Resuscitation plus最新文献

英文中文

First automated detection of a cardiac arrest using a commercially available smartwatch: a case report 首次使用市售智能手表自动检测心脏骤停：病例报告

IF 2.4 Q3 CRITICAL CARE MEDICINE

Resuscitation plus

Pub Date : 2026-03-01 Epub Date: 2026-01-29 DOI: 10.1016/j.resplu.2026.101247

Wisse M.F. van den Beuken , Pieter R. Tuinman , Beat Nideröst , Sebastiaan A. Goossen , Hans van Schuppen , Stephan A. Loer , Lothar A. Schwarte , Patrick Schober

Background

Automated cardiac arrest detection aims to shorten the time between arrest onset and emergency medical services activation, thereby reducing the number of unwitnessed out-of-hospital cardiac arrests (OHCA) and shortening time to treatment in witnessed OHCA. Current arrest detection algorithms are largely developed using simulated or artificially induced cardiac arrest data. To our knowledge, this case report provides the first detailed description of the automated detection of spontaneous, non-procedural, end-of-life cardiac arrest using consumer-grade smartwatch-derived sensor data.

Case report

An 82-year-old patient presented to the emergency department with a severe intracerebral hemorrhage with poor prognosis. Following shared decision-making with the family, palliative management was initiated. The patient was continuously monitored with electrocardiography (ECG), invasive arterial blood pressure, and clinical photoplethysmography (PPG). In addition, a commercial smartwatch was placed on the wrist to collect sensor data during the palliative phase and up to 20 min after confirmed cardiac arrest. The smartwatch PPG data were retrospectively analyzed using a previously described diagnostic algorithm. This preliminary algorithm detects circulatory arrest using the photoplethysmography sensor signals acquired from a commercial smartwatch. The algorithm accurately identified the moment of cardiac arrest in concordance with the clinical reference signals. Informed consent was obtained for this research from a legal representative.

Conclusion

Although this controlled end-of-life setting does not represent the circumstances of an OHCA, this case demonstrates the feasibility of detecting true cardiac arrest using a commercial available smartwatch. Prospective studies in real-world OHCA populations are needed to assess clinical performance and practical applicability.

心脏骤停自动检测旨在缩短心脏骤停发生和紧急医疗服务启动之间的时间，从而减少院外心脏骤停（OHCA）的数量，缩短院外心脏骤停的治疗时间。目前的心脏骤停检测算法主要是利用模拟或人工诱发的心脏骤停数据开发的。据我们所知，本病例报告首次详细描述了使用消费级智能手表传感器数据自动检测自发、非程序性、生命末期心脏骤停。病例报告：一名82岁高龄患者因严重脑出血而就诊于急诊科，预后不良。在与家人共同决策后，开始了姑息治疗。连续监测患者心电图（ECG）、有创动脉血压和临床光容积脉搏波（PPG）。此外，在姑息期和确认心脏骤停后20分钟内，在手腕上放置一块商用智能手表，以收集传感器数据。使用先前描述的诊断算法回顾性分析智能手表的PPG数据。该初步算法使用从商用智能手表获取的光电容积脉搏波传感器信号检测循环骤停。该算法根据临床参考信号准确识别心脏骤停瞬间。本研究获得了法定代表人的知情同意。尽管这种受控的临终环境并不代表OHCA的情况，但该案例证明了使用商用智能手表检测真正的心脏骤停的可行性。需要在现实世界的OHCA人群中进行前瞻性研究，以评估临床表现和实际适用性。

{"title":"First automated detection of a cardiac arrest using a commercially available smartwatch: a case report","authors":"Wisse M.F. van den Beuken , Pieter R. Tuinman , Beat Nideröst , Sebastiaan A. Goossen , Hans van Schuppen , Stephan A. Loer , Lothar A. Schwarte , Patrick Schober","doi":"10.1016/j.resplu.2026.101247","DOIUrl":"10.1016/j.resplu.2026.101247","url":null,"abstract":"<div><h3>Background</h3><div>Automated cardiac arrest detection aims to shorten the time between arrest onset and emergency medical services activation, thereby reducing the number of unwitnessed out-of-hospital cardiac arrests (OHCA) and shortening time to treatment in witnessed OHCA. Current arrest detection algorithms are largely developed using simulated or artificially induced cardiac arrest data. To our knowledge, this case report provides the first detailed description of the automated detection of spontaneous, non-procedural, end-of-life cardiac arrest using consumer-grade smartwatch-derived sensor data.</div></div><div><h3>Case report</h3><div>An 82-year-old patient presented to the emergency department with a severe intracerebral hemorrhage with poor prognosis. Following shared decision-making with the family, palliative management was initiated. The patient was continuously monitored with electrocardiography (ECG), invasive arterial blood pressure, and clinical photoplethysmography (PPG). In addition, a commercial smartwatch was placed on the wrist to collect sensor data during the palliative phase and up to 20 min after confirmed cardiac arrest. The smartwatch PPG data were retrospectively analyzed using a previously described diagnostic algorithm. This preliminary algorithm detects circulatory arrest using the photoplethysmography sensor signals acquired from a commercial smartwatch. The algorithm accurately identified the moment of cardiac arrest in concordance with the clinical reference signals. Informed consent was obtained for this research from a legal representative.</div></div><div><h3>Conclusion</h3><div>Although this controlled end-of-life setting does not represent the circumstances of an OHCA, this case demonstrates the feasibility of detecting true cardiac arrest using a commercial available smartwatch. Prospective studies in real-world OHCA populations are needed to assess clinical performance and practical applicability.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"28 ","pages":"Article 101247"},"PeriodicalIF":2.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146190132","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}

引用次数: 0

Wolf Creek XVIII Part 8: Wolf Creek Innovator in Cardiac Arrest and Resuscitation Science Award Wolf Creek XVIII Part 8: Wolf Creek心脏骤停和复苏科学奖的创新者

IF 2.4 Q3 CRITICAL CARE MEDICINE

Resuscitation plus

Pub Date : 2026-03-01 Epub Date: 2026-01-21 DOI: 10.1016/j.resplu.2026.101230

Alexis Steinberg , Filippo Annoni , Kei Hayashida , Jacob Hutton , Matthew P. Kirschen , Ryan W. Morgan

The Wolf Creek Conference is an integral event showcasing innovative resuscitation research from academia and industry. The Wolf Creek XVIII took place in Ann Arbor, Michigan, on June 18–21, 2025 and it was hosted by the Max Harry Weil Institute of Critical Care Research and Innovation. For the second time, Wolf Creek XVIII hosted the Wolf Creek Innovator in Cardiac Arrest and Resuscitation Science Award, which recognizes early-career investigators who are challenging current paradigms in resuscitation science. Among a field of applicants, a panel of international experts chose the finalists for the competition. Finalists included Filippo Annoni from Erasme Hospital, Kei Hayashida from Northwell Health, Jacob Hutton from University of British Columbia, Matthew Kirschen from Children’s Hospital of Philadelphia, and Alexis Steinberg from University of Pittsburgh. The finalists each presented a summary of their research, followed by questions from the panel and audience. As determined by electronic audience vote, Dr. Alexis Steinberg was designated as the recipient of the 2025 Wolf Creek Innovator Award and a $10,000 cash prize. The manuscript aims to outline each of the early career innovator award finalists’ work in further detail.

