for EQ-5D-5L.
Results
62 survivors and 36 co-survivors completed 3-month assessments. 9.7 %, 6.5 %, 3.6 % of survivors screened positive for anxiety, depression, and post-traumatic stress disorder (PTSD), respectively. Survivors experienced mild cognitive impairment (43.1 %), impaired mobility (41.1 %), and weak muscle strength (39.7 %). Functional independence was high, and 73.9 % of survivors returned to employment. Survivors’ HRQoL was lower compared to the general population (0.90 vs. 0.96). Co-survivors reported experiencing caregiving burden (41.7 %), with 22.2 %, 11.1 % and 6.1 % screening positive for anxiety, depression, and PTSD, respectively. Co-survivors’ HRQoL was comparable to the general population (0.94 vs. 0.94).
Conclusion
A significant subset of OHCA survivors experienced limitations in physical and cognitive functioning and return to work, and lower HRQoL. Psychological distress and caregiving burden were high among co-survivors. Our findings underscore the importance of systematic assessments of multi-dimensional aspects of health and referral to multi-component rehabilitation for both survivors and co-survivors.
院外心脏骤停（OHCA）的幸存者和共同幸存者在恢复正常过程中经历了中断。对ohca相关后遗症及其对共同幸存者的影响的了解有限。本研究描述了高质量心脏骤停幸存者队列研究（QualiCAS）中OHCA幸存者和共同幸存者出院后3个月的健康结果。方法：我们在2023年2月1日至2024年11月30日期间进行了一项前瞻性、基于人群的队列研究。幸存者和共同幸存者分别描述了身体、心理、认知和社会健康、健康相关生活质量（HRQoL）和照顾者负担。将幸存者和共同幸存者的HRQoL与年龄、性别和种族调整后的新加坡人口EQ-5D-5L标准进行比较。结果62例幸存者和36例共同幸存者完成了3个月的评估。9.7%、6.5%和3.6%的幸存者分别在焦虑、抑郁和创伤后应激障碍（PTSD）筛查中呈阳性。幸存者经历轻度认知障碍（43.1%），活动能力受损（41.1%）和肌肉力量弱（39.7%）。功能独立性高，73.9%的幸存者重返工作岗位。与一般人群相比，幸存者的HRQoL较低（0.90比0.96）。共同幸存者报告了照顾负担（41.7%），分别有22.2%，11.1%和6.1%的焦虑，抑郁和创伤后应激障碍筛查呈阳性。共同幸存者的HRQoL与一般人群相当（0.94 vs 0.94）。结论相当一部分OHCA幸存者在身体和认知功能以及重返工作岗位方面存在局限性，HRQoL较低。共同幸存者的心理压力和照顾负担较高。我们的研究结果强调了对幸存者和共同幸存者的健康多维方面进行系统评估和转介到多成分康复的重要性。
{"title":"Physical, psychological, cognitive, social health outcomes, and health-related quality of life in out-of-hospital cardiac arrest survivors and co-survivors: 3-month outcomes from the Quality Cardiac Arrest Survivorship cohort study (QualiCAS)","authors":"Pin Pin Pek , Kexin Fang , Shir Lynn Lim , Felix Maverick Rubillar Uy , Vui Kian Ho , Yew Woon Chia , Jia Min Chua , Ee Ling Goh , Le Xuan Liew , Christina Chen , Nan Luo , Kai Yi Lee , Han Nee Gan , Benjamin Sieu-Hon Leong , Desmond Ren-Hao Mao , Nausheen Edwin Doctor , Wei Ming Ng , Ying Zi Oh , Kah Hua Peck , Michael Yih-Chong Chia , Andrew Fuwah Ho","doi":"10.1016/j.resplu.2025.101179","DOIUrl":"10.1016/j.resplu.2025.101179","url":null,"abstract":"<div><h3>Background</h3><div>Survivors and co-survivors of out-of-hospital cardiac arrest (OHCA) experience disruptions in returning to normality. There is limited understanding of OHCA-related sequelae and their impact on co-survivors. This study describes the 3-month post-discharge health outcomes among OHCA survivors and co-survivors in the Quality Cardiac Arrest Survivorship cohort study (QualiCAS).</div></div><div><h3>Methods</h3><div>We conducted a prospective, population-based cohort study, enrolling subjects from 1 February 2023 to 30 November 2024. Physical, psychological, cognitive, and social health, health-related quality of life (HRQoL), and caregiver burden were described separately for survivors and co-survivors. HRQoL of survivors and co-survivors was compared against age-, sex-, and ethnicity-adjusted Singapore population norm for EQ-5D-5L.</div></div><div><h3>Results</h3><div>62 survivors and 36 co-survivors completed 3-month assessments. 