沃尔夫克里克会议是一个完整的活动，展示了学术界和工业界的创新复苏研究。Wolf Creek XVIII于2025年6月18日至21日在密歇根州安娜堡举行，由马克斯·哈里·威尔重症监护研究与创新研究所主办。第二次，Wolf Creek XVIII主办了Wolf Creek心脏骤停和复苏科学奖的创新者，该奖项旨在表彰那些挑战当前复苏科学范式的早期职业研究者。在众多申请者中，一个国际专家小组选出了决赛选手。决赛选手包括来自Erasme医院的Filippo Annoni、来自Northwell Health的Kei Hayashida、来自英属哥伦比亚大学的Jacob Hutton、来自费城儿童医院的Matthew Kirschen和来自匹兹堡大学的Alexis Steinberg。每位入围者都简要介绍了他们的研究，然后回答了小组和观众的问题。通过电子观众投票决定，亚历克西斯·斯坦伯格博士被指定为2025年狼溪创新奖的获得者，并获得10,000美元的现金奖励。该手稿旨在进一步详细概述每个早期职业创新者奖决赛入围者的工作。

{"title":"Wolf Creek XVIII Part 8: Wolf Creek Innovator in Cardiac Arrest and Resuscitation Science Award","authors":"Alexis Steinberg , Filippo Annoni , Kei Hayashida , Jacob Hutton , Matthew P. Kirschen , Ryan W. Morgan","doi":"10.1016/j.resplu.2026.101230","DOIUrl":"10.1016/j.resplu.2026.101230","url":null,"abstract":"<div><div>The Wolf Creek Conference is an integral event showcasing innovative resuscitation research from academia and industry. The Wolf Creek XVIII took place in Ann Arbor, Michigan, on June 18–21, 2025 and it was hosted by the Max Harry Weil Institute of Critical Care Research and Innovation. For the second time, Wolf Creek XVIII hosted the Wolf Creek Innovator in Cardiac Arrest and Resuscitation Science Award, which recognizes early-career investigators who are challenging current paradigms in resuscitation science. Among a field of applicants, a panel of international experts chose the finalists for the competition. Finalists included Filippo Annoni from Erasme Hospital, Kei Hayashida from Northwell Health, Jacob Hutton from University of British Columbia, Matthew Kirschen from Children’s Hospital of Philadelphia, and Alexis Steinberg from University of Pittsburgh. The finalists each presented a summary of their research, followed by questions from the panel and audience. As determined by electronic audience vote, Dr. Alexis Steinberg was designated as the recipient of the 2025 Wolf Creek Innovator Award and a $10,000 cash prize. The manuscript aims to outline each of the early career innovator award finalists’ work in further detail.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"28 ","pages":"Article 101230"},"PeriodicalIF":2.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146190134","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}

引用次数: 0

Emergency department cardiac arrest in Thailand: a two-regional medical center comparative cohort study of characteristics, resuscitation processes, and outcomes 泰国急诊科心脏骤停：两个区域医疗中心的特征、复苏过程和结果的比较队列研究

IF 2.4 Q3 CRITICAL CARE MEDICINE

Resuscitation plus

Pub Date : 2026-03-01 Epub Date: 2026-01-14 DOI: 10.1016/j.resplu.2026.101227

Thanat Tangpaisarn , Wachira Wongtanasarasin , Monthira Wangnongseaw , Chiratchaya Chinvanichai , Disatorn Dejvajara , Nattaphan Siritikul , Yonlada Yodsao , Marturod Buranasakda , Pariwat Phungoen

Background

Emergency department cardiac arrest is increasingly recognized as a distinct entity, but little is known about its epidemiology in Asia. We compared patient characteristics, arrest etiologies, resuscitation processes, and outcomes between two tertiary university hospitals in Thailand.

Methods

We conducted a retrospective cohort study of adults (≥18 years) with emergency department cardiac arrest at Chiang Mai University Hospital (January 2020–December 2024) and Khon Kaen University Hospital (November 2021–December 2024). Cases were identified using institutional electronic cardiac arrest registries. Data included demographics, comorbidities, presumed etiology (5H/5T framework), initial rhythm, resuscitation processes, and outcomes. Primary outcomes were return of spontaneous circulation, survival to hospital admission, and survival to discharge.

Results

A total of 261 cases were analyzed (192 from Chiang Mai University Hospital and 69 from Khon Kaen University Hospital). The median age was 65 years (interquartile range 53–75), and 56.7% were male. Most arrests were non-traumatic (72.8%), and pulseless electrical activity predominated (76.6%). Hypoxia (43.3%), acidosis (33.7%), and hypovolemia (31.0%) were the leading presumed causes. Institutional variation was observed in comorbidity profiles, presumed etiologies, ventilation strategies, and resuscitation durations. Median cardiopulmonary resuscitation duration was longer at Khon Kaen University Hospital (9 vs. 6 min). No statistically significant differences in survival outcomes were detected between hospitals.

Conclusion

Emergency department cardiac arrest in Thailand mirrors global patterns, with a predominance of non-shockable rhythms and low discharge survival rates. Observed institutional variation in patient characteristics and resuscitation processes highlights the need for standardized protocols, training, and the development of national emergency department cardiac arrest registries to support quality improvement in low- and middle-income country settings.