9.7 %, 6.5 %, 3.6 % of survivors screened positive for anxiety, depression, and post-traumatic stress disorder (PTSD), respectively. Survivors experienced mild cognitive impairment (43.1 %), impaired mobility (41.1 %), and weak muscle strength (39.7 %). Functional independence was high, and 73.9 % of survivors returned to employment. Survivors’ HRQoL was lower compared to the general population (0.90 vs. 0.96). Co-survivors reported experiencing caregiving burden (41.7 %), with 22.2 %, 11.1 % and 6.1 % screening positive for anxiety, depression, and PTSD, respectively. Co-survivors’ HRQoL was comparable to the general population (0.94 vs. 0.94).</div></div><div><h3>Conclusion</h3><div>A significant subset of OHCA survivors experienced limitations in physical and cognitive functioning and return to work, and lower HRQoL. Psychological distress and caregiving burden were high among co-survivors. Our findings underscore the importance of systematic assessments of multi-dimensional aspects of health and referral to multi-component rehabilitation for both survivors and co-survivors.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"27 ","pages":"Article 101179"},"PeriodicalIF":2.4,"publicationDate":"2025-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145737549","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}
Pub Date : 2025-11-25DOI: 10.1016/j.resplu.2025.101178
Ana Belén Ocampo Cervantes , Carmen Amalia López López , Cristina Cerezo Espinosa , Robert Greif , Manuel Pardo Rios , Daniel Guillén Martínez
Objective
This study evaluated the effectiveness of a virtual reality (VR)-based cardiopulmonary resuscitation (CPR) training program compared with traditional theoretical instruction and a non-intervention control group, on improving and retaining knowledge, attitudes, and self-efficacy of secondary school students. Design
Randomized trial with three parallel groups and longitudinal follow-up at baseline (T0), immediate post-intervention (T-Immediate), one-month follow-up (T-Month), and twelve-month follow-up (T-Year). Participants: 102 secondary school students (aged 14–15 years) from the Region of Murcia, Spain were randomly assigned to three groups (n = 34 each). Intervention: Group 1: immersive VR training (interactive 360° video); Group 2: Traditional theoretical training; Group 3: control (no intervention). The primary outcome was the objective CPR knowledge. The secondary outcomes were attitude towards CPR, perceived self-efficacy, and system usability (only in the VR group), and correlations between motivational variables and knowledge.
Results
All groups showed changes after the intervention, but improvements were significantly greater in the two instructional groups. The VR group achieved the highest scores in knowledge, attitude, and self-efficacy immediately after the intervention (p < 0.001), and maintained more stable results at 1-month and 1-year follow-ups as compared to the theoretical group, whose initial gains declined over time. The control group did not show relevant changes in any of the variables. Additionally, the System Usability Scale (SUS) (0–100) of the VR system was rated positively (SUS = 75.3 ± 4.5), supporting its applicability in educational contexts.
Conclusions
Both virtual reality training and theoretical instruction were effective in improving cardiopulmonary resuscitation knowledge, attitudes, and self-efficacy among adolescents. However, virtual reality showed a greater long-term retention of effects and received high usability ratings, reinforcing its potential as an educational tool in school settings.