急诊科心脏骤停越来越被认为是一个独特的实体，但对其在亚洲的流行病学知之甚少。我们比较了泰国两所三级大学医院的患者特征、骤停病因、复苏过程和结果。方法对清迈大学医院（2020年1月- 2024年12月）和孔敬大学医院（2021年11月- 2024年12月）急诊科心脏骤停的成人（≥18岁）进行回顾性队列研究。使用机构电子心脏骤停登记处确定病例。数据包括人口统计学、合并症、推定病因（5H/5T框架）、初始节律、复苏过程和结果。主要结局为自然循环恢复、住院生存和出院生存。结果共分析病例261例，其中清迈大学医院192例，孔敬大学医院69例。中位年龄为65岁（四分位数范围为53-75），56.7%为男性。大多数逮捕是非创伤性的（72.8%），无脉电活动占主导地位（76.6%）。缺氧（43.3%）、酸中毒（33.7%）和低血容量（31.0%）是主要的推定原因。在合并症概况、推测的病因、通气策略和复苏持续时间方面观察到制度差异。孔敬大学医院的中位心肺复苏时间更长（9分钟vs. 6分钟）。两家医院的生存结果没有统计学上的显著差异。结论泰国急诊科心脏骤停反映了全球规律，以非震荡性心律为主，出院生存率较低。观察到的患者特征和复苏过程的制度差异突出表明，需要制定标准化的方案、培训和建立国家急诊科心脏骤停登记处，以支持中低收入国家环境下的质量改进。

{"title":"Emergency department cardiac arrest in Thailand: a two-regional medical center comparative cohort study of characteristics, resuscitation processes, and outcomes","authors":"Thanat Tangpaisarn , Wachira Wongtanasarasin , Monthira Wangnongseaw , Chiratchaya Chinvanichai , Disatorn Dejvajara , Nattaphan Siritikul , Yonlada Yodsao , Marturod Buranasakda , Pariwat Phungoen","doi":"10.1016/j.resplu.2026.101227","DOIUrl":"10.1016/j.resplu.2026.101227","url":null,"abstract":"<div><h3>Background</h3><div>Emergency department cardiac arrest is increasingly recognized as a distinct entity, but little is known about its epidemiology in Asia. We compared patient characteristics, arrest etiologies, resuscitation processes, and outcomes between two tertiary university hospitals in Thailand.</div></div><div><h3>Methods</h3><div>We conducted a retrospective cohort study of adults (≥18 years) with emergency department cardiac arrest at Chiang Mai University Hospital (January 2020–December 2024) and Khon Kaen University Hospital (November 2021–December 2024). Cases were identified using institutional electronic cardiac arrest registries. Data included demographics, comorbidities, presumed etiology (5H/5T framework), initial rhythm, resuscitation processes, and outcomes. Primary outcomes were return of spontaneous circulation, survival to hospital admission, and survival to discharge.</div></div><div><h3>Results</h3><div>A total of 261 cases were analyzed (192 from Chiang Mai University Hospital and 69 from Khon Kaen University Hospital). The median age was 65 years (interquartile range 53–75), and 56.7% were male. Most arrests were non-traumatic (72.8%), and pulseless electrical activity predominated (76.6%). Hypoxia (43.3%), acidosis (33.7%), and hypovolemia (31.0%) were the leading presumed causes. Institutional variation was observed in comorbidity profiles, presumed etiologies, ventilation strategies, and resuscitation durations. Median cardiopulmonary resuscitation duration was longer at Khon Kaen University Hospital (9 vs. 6 min). No statistically significant differences in survival outcomes were detected between hospitals.</div></div><div><h3>Conclusion</h3><div>Emergency department cardiac arrest in Thailand mirrors global patterns, with a predominance of non-shockable rhythms and low discharge survival rates. Observed institutional variation in patient characteristics and resuscitation processes highlights the need for standardized protocols, training, and the development of national emergency department cardiac arrest registries to support quality improvement in low- and middle-income country settings.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"28 ","pages":"Article 101227"},"PeriodicalIF":2.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146039300","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}

引用次数: 0

Comparison of different airway pressures in (synchronized) ventilation during cardiopulmonary resuscitation in pigs 猪心肺复苏期间同步通气不同气道压力的比较

IF 2.4 Q3 CRITICAL CARE MEDICINE

Resuscitation plus

Pub Date : 2026-03-01 Epub Date: 2026-01-29 DOI: 10.1016/j.resplu.2026.101248

Miriam Renz , Lea Müller , Jan Köhler , Roman Paul , Katja Mohnke , Andrea Urmann , Johanna Hain , René Rissel , Alexander Ziebart , Robert Ruemmler

Background

The optimal ventilation strategy during cardiopulmonary resuscitation (CPR) remains undetermined. Synchronizing ventilation to chest compressions has been proposed to enhance end-organ perfusion and oxygenation. This study evaluates the pulmonary function and injury in a synchronized ventilation (SV) strategy using lower peak pressure compared to chest compression synchronized ventilation (CCSV) with higher peak pressures and intermittent positive pressure ventilation (IPPV).

Materials/methods

35 pigs underwent cardiac arrest, followed by basic and advanced life support with mechanical chest compressions and ventilation according to randomized groups: IPPV (peak pressure (P_peak) 40 mbar), SV (P_peak 20 mbar), and CCSV (P_peak 40 mbar). Arterial blood gases, ventilation-perfusion (V/Q) ratios, and hemodynamics were assessed during CPR and after return of spontaneous circulation (ROSC). Pulmonary histopathology and inflammatory markers (IL-6, TNF-α) were analyzed post-mortem.

Results

During CPR, CCSV demonstrated superior oxygenation compared to SV (p_aO₂: CCSV 190.61 mmHg, SV 96.02 mmHg; p = 0.006), while CCSV and IPPV utilized significant higher airway pressures. SV showed the highest mean arterial pressure. Lactate levels were non-significantly highest in CCSV during CPR. ROSC rates were lower in CCSV (4/10) than in IPPV and SV (both 9/10); all non-ROSC CCSV cases exhibited pneumothoraces. Post-CPR, increased low V/Q and shunt fractions were observed in CCSV and SV exhibited reduced IL-6 expression.

Conclusions

SV resulted in lower oxygenation but utilized lower airway pressures compared with CCSV and IPPV, produced less lactate, and achieved ROSC rates comparable to IPPV with fewer complications compared to CCSV. These findings suggest that SV may represent a viable alternative ventilation strategy during CPR. Further studies are needed to confirm these results.