{"title":"Virtual reality versus theoretical training in CPR among adolescents: a randomized trial with a one-year longitudinal follow-up","authors":"Ana Belén Ocampo Cervantes , Carmen Amalia López López , Cristina Cerezo Espinosa , Robert Greif , Manuel Pardo Rios , Daniel Guillén Martínez","doi":"10.1016/j.resplu.2025.101178","DOIUrl":"10.1016/j.resplu.2025.101178","url":null,"abstract":"<div><h3>Objective</h3><div>This study evaluated the effectiveness of a virtual reality (VR)-based cardiopulmonary resuscitation (CPR) training program compared with traditional theoretical instruction and a non-intervention control group, on improving and retaining knowledge, attitudes, and self-efficacy of secondary school students. Design</div><div>Randomized trial with three parallel groups and longitudinal follow-up at baseline (T0), immediate post-intervention (T-Immediate), one-month follow-up (T-Month), and twelve-month follow-up (T-Year). Participants: 102 secondary school students (aged 14–15 years) from the Region of Murcia, Spain were randomly assigned to three groups (<em>n</em> = 34 each). Intervention: Group 1: immersive VR training (interactive 360° video); Group 2: Traditional theoretical training; Group 3: control (no intervention). The primary outcome was the objective CPR knowledge. The secondary outcomes were attitude towards CPR, perceived self-efficacy, and system usability (only in the VR group), and correlations between motivational variables and knowledge.</div></div><div><h3>Results</h3><div>All groups showed changes after the intervention, but improvements were significantly greater in the two instructional groups. The VR group achieved the highest scores in knowledge, attitude, and self-efficacy immediately after the intervention (<em>p</em> < 0.001), and maintained more stable results at 1-month and 1-year follow-ups as compared to the theoretical group, whose initial gains declined over time. The control group did not show relevant changes in any of the variables. Additionally, the System Usability Scale (SUS) (0–100) of the VR system was rated positively (SUS = 75.3 ± 4.5), supporting its applicability in educational contexts.</div></div><div><h3>Conclusions</h3><div>Both virtual reality training and theoretical instruction were effective in improving cardiopulmonary resuscitation knowledge, attitudes, and self-efficacy among adolescents. However, virtual reality showed a greater long-term retention of effects and received high usability ratings, reinforcing its potential as an educational tool in school settings.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"27 ","pages":"Article 101178"},"PeriodicalIF":2.4,"publicationDate":"2025-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145738013","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}
Pub Date : 2025-11-24DOI: 10.1016/j.resplu.2025.101176
Shuo Pang , Chu Fan , Shen Wang , Yue Wang , Xiaofan Wu
Objectives
Out-of-hospital cardiac arrest (OHCA) is a major cause of mortality in patients with ST-segment elevation myocardial infarction (STEMI). However, the clinical characteristics and prognostic outcomes of STEMI patients who experience OHCA remain poorly understood.
Methods
Using data from the CCC-ACS (Improving Care for Cardiovascular Disease in China – Acute Coronary Syndrome) project, we analyzed data from 70,901 patients with STEMI. Multivariable regression models were used to evaluate the associations between patient characteristics and the occurrence of OHCA as well as subsequent in-hospital cardiac arrest (IHCA).
Results
Among the 70,901 STEMI patients included in this national retrospective cohort study, 1.9 % experienced OHCA, of whom 35.1 % subsequently developed IHCA. Ten independent predictors of OHCA were identified, including a history of atrial fibrillation, chronic heart failure, chronic renal failure, diabetes mellitus, ischemic stroke, culprit lesions in the left main coronary artery (LMCA), left circumflex artery (LCX), or right coronary artery (RCA), and the use of antiplatelet agents or angiotensin-converting enzyme inhibitors/angiotensin II receptor blockers (ACEI/ARB). IHCA was the strongest predictor of in-hospital mortality among OHCA patients, with four factors independently associated with IHCA: advanced age, female gender, Killip class IV, and absence of standard modifiable cardiovascular risk factors (SMuRF-less). Percutaneous coronary intervention (PCI) and timely medical treatment (statins, ACEI/ARB, and mineralocorticoid receptor antagonists [MRA]) are critical for preventing IHCA.
Conclusions
OHCA is a rare but highly fatal complication in STEMI patients. A multitude of factors are associated with OHCA and subsequent IHCA, laying the groundwork for early risk stratification and optimized treatment strategies to enhance patient outcomes.
{"title":"Clinical profiling and prognosis of out-of-hospital cardiac arrest in ST-segment elevation myocardial infarction in an Asian population","authors":"Shuo Pang , Chu Fan , Shen Wang , Yue Wang , Xiaofan Wu","doi":"10.1016/j.resplu.2025.101176","DOIUrl":"10.1016/j.resplu.2025.101176","url":null,"abstract":"<div><h3>Objectives</h3><div>Out-of-hospital cardiac arrest (OHCA) is a major cause of mortality in patients with ST-segment elevation myocardial infarction (STEMI). However, the clinical characteristics and prognostic outcomes of STEMI patients who experience OHCA remain poorly understood.</div></div><div><h3>Methods</h3><div>Using data from the CCC-ACS (Improving Care for Cardiovascular Disease in China – Acute Coronary Syndrome) project, we analyzed data from 70,901 patients with STEMI. Multivariable regression models were used to evaluate the associations between patient characteristics and the occurrence of OHCA as well as subsequent in-hospital cardiac arrest (IHCA).</div></div><div><h3>Results</h3><div>Among the 70,901 STEMI patients included in this national retrospective cohort study, 1.9 % experienced OHCA, of whom 35.1 % subsequently developed IHCA. Ten independent predictors of OHCA were identified, including a history of atrial fibrillation, chronic heart failure, chronic renal failure, diabetes mellitus, ischemic stroke, culprit lesions in the left main coronary artery (LMCA), left circumflex artery (LCX), or right coronary artery (RCA), and the use of antiplatelet agents or angiotensin-converting enzyme inhibitors/angiotensin II receptor blockers (ACEI/ARB). IHCA was the strongest predictor of in-hospital mortality among OHCA patients, with four factors independently associated with IHCA: advanced age, female gender, Killip class IV, and absence of standard modifiable cardiovascular risk factors (SMuRF-less). Percutaneous coronary intervention (PCI) and timely medical treatment (statins, ACEI/ARB, and mineralocorticoid receptor antagonists [MRA]) are critical for preventing IHCA.</div></div><div><h3>Conclusions</h3><div>OHCA is a rare but highly fatal complication in STEMI patients. A multitude of factors are associated with OHCA and subsequent IHCA, laying the groundwork for early risk stratification and optimized treatment strategies to enhance patient outcomes.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"27 ","pages":"Article 101176"},"PeriodicalIF":2.4,"publicationDate":"2025-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145685176","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}
Pub Date : 2025-11-24DOI: 10.1016/j.resplu.2025.101177
Nichole Bosson , Juliana Tolles , Clayton Kazan , Stephen Sanko , Tiffany M. Abramson , Marc Eckstein , David Eisner , Joel Geiderman , Walid Ghurabi , Vadim Gudzenko , Anil Mehra , Sam Torbati , Atilla Uner , Amir Abolhoda , Marianne Gausche-Hill , David Shavelle
Background
We implemented a multi-centre extracorporeal cardiopulmonary resuscitation (eCPR) program in a regional emergency medical services (EMS) system and assessed the time-to-cannulation, survival, and neurologic outcomes for patients routed by EMS to eCPR-capable centres.
Methods
This was an observational study of patients with out-of-hospital cardiac arrest (OHCA) transported to eCPR-capable centres from July 2020 to September 2024. Patients were routed to an eCPR-capable centre if all applied: age 15–75, refractory/recurrent shockable arrest, a mechanical compression device (MCD) applied, and treatment by a participating EMS unit. Additional patients were routed on clinician judgment. Patients with traumatic arrest, do-not-resuscitate order, known terminal illness, baseline severe neurologic deficit, pregnancy, MCD contraindications, or estimated >30-min transport to an eCPR-capable centre were not routed. The outcomes were survival to hospital discharge (SHD) and neurologic status at discharge. We conducted a logistic regression with inverse-probability weighting to evaluate the association between eCPR and patient outcomes.