背景：心肺复苏（CPR）过程中的最佳通气策略仍未确定。同步通气与胸外按压已被提出，以加强终末器官灌注和氧合。本研究评估了同步通气（SV）策略中使用较低峰压的肺功能和损伤，与胸压同步通气（CCSV）相比，采用较高峰压和间歇正压通气（IPPV）。材料/方法35头猪进行心脏骤停，随后进行基本和高级生命支持，机械胸外按压和通气，随机分组：IPPV（峰值压力（峰值）40 mbar）， SV（峰值20 mbar）和CCSV（峰值40 mbar）。在心肺复苏术期间和自然循环恢复（ROSC）后评估动脉血气、通气灌注（V/Q）比和血流动力学。死后分析肺组织病理学和炎症标志物（IL-6、TNF-α）。结果在心肺复苏术中，CCSV比SV表现出更好的氧合（paO2: CCSV 190.61 mmHg, SV 96.02 mmHg; p = 0.006），而CCSV和IPPV使用了更高的气道压力。SV组平均动脉压最高。CPR期间CCSV的乳酸水平无显著性最高。CCSV的ROSC率（4/10）低于IPPV和SV（均为9/10）；所有非rosc CCSV病例均出现气胸。心肺复苏术后，CCSV低V/Q和分流分数增加，SV IL-6表达降低。结论与CCSV和IPPV相比，ssv使氧合降低，气道压力降低，产生的乳酸减少，ROSC率与IPPV相当，并发症与CCSV相比较少。这些发现表明，SV可能是心肺复苏术中可行的替代通气策略。需要进一步的研究来证实这些结果。

{"title":"Comparison of different airway pressures in (synchronized) ventilation during cardiopulmonary resuscitation in pigs","authors":"Miriam Renz , Lea Müller , Jan Köhler , Roman Paul , Katja Mohnke , Andrea Urmann , Johanna Hain , René Rissel , Alexander Ziebart , Robert Ruemmler","doi":"10.1016/j.resplu.2026.101248","DOIUrl":"10.1016/j.resplu.2026.101248","url":null,"abstract":"<div><h3>Background</h3><div>The optimal ventilation strategy during cardiopulmonary resuscitation (CPR) remains undetermined. Synchronizing ventilation to chest compressions has been proposed to enhance end-organ perfusion and oxygenation. This study evaluates the pulmonary function and injury in a synchronized ventilation (SV) strategy using lower peak pressure compared to chest compression synchronized ventilation (CCSV) with higher peak pressures and intermittent positive pressure ventilation (IPPV).</div></div><div><h3>Materials/methods</h3><div>35 pigs underwent cardiac arrest, followed by basic and advanced life support with mechanical chest compressions and ventilation according to randomized groups: IPPV (peak pressure (<em>P</em><sub>peak</sub>) 40 mbar), SV (<em>P</em><sub>peak</sub> 20 mbar), and CCSV (<em>P</em><sub>peak</sub> 40 mbar). Arterial blood gases, ventilation-perfusion (V/Q) ratios, and hemodynamics were assessed during CPR and after return of spontaneous circulation (ROSC). Pulmonary histopathology and inflammatory markers (IL-6, TNF-α) were analyzed post-mortem.</div></div><div><h3>Results</h3><div>During CPR, CCSV demonstrated superior oxygenation compared to SV (p<sub>a</sub>O<sub>2</sub>: CCSV 190.61 mmHg, SV 96.02 mmHg; <em>p</em> = 0.006), while CCSV and IPPV utilized significant higher airway pressures. SV showed the highest mean arterial pressure. Lactate levels were non-significantly highest in CCSV during CPR. ROSC rates were lower in CCSV (4/10) than in IPPV and SV (both 9/10); all non-ROSC CCSV cases exhibited pneumothoraces. Post-CPR, increased low V/Q and shunt fractions were observed in CCSV and SV exhibited reduced IL-6 expression.</div></div><div><h3>Conclusions</h3><div>SV resulted in lower oxygenation but utilized lower airway pressures compared with CCSV and IPPV, produced less lactate, and achieved ROSC rates comparable to IPPV with fewer complications compared to CCSV. These findings suggest that SV may represent a viable alternative ventilation strategy during CPR. Further studies are needed to confirm these results.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"28 ","pages":"Article 101248"},"PeriodicalIF":2.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146190450","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}

引用次数: 0

Evaluation of systemic and cerebral hemodynamics after systematic and early extracorporeal cardiopulmonary resuscitation in swine 猪系统和早期体外心肺复苏后全身和脑血流动力学的评价

IF 2.4 Q3 CRITICAL CARE MEDICINE

Resuscitation plus

Pub Date : 2026-03-01 Epub Date: 2026-01-18 DOI: 10.1016/j.resplu.2026.101233

Julian San Geroteo , Ali Jendoubi , Fanny Lidouren , Naoto Watanabe , Yara Abi Zeid Daou , Alice Hutin , Lionel Lamhaut , Nadir Mouri , Bijan Ghaleh , Pierre-Louis Léger , Jerome Rambaud , Rebecca Goutchtat , Matthias Kohlhauer , Renaud Tissier

Background

Extracorporeal cardiopulmonary resuscitation (ECPR) is thought to be efficient when performed promptly after cardiac arrest. However, its neurological benefit remains questionable if applied very early and systematically. Accordingly, we sought to compare systemic and cerebral hemodynamics when ECPR was implemented systematically compared to conventional cardiopulmonary resuscitation (CCPR) with epinephrine.

Material and methods

Following 5 min of untreated ventricular fibrillation, pigs were randomly submitted to CCPR with epinephrine or crystalloid-primed ECPR after either a 10- or 30-min low-flow (4 groups: CCPR 10′, ECPR 10′, CCPR 30′ and ECPR 30′. Defibrillations were then delivered until the return of spontaneous circulation (ROSC). Swine were followed 240 min from cardiopulmonary onset.

Results

Six pigs were included in each group. Survival rate was higher in CCPR 10′ group vs ECPR 10′ (6/6 vs 2/6; p = 0.02) but not significantly different between CCPR 30′ and ECPR 30′ groups (2/6 vs 0/6; p = 0.53). In ECPR 10′ and 30′ groups, ECPR was associated with lower cerebral perfusion pressure, lower jugular venous oxygen saturation and higher-pressure reactivity index after ROSC, as compared to CCPR 10′ and 30′. A decrease in mean arterial pressure, along with an increase in norepinephrine dose and blood lactate level were also found in ECPR 10′ and 30′ groups after ROSC, as compared to CCPR 10′ and 30′.

Conclusions

The early and systemic implementation of ECPR after either a 10- or 30-min low-flow was associated with impaired cerebral and systemic hemodynamics after ROSC, as compared to CCPR with epinephrine.

背景：体外心肺复苏（ECPR）被认为在心脏骤停后及时进行是有效的。然而，如果早期和系统地应用，其神经学益处仍然值得怀疑。因此，我们试图比较系统实施ECPR与常规肾上腺素心肺复苏（CCPR）时的全身和脑血流动力学。材料和方法未经心室颤动治疗5 min后，在低流量10 min或30 min后随机给猪进行肾上腺素或晶体引物ECPR（4组：CCPR 10′、ECPR 10′、CCPR 30′和ECPR 30′）。然后进行除颤直到恢复自然循环（ROSC）。猪在心肺发作后240分钟进行随访。结果每组6头猪。CCPR 10 ‘组的生存率高于ECPR 10 ’组（6/6 vs 2/6, p = 0.02），但CCPR 30 ‘组与ECPR 30 ’组的生存率无显著差异（2/6 vs 0/6, p = 0.53）。与CCPR 10′和30′组相比，ECPR 10′和30′组ROSC后脑灌注压降低、颈静脉血氧饱和度降低、压力反应性指数升高。与CCPR 10′和30′相比，ROSC后ECPR 10′和30′组平均动脉压降低，去甲肾上腺素剂量和血乳酸水平升高。结论与使用肾上腺素的CCPR相比，在10分钟或30分钟低流量后早期和系统实施ECPR与ROSC后脑和全身血流动力学受损相关。

{"title":"Evaluation of systemic and cerebral hemodynamics after systematic and early extracorporeal cardiopulmonary resuscitation in swine","authors":"Julian San Geroteo , Ali Jendoubi , Fanny Lidouren , Naoto Watanabe , Yara Abi Zeid Daou , Alice Hutin , Lionel Lamhaut , Nadir Mouri , Bijan Ghaleh , Pierre-Louis Léger , Jerome Rambaud , Rebecca Goutchtat , Matthias Kohlhauer , Renaud Tissier","doi":"10.1016/j.resplu.2026.101233","DOIUrl":"10.1016/j.resplu.2026.101233","url":null,"abstract":"<div><h3>Background</h3><div>Extracorporeal cardiopulmonary resuscitation (ECPR) is thought to be efficient when performed promptly after cardiac arrest. However, its neurological benefit remains questionable if applied very early and systematically. Accordingly, we sought to compare systemic and cerebral hemodynamics when ECPR was implemented systematically compared to conventional cardiopulmonary resuscitation (CCPR) with epinephrine.</div></div><div><h3>Material and methods</h3><div>Following 5 min of untreated ventricular fibrillation, pigs were randomly submitted to CCPR with epinephrine or crystalloid-primed ECPR after either a 10- or 30-min low-flow (4 groups: CCPR 10′, ECPR 10′, CCPR 30′ and ECPR 30′. Defibrillations were then delivered until the return of spontaneous circulation (ROSC). Swine were followed 240 min from cardiopulmonary onset.</div></div><div><h3>Results</h3><div>Six pigs were included in each group. Survival rate was higher in CCPR 10′ group vs ECPR 10′ (6/6 vs 2/6; <em>p</em> = 0.02) but not significantly different between CCPR 30′ and ECPR 30′ groups (2/6 vs 0/6; <em>p</em> = 0.53). In ECPR 10′ and 30′ groups, ECPR was associated with lower cerebral perfusion pressure, lower jugular venous oxygen saturation and higher-pressure reactivity index after ROSC, as compared to CCPR 10′ and 30′. A decrease in mean arterial pressure, along with an increase in norepinephrine dose and blood lactate level were also found in ECPR 10′ and 30′ groups after ROSC, as compared to CCPR 10′ and 30′.</div></div><div><h3>Conclusions</h3><div>The early and systemic implementation of ECPR after either a 10- or 30-min low-flow was associated with impaired cerebral and systemic hemodynamics after ROSC, as compared to CCPR with epinephrine.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"28 ","pages":"Article 101233"},"PeriodicalIF":2.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146080277","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}

引用次数: 0

Survival with one versus three centimeters of active decompression during automated head-up CPR in a porcine cardiac arrest model 在猪心脏骤停模型的自动抬头心肺复苏术中，1厘米与3厘米主动减压的存活率

IF 2.4 Q3 CRITICAL CARE MEDICINE

Resuscitation plus

Pub Date : 2026-03-01 Epub Date: 2026-01-19 DOI: 10.1016/j.resplu.2026.101231

Pouria Pourzand , Anja Metzger , Johanna Moore , Bayert Salverda , Hamza Hai , Mithun Suresh , Sarah Bubier , Kerry Bachista , Nicolas Segond , Guillaume Debaty , Keith Lurie

Background

Automated head-up (AHUP) CPR, combining controlled head/thorax elevation, active compression-decompression CPR, and an impedance threshold device, has shown improved survival with favorable neurological outcomes versus conventional (C) CPR. The optimal amount of active lift (AD) during AHUP-CPR to optimize survival remains unknown. This study focused primarily on 24-h survival with 1-cm of active lift (AL-1 cm) with a rectilinear waveform versus 3-cm of active lift (AL-3 cm) with a trapezoidal waveform during AHUP-CPR.

Methods

Anesthetized pigs (n = 24, ∼40 kg) were randomized to AL-1 cm or AL-3 cm after 10 min of ventricular fibrillation. CPR began with 2 min of C-CPR (21% AP depth, sinusoidal waveform, 100/min), followed by 18 min of AHUP-CPR using the assigned AL. Asynchronous ventilation (10 ml/kg, 10/min) was provided. Epinephrine and amiodarone were administered after 19 min of CPR with defibrillation 1 min later. Primary outcome: 24-h survival; Secondary outcomes: return of spontaneous circulation (ROSC), hemodynamics, epinephrine response, and neurological function (Neurological Deficit Score [NDS], 0 = normal, 320 = death). Statistical analyses included t-test, Kaplan-Meier, log-rank, and Mann-Whitney U tests.

Results

ROSC occurred in 6/12 pigs with AL-1 cm vs 12/12 with AL-3 cm (p = 0.03), and 24-h survival rates were 16.7% vs 41.7%, respectively (p = 0.04). Hemodynamics, ETCO2, epinephrine response, and changes in rSO2 values were significantly higher with AL-3 cm. NDS was 286 ± 79 (AL-1 cm) vs 213 ± 130 (AL-3 cm, p = 0.09).