Results
There were 233 patients routed for eCPR. Median age was 58 years (IQR 48–65), 51 (22 %) were female. Fifty-eight (27 %) were cannulated for eCPR; median time from arrest to cannulation was 66 min (IQR 58–78). Both for all routed patients and among those cannulated, SHD was 27 % and SHD with cerebral performance category (CPC) 1 or 2 was 21 %. In the regression analysis, eCPR was not associated with improved outcomes.
Conclusion
In this regional eCPR program, survival among patients refractory to conventional therapy and treated with eCPR was 27%.
背景：我们在一个地区紧急医疗服务（EMS）系统中实施了一个多中心体外心肺复苏（eCPR）项目，并评估了由EMS送到具备eCPR能力的中心的患者的插管时间、生存率和神经系统预后。方法：这是一项观察性研究，研究对象是2020年7月至2024年9月期间被送往ecpr中心的院外心脏骤停（OHCA）患者。如果所有患者都使用了ecpr，则将其送往具有ecpr功能的中心：年龄15-75岁，难治性/复发性休克骤停，使用机械压缩装置（MCD），并由参与的EMS单位进行治疗。其他患者根据临床医生的判断进行分组。有创伤性骤停、不复苏命令、已知绝症、基线严重神经功能缺陷、妊娠、MCD禁忌症或估计需要30分钟才能到达有ecpr能力的中心的患者没有被纳入研究。结果是生存至出院（SHD）和出院时的神经状况。我们采用逆概率加权的逻辑回归来评估eCPR与患者预后之间的关系。结果233例患者行eCPR。中位年龄58岁（IQR 48 ~ 65），女性51例（22%）。58例（27%）接受eCPR插管；从心脏骤停到插管的中位时间为66 min （IQR 58-78）。在所有分组患者和插管患者中，SHD为27%，脑功能类别（CPC） 1或2的SHD为21%。在回归分析中，eCPR与预后改善无关。结论在这个区域性eCPR项目中，难以接受常规治疗和接受eCPR治疗的患者生存率为27%。
{"title":"Implementation of a regional extracorporeal membrane oxygenation program for out-of-hospital cardiac arrest: results of the prospective observational study","authors":"Nichole Bosson , Juliana Tolles , Clayton Kazan , Stephen Sanko , Tiffany M. Abramson , Marc Eckstein , David Eisner , Joel Geiderman , Walid Ghurabi , Vadim Gudzenko , Anil Mehra , Sam Torbati , Atilla Uner , Amir Abolhoda , Marianne Gausche-Hill , David Shavelle","doi":"10.1016/j.resplu.2025.101177","DOIUrl":"10.1016/j.resplu.2025.101177","url":null,"abstract":"<div><h3>Background</h3><div>We implemented a multi-centre extracorporeal cardiopulmonary resuscitation (eCPR) program in a regional emergency medical services (EMS) system and assessed the time-to-cannulation, survival, and neurologic outcomes for patients routed by EMS to eCPR-capable centres.</div></div><div><h3>Methods</h3><div>This was an observational study of patients with out-of-hospital cardiac arrest (OHCA) transported to eCPR-capable centres from July 2020 to September 2024. Patients were routed to an eCPR-capable centre if all applied: age 15–75, refractory/recurrent shockable arrest, a mechanical compression device (MCD) applied, and treatment by a participating EMS unit. Additional patients were routed on clinician judgment. Patients with traumatic arrest, do-not-resuscitate order, known terminal illness, baseline severe neurologic deficit, pregnancy, MCD contraindications, or estimated >30-min transport to an eCPR-capable centre were not routed. The outcomes were survival to hospital discharge (SHD) and neurologic status at discharge. We conducted a logistic regression with inverse-probability weighting to evaluate the association between eCPR and patient outcomes.</div></div><div><h3>Results</h3><div>There were 233 patients routed for eCPR. Median age was 58 years (IQR 48–65), 51 (22 %) were female. Fifty-eight (27 %) were cannulated for eCPR; median time from arrest to cannulation was 66 min (IQR 58–78). Both for all routed patients and among those cannulated, SHD was 27 % and SHD with cerebral performance category (CPC) 1 or 2 was 21 %. In the regression analysis, eCPR was not associated with improved outcomes.</div></div><div><h3>Conclusion</h3><div>In this regional eCPR program, survival among patients refractory to conventional therapy and treated with eCPR was 27%.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"27 ","pages":"Article 101177"},"PeriodicalIF":2.4,"publicationDate":"2025-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145685177","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}