Conclusion

24-h survival rates were significantly higher with AL-3 cm vs AL-1 cm during AHUP-CPR. Together with improved hemodynamics observed with AL-3 cm, these outcomes underscore the critical importance of AL-3 cm to optimize AHUP-CPR.

与传统的(C) CPR相比，自动平视（AHUP） CPR结合了控制头部/胸部抬高、主动加压减压CPR和阻抗阈值装置，显示出良好的神经系统预后，提高了生存率。在AHUP-CPR过程中，优化生存的最佳主动举升量（AD）仍然未知。本研究主要关注在AHUP-CPR期间，1 cm主动抬升（AL-1 cm）呈直线波形与3 cm主动抬升（AL-3 cm）呈梯形波形的24小时生存率。方法在心室颤动10 min后，将24头、40 kg的麻醉猪随机分为AL-1 cm和AL-3 cm两组。CPR开始时为2分钟的C-CPR (21% AP深度，正弦波形，100/min)，随后使用指定的人工呼吸器进行18分钟的AHUP-CPR。提供异步通气（10 ml/kg, 10/min）。心肺复苏术19分钟后给予肾上腺素和胺碘酮，1分钟后除颤。主要结局：24小时生存期；次要结局：自发循环恢复（ROSC）、血流动力学、肾上腺素反应和神经功能（神经功能缺损评分[NDS]， 0 =正常，320 =死亡）。统计分析包括t检验、Kaplan-Meier检验、log-rank检验和Mann-Whitney U检验。结果AL-1 cm组6/12头猪发生rosc， AL-3 cm组12/12头猪发生rosc (p = 0.03)， 24 h存活率分别为16.7%和41.7% （p = 0.04）。血流动力学、ETCO2、肾上腺素反应和rSO2值的变化在AL-3 cm时显著升高。NDS是286±79 (AL-1厘米)vs 213±130 (AL-3厘米,p = 0.09)。结论在AHUP-CPR中，AL-3 cm比AL-1 cm的24h生存率明显高于AL-1 cm。再加上AL-3 cm观察到的血流动力学改善，这些结果强调了AL-3 cm对优化AHUP-CPR的关键重要性。

{"title":"Survival with one versus three centimeters of active decompression during automated head-up CPR in a porcine cardiac arrest model","authors":"Pouria Pourzand , Anja Metzger , Johanna Moore , Bayert Salverda , Hamza Hai , Mithun Suresh , Sarah Bubier , Kerry Bachista , Nicolas Segond , Guillaume Debaty , Keith Lurie","doi":"10.1016/j.resplu.2026.101231","DOIUrl":"10.1016/j.resplu.2026.101231","url":null,"abstract":"<div><h3>Background</h3><div>Automated head-up (AHUP) CPR, combining controlled head/thorax elevation, active compression-decompression CPR, and an impedance threshold device, has shown improved survival with favorable neurological outcomes versus conventional (C) CPR. The optimal amount of active lift (AD) during AHUP-CPR to optimize survival remains unknown. This study focused primarily on 24-h survival with 1-cm of active lift (AL-1 cm) with a rectilinear waveform versus 3-cm of active lift (AL-3 cm) with a trapezoidal waveform during AHUP-CPR.</div></div><div><h3>Methods</h3><div>Anesthetized pigs (<em>n</em> = 24, ∼40 kg) were randomized to AL-1 cm or AL-3 cm after 10 min of ventricular fibrillation. CPR began with 2 min of C-CPR (21% AP depth, sinusoidal waveform, 100/min), followed by 18 min of AHUP-CPR using the assigned AL. Asynchronous ventilation (10 ml/kg, 10/min) was provided. Epinephrine and amiodarone were administered after 19 min of CPR with defibrillation 1 min later. Primary outcome: 24-h survival; Secondary outcomes: return of spontaneous circulation (ROSC), hemodynamics, epinephrine response, and neurological function (Neurological Deficit Score [NDS], 0 = normal, 320 = death). Statistical analyses included <em>t</em>-test, Kaplan-Meier, log-rank, and Mann-Whitney U tests.</div></div><div><h3>Results</h3><div>ROSC occurred in 6/12 pigs with AL-1 cm vs 12/12 with AL-3 cm (<em>p</em> = 0.03), and 24-h survival rates were 16.7% vs 41.7%, respectively (<em>p</em> = 0.04). Hemodynamics, ETCO2, epinephrine response, and changes in rSO2 values were significantly higher with AL-3 cm. NDS was 286 ± 79 (AL-1 cm) vs 213 ± 130 (AL-3 cm, <em>p</em> = 0.09).</div></div><div><h3>Conclusion</h3><div>24-h survival rates were significantly higher with AL-3 cm vs AL-1 cm during AHUP-CPR. Together with improved hemodynamics observed with AL-3 cm, these outcomes underscore the critical importance of AL-3 cm to optimize AHUP-CPR.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"28 ","pages":"Article 101231"},"PeriodicalIF":2.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146080278","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}

引用次数: 0

Impact of resuscitation-trained healthcare workforce availability on neonatal asphyxia mortality: a population-based study 接受过复苏培训的医护人员对新生儿窒息死亡率的影响：一项基于人群的研究。

IF 2.4 Q3 CRITICAL CARE MEDICINE

Resuscitation plus

Pub Date : 2026-03-01 Epub Date: 2026-02-10 DOI: 10.1016/j.resplu.2026.101260

Mandira D. Kawakami , Adriana Sanudo , Ana Sílvia S. Marinonio , Kelsy N. Areco , Rita de Cássia X. Balda , Milton H. Miyoshi , Daniela T. Costa-Nobre , Tulio Konstantyner , Carina N. Vieira e Oliveira , Paulo Bandiera-Paiva , Rosa M.V. Freitas , Mônica L.P. Teixeira , Bernadette Waldvogel , Carlos Roberto V. Kiffer , Maria Fernanda de Almeida , Ruth Guinsburg

Background

Intrapartum events cause approximately 900,000 neonatal deaths annually worldwide. This study investigated whether the number of healthcare providers trained in resuscitation at the municipal level is associated with decreased neonatal mortality due to perinatal asphyxia.

Methods

This population-based study analyzed neonatal deaths with birth weight ≥1500 g without congenital anomalies in São Paulo State, Brazil (2011–2020). Deaths were classified as asphyxia-associated when ICD-10 codes indicating intrauterine hypoxia, birth asphyxia, or neonatal meconium aspiration appeared on any line of death certificates. Temporal trends of neonatal mortality rate associated with perinatal asphyxia (Asphyxia-NMR) and density of Brazilian Neonatal Resuscitation Program (NRP) trained professionals per thousand live births across the 645 municipalities of the State were analyzed using Prais-Winsten regression. A multilevel mixed-effects logistic regression included three hierarchical levels (newborns, municipalities, regional health districts), adjusting for maternal age, prenatal visits, delivery mode, newborn sex, NRP-trained professional density, Gross Domestic Product (log-transformed), and year of birth.

Results

Among 6,044,527 live births, 2527 neonatal deaths met inclusion criteria. Asphyxia-NMR declined from 0.43‰ (2011) to 0.31‰ (2020), an annual reduction of 3.84% (95% CI: 0.46–7.10%). The density of NRP-trained professionals rose from 1.67‰ to 35.78‰, an annual increase of 39.97% (95%CI: 24.50–57.35%). Having ≥7 trained professionals per thousand live births decreased the odds of asphyxia-associated neonatal deaths (OR 0.88; 95%CI: 0.80–0.97).

Conclusion

Greater availability of healthcare professionals trained in neonatal resuscitation was independently associated with lower neonatal mortality associated with asphyxia, after adjustment for biological, economic, and regional factors.

背景：产时事件每年导致全世界约90万新生儿死亡。本研究调查了市级接受复苏培训的医疗保健提供者的数量是否与围产期窒息导致的新生儿死亡率降低有关。方法：这项基于人群的研究分析了巴西圣保罗州（2011-2020）出生体重≥1500 g无先天性异常的新生儿死亡情况。当ICD-10代码显示宫内缺氧、出生窒息或新生儿胎粪误吸出现在死亡证明的任何一行时，死亡被归类为窒息相关。使用Prais-Winsten回归分析了全国645个城市中与围产期窒息（窒息- nmr）相关的新生儿死亡率的时间趋势以及巴西新生儿复苏计划（NRP）培训过的专业人员密度。多层混合效应逻辑回归包括三个层次（新生儿、城市、区域卫生区），调整了产妇年龄、产前检查、分娩方式、新生儿性别、npp培训的专业人员密度、国内生产总值（对数转换）和出生年份。结果：在6044527例活产中，2527例新生儿死亡符合纳入标准。窒息- nmr从0.43‰（2011年）下降到0.31‰（2020年），每年下降3.84% （95% CI: 0.46-7.10%）。nrp培养的专业人才密度从1.67‰上升到35.78‰，年均增长39.97% （95%CI: 24.50 ~ 57.35%）。每千名活产婴儿中有≥7名训练有素的专业人员可降低窒息相关新生儿死亡的几率（OR 0.88; 95%CI: 0.80-0.97）。结论：在调整了生物、经济和地区因素后，接受过新生儿复苏培训的医护人员越多，与与窒息相关的新生儿死亡率越低独立相关。

{"title":"Impact of resuscitation-trained healthcare workforce availability on neonatal asphyxia mortality: a population-based study","authors":"Mandira D. Kawakami , Adriana Sanudo , Ana Sílvia S. Marinonio , Kelsy N. Areco , Rita de Cássia X. Balda , Milton H. Miyoshi , Daniela T. Costa-Nobre , Tulio Konstantyner , Carina N. Vieira e Oliveira , Paulo Bandiera-Paiva , Rosa M.V. Freitas , Mônica L.P. Teixeira , Bernadette Waldvogel , Carlos Roberto V. Kiffer , Maria Fernanda de Almeida , Ruth Guinsburg","doi":"10.1016/j.resplu.2026.101260","DOIUrl":"10.1016/j.resplu.2026.101260","url":null,"abstract":"<div><h3>Background</h3><div>Intrapartum events cause approximately 900,000 neonatal deaths annually worldwide. This study investigated whether the number of healthcare providers trained in resuscitation at the municipal level is associated with decreased neonatal mortality due to perinatal asphyxia.</div></div><div><h3>Methods</h3><div>This population-based study analyzed neonatal deaths with birth weight ≥1500 g without congenital anomalies in São Paulo State, Brazil (2011–2020). Deaths were classified as asphyxia-associated when ICD-10 codes indicating intrauterine hypoxia, birth asphyxia, or neonatal meconium aspiration appeared on any line of death certificates. Temporal trends of neonatal mortality rate associated with perinatal asphyxia (Asphyxia-NMR) and density of Brazilian Neonatal Resuscitation Program (NRP) trained professionals per thousand live births across the 645 municipalities of the State were analyzed using Prais-Winsten regression. A multilevel mixed-effects logistic regression included three hierarchical levels (newborns, municipalities, regional health districts), adjusting for maternal age, prenatal visits, delivery mode, newborn sex, NRP-trained professional density, Gross Domestic Product (log-transformed), and year of birth.</div></div><div><h3>Results</h3><div>Among 6,044,527 live births, 2527 neonatal deaths met inclusion criteria. Asphyxia-NMR declined from 0.43‰ (2011) to 0.31‰ (2020), an annual reduction of 3.84% (95% CI: 0.46–7.10%). The density of NRP-trained professionals rose from 1.67‰ to 35.78‰, an annual increase of 39.97% (95%CI: 24.50–57.35%). Having ≥7 trained professionals per thousand live births decreased the odds of asphyxia-associated neonatal deaths (OR 0.88; 95%CI: 0.80–0.97).</div></div><div><h3>Conclusion</h3><div>Greater availability of healthcare professionals trained in neonatal resuscitation was independently associated with lower neonatal mortality associated with asphyxia, after adjustment for biological, economic, and regional factors.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"28 ","pages":"Article 101260"},"PeriodicalIF":2.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147313851","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}

引用次数: 0

Differences in bystander CPR by patient, caller, and telecommunicator sex: a retrospective analysis of emergency calls 病人、呼叫者和电传者性别对旁观者CPR的差异：对紧急呼叫的回顾性分析

IF 2.4 Q3 CRITICAL CARE MEDICINE

Resuscitation plus

Pub Date : 2026-03-01 Epub Date: 2026-02-18 DOI: 10.1016/j.resplu.2026.101277

Lauren Hart , Anjni P. Joiner , Monique A. Starks , Heather A. King , Lee Van Vleet , Fahad J. Siddiqui , Charlotte Patterson , Angel Gonzalez , Pedro Gomez Altamirano , Truls Østbye , Janet P. Bettger , Audrey L. Blewer

引用次数: 0

Defining thoracic impedance thresholds for rescue ventilation: a laboratory study 确定抢救通气的胸阻抗阈值：一项实验室研究

IF 2.4 Q3 CRITICAL CARE MEDICINE

Resuscitation plus

Pub Date : 2026-03-01 Epub Date: 2026-03-02 DOI: 10.1016/j.resplu.2026.101284

Philip Jarrett , Rithika Prakash , Bhaskar Thakur, Jordan Thomas, Dazhe Cao, Mary Chang, Betty Yang, Sarah Shaver, Ahamed Idris

Aim

To establish evidence-based peak amplitude thresholds for thoracic bioimpedance monitoring of ventilation and characterize the relationship between peak amplitude and tidal volume across two defibrillator devices used in pre-hospital care during cardiopulmonary resuscitation.