Pub Date : 2025-11-24DOI: 10.1016/j.resplu.2025.101173
Robert W. Neumar
The Wolf Creek Conference, initiated in 1975, provides a unique forum for robust intellectual exchange between thought leaders and scientists from academia and industry focused on advancing the science and practice of cardiac arrest resuscitation. The 50th year anniversary Wolf Creek XVIII Conference was hosted by the Max Harry Weil Institute for Critical Care Research and Innovation in Ann Arbor, Michigan, USA, on June 19–21, 2025. A major focus of the conference proceedings was to identify and prioritize knowledge gaps, barriers to translation, and research priorities for six major domains in the field of resuscitation: (1) optimizing time intervals in cardiac arrest care, (2) innovations in defibrillation science, (3) innovations in extracorporeal cardiopulmonary resuscitation (ECPR) technology, (4) cardiac arrest survivorship science, (5) transforming clinical trial design in cardiac arrest research, and (6) strategies to optimize international collaboration in cardiac arrest research. In addition, industry scientists and academic investigators were given the opportunity to present and discuss cutting edge innovations. Finally, the “Wolf Creek Innovator Award” competition recognized early career investigators who were challenging current paradigms in resuscitation science. The overall goal was to fuel active discussion and debate among emerging and established experts and steer the future direction of research efforts in the field. This manuscript provides an overview of the conference, which is expanded upon in the individual manuscripts within this special edition of Resuscitation Plus. The intent of these publications is to provide a roadmap for impactful academic and commercial advances in the field of cardiac arrest resuscitation.
沃尔夫克里克会议于1975年发起，为来自学术界和工业界的思想领袖和科学家之间提供了一个独特的学术交流论坛，专注于推进心脏骤停复苏的科学和实践。2025年6月19日至21日，美国密歇根州安娜堡市马克斯·哈里·威尔危重病研究与创新研究所主办了50周年Wolf Creek XVIII会议。会议记录的一个主要焦点是确定和优先考虑复苏领域的六个主要领域的知识差距、翻译障碍和研究重点：(1)优化心脏骤停护理的时间间隔，(2)除颤科学的创新，(3)体外心肺复苏（ECPR）技术的创新，(4)心脏骤停生存科学，(5)改变心脏骤停研究的临床试验设计，(6)优化心脏骤停研究的国际合作策略。此外，行业科学家和学术研究人员有机会展示和讨论尖端创新。最后，“Wolf Creek创新奖”竞赛表彰了那些挑战当前复苏科学范式的早期职业研究者。总体目标是推动新兴和成熟专家之间的积极讨论和辩论，并指导该领域研究工作的未来方向。这份手稿提供了会议的概述，这是扩大在这个特别版的复苏加上个别手稿。这些出版物的目的是为心脏骤停复苏领域有影响力的学术和商业进展提供路线图。
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Pub Date : 2025-11-22DOI: 10.1016/j.resplu.2025.101175
Timo de Raad , Olfa Chakroun-Walha , Brenna Leslie , Robert Greif , Sabine Nabecker
Objectives
This scoping review aimed to identify Artificial Intelligence methods used in cardiopulmonary resuscitation (CPR) training.
Methods
Members of the writing group ‘Education for Resuscitation’ of the European Resuscitation Council 2025 guidelines used the PICOST format for this scoping review, which included only published randomized and non-randomized studies. Medline, Embase, Cochrane, Education Resources Information Center, Web of Science, and PubMed were searched from inception to July 2025. Title and abstract screening, full-text review, and data extraction were performed by two researchers in pairs. PRISMA reporting standards were followed. The review was registered at PROSPERO. Because the evidence was insufficient for a systematic review, we changed our initial plan and performed a scoping review.