Methods

Thirty healthy adults underwent mechanical ventilation while thoracic bioimpedance was monitored using LifePak12 and HeartStart MRx defibrillators at five tidal volumes (250–800 mL). Peak amplitude measurements were extracted from thoracic bioimpedance waveforms. Linear mixed-effects models accounted for repeated measurements. Sex-stratified analyses examined device-specific sensitivity differences. Breath detection thresholds were calculated at various target sensitivities.

Results

Linear relationships were observed for both devices. The LifePak 12 device showed tidal volume slopes of 0.0022 Ω/mL for females and 0.0013 Ω/mL for males. The HeartStart MRx device demonstrated slopes of 0.0030 Ω/mL for females and 0.0016 Ω/mL for males. Males showed 41–47% lower sensitivity to tidal volume changes than females across both devices. Model performance showed intraclass-correlations of 0.713–0.783 with prediction correlations exceeding 0.97. For the 250 mL breath, peak amplitude thresholds were 0.630/0.40 Ω (female/male) for LifePak12 and 0.45/0.30 Ω for HeartStart MRx at 90% detection sensitivity.

Conclusion

This study provides preliminary sex- and device-specific peak amplitude thresholds for breath identification using thoracic bioimpedance waveforms. The observed linear relationships and provided thresholds may improve categorical breath detection in resuscitation research. These findings require validation in cardiac arrest patients to ensure generalizability for clinical application.

目的建立胸腔通气生物阻抗监测的循证峰值阈值，并表征院前心肺复苏中使用的两种除颤器的峰值振幅与潮气量之间的关系。方法30例健康成人接受机械通气，同时使用LifePak12和HeartStart MRx除颤器监测5个潮气量（250 ~ 800 mL）的胸部生物阻抗。峰值幅度测量是从胸部生物阻抗波形中提取的。线性混合效应模型解释了重复测量。性别分层分析检查了器械特异性敏感性差异。根据不同的目标灵敏度计算呼吸检测阈值。结果两种仪器均呈线性关系。LifePak 12装置显示女性潮汐体积斜率为0.0022 Ω/mL，男性为0.0013 Ω/mL。HeartStart MRx设备显示女性的斜率为0.0030 Ω/mL，男性为0.0016 Ω/mL。在两种设备上，男性对潮汐量变化的敏感性比女性低41-47%。模型性能的类内相关性为0.713-0.783，预测相关性超过0.97。对于250 mL呼吸，LifePak12的峰值振幅阈值为0.63 /0.40 Ω（女性/男性），HeartStart MRx的峰值振幅阈值为0.45/0.30 Ω，检测灵敏度为90%。结论：本研究为胸腔生物阻抗波形呼吸识别提供了初步的性别和设备特异性峰值阈值。观察到的线性关系和提供的阈值可以改善复苏研究中的分类呼吸检测。这些发现需要在心脏骤停患者中验证，以确保临床应用的普遍性。

{"title":"Defining thoracic impedance thresholds for rescue ventilation: a laboratory study","authors":"Philip Jarrett , Rithika Prakash , Bhaskar Thakur, Jordan Thomas, Dazhe Cao, Mary Chang, Betty Yang, Sarah Shaver, Ahamed Idris","doi":"10.1016/j.resplu.2026.101284","DOIUrl":"10.1016/j.resplu.2026.101284","url":null,"abstract":"<div><h3>Aim</h3><div>To establish evidence-based peak amplitude thresholds for thoracic bioimpedance monitoring of ventilation and characterize the relationship between peak amplitude and tidal volume across two defibrillator devices used in pre-hospital care during cardiopulmonary resuscitation.</div></div><div><h3>Methods</h3><div>Thirty healthy adults underwent mechanical ventilation while thoracic bioimpedance was monitored using LifePak12 and HeartStart MRx defibrillators at five tidal volumes (250–800 mL). Peak amplitude measurements were extracted from thoracic bioimpedance waveforms. Linear mixed-effects models accounted for repeated measurements. Sex-stratified analyses examined device-specific sensitivity differences. Breath detection thresholds were calculated at various target sensitivities.</div></div><div><h3>Results</h3><div>Linear relationships were observed for both devices. The LifePak 12 device showed tidal volume slopes of 0.0022 Ω/mL for females and 0.0013 Ω/mL for males. The HeartStart MRx device demonstrated slopes of 0.0030 Ω/mL for females and 0.0016 Ω/mL for males. Males showed 41–47% lower sensitivity to tidal volume changes than females across both devices. Model performance showed intraclass-correlations of 0.713–0.783 with prediction correlations exceeding 0.97. For the 250 mL breath, peak amplitude thresholds were 0.630/0.40 Ω (female/male) for LifePak12 and 0.45/0.30 Ω for HeartStart MRx at 90% detection sensitivity.</div></div><div><h3>Conclusion</h3><div>This study provides preliminary sex- and device-specific peak amplitude thresholds for breath identification using thoracic bioimpedance waveforms. The observed linear relationships and provided thresholds may improve categorical breath detection in resuscitation research. These findings require validation in cardiac arrest patients to ensure generalizability for clinical application.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"28 ","pages":"Article 101284"},"PeriodicalIF":2.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147448678","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}

引用次数: 0

Current based defibrillation: an old concept revisited 基于电流的除颤：一个旧概念的重新审视

IF 2.4 Q3 CRITICAL CARE MEDICINE

Resuscitation plus

Pub Date : 2026-03-01 Epub Date: 2026-02-10 DOI: 10.1016/j.resplu.2026.101263

Rudolph W. Koster

引用次数: 0

首页上一页