Results
The search identified 6977 citations. After removing 2521 duplicates, reviewing titles and abstracts yielded 43 articles for full-text review. Of these, 15 studies were included in the final analysis. Our findings reveal that Artificial Intelligence is being explored across key areas of CPR training, including its accuracy in detecting CPR quality parameters, providing real-time feedback, creating personalized training experiences, detecting and analyzing dialog segments during and after simulation, generating medical teaching illustrations, its capacity for interactive simulations, and answering laypersons’ medical questions.
Conclusion
Artificial Intelligence shows potential for transforming CPR training via enhancing real-time feedback, enabling personalized learning, improving dialog analysis, facilitating content creation, and serving as an information source. The current evidence is dominated by proof-of-concept studies. Future research needs to establish the efficacy of Artificial Intelligence-supported CPR training compared to traditional methods.
目的：本综述旨在确定人工智能方法在心肺复苏（CPR）培训中的应用。方法欧洲复苏委员会2025指南“复苏教育”写作小组的成员使用PICOST格式进行范围审查，其中仅包括已发表的随机和非随机研究。Medline、Embase、Cochrane、教育资源信息中心、Web of Science和PubMed从成立到2025年7月被检索。题目和摘要筛选、全文审查和数据提取由两位研究者两两进行。遵循PRISMA报告标准。该评论已在普洛斯彼罗登记。因为证据不足以进行系统的审查，我们改变了最初的计划，并进行了范围审查。结果：检索确定了6977条引文。在删除了2521个重复项后，对标题和摘要进行了审查，产生了43篇文章进行全文审查。其中15项研究被纳入最终分析。我们的研究结果表明，人工智能正在心肺复苏培训的关键领域进行探索，包括检测心肺复苏质量参数的准确性、提供实时反馈、创建个性化培训体验、检测和分析模拟期间和之后的对话片段、生成医学教学插图、交互式模拟的能力以及回答外行人的医学问题。结论人工智能通过增强实时反馈、实现个性化学习、改进对话分析、促进内容创作和作为信息源，显示了改变心肺复苏培训的潜力。目前的证据主要是概念验证研究。未来的研究需要确定人工智能支持的心肺复苏训练与传统方法相比的有效性。
{"title":"Artificial Intelligence in cardiopulmonary resuscitation training – A scoping review","authors":"Timo de Raad , Olfa Chakroun-Walha , Brenna Leslie , Robert Greif , Sabine Nabecker","doi":"10.1016/j.resplu.2025.101175","DOIUrl":"10.1016/j.resplu.2025.101175","url":null,"abstract":"<div><h3>Objectives</h3><div>This scoping review aimed to identify Artificial Intelligence methods used in cardiopulmonary resuscitation (CPR) training.</div></div><div><h3>Methods</h3><div>Members of the writing group ‘Education for Resuscitation’ of the European Resuscitation Council 2025 guidelines used the PICOST format for this scoping review, which included only published randomized and non-randomized studies. Medline, Embase, Cochrane, Education Resources Information Center, Web of Science, and PubMed were searched from inception to July 2025. Title and abstract screening, full-text review, and data extraction were performed by two researchers in pairs. PRISMA reporting standards were followed. The review was registered at PROSPERO. Because the evidence was insufficient for a systematic review, we changed our initial plan and performed a scoping review.</div></div><div><h3>Results</h3><div>The search identified 6977 citations. After removing 2521 duplicates, reviewing titles and abstracts yielded 43 articles for full-text review. Of these, 15 studies were included in the final analysis. Our findings reveal that Artificial Intelligence is being explored across key areas of CPR training, including its accuracy in detecting CPR quality parameters, providing real-time feedback, creating personalized training experiences, detecting and analyzing dialog segments during and after simulation, generating medical teaching illustrations, its capacity for interactive simulations, and answering laypersons’ medical questions.</div></div><div><h3>Conclusion</h3><div>Artificial Intelligence shows potential for transforming CPR training via enhancing real-time feedback, enabling personalized learning, improving dialog analysis, facilitating content creation, and serving as an information source. The current evidence is dominated by proof-of-concept studies. Future research needs to establish the efficacy of Artificial Intelligence-supported CPR training compared to traditional methods.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"27 ","pages":"Article 101175"},"PeriodicalIF":2.4,"publicationDate":"2025-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145685122","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}
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