Resuscitation plus最新文献_第9页

Bag-valve-endotracheal ventilation vs mechanical ventilation during cardiopulmonary resuscitation: a randomized experimental porcine study 心肺复苏期间气囊-瓣膜-气管内通气vs机械通气：一项随机实验猪研究

IF 2.4 Q3 CRITICAL CARE MEDICINE

Resuscitation plus

Pub Date : 2026-01-01 Epub Date: 2025-12-23 DOI: 10.1016/j.resplu.2025.101192

Jingyi Wang, Ziyi Li, Hongmeng Dong, Le Hu, Junyuan Wu

Background

The impact of ventilation strategy during cardiopulmonary resuscitation (CPR) on downstream cardio-cerebral injury remains uncertain.

Methods

Animals were randomized to bag-valve–endotracheal ventilation (BVE) or mechanical ventilation (MV) in a standardized porcine CPR model. Ventilator settings were predefined and held constant. MV (Oxylog 3000 plus) was delivered in a controlled mode (Vt 6–8 mL·kg⁻¹, RR 10/min, I:E 1:2, PEEP 0 cmH₂O, P_peak limit 40 cmH₂O) with triggers disabled. BVE used a 1.6 L self-inflating bag connected to the ETT with a 40 cmH₂O pop-off valve; RR was guided at 10/min with a metronome targeting I:E 1:2 and no PEEP. Biomarkers for cardiac and cerebral injury were sampled at baseline, after 4 min ventilation during CPR (post-Vent), at ROSC, and 24 h after ROSC (ROSC-24 h). We also compared hemodynamics, respiratory mechanics, oxidative-stress markers, inflammatory cytokines, and performed qualitative histology.

Results

Compared with MV, BVE maintained lower mean airway and intrathoracic pressures (ITP), accompanied by more favorable perfusion and oxygen–metabolic profiles. BVE was associated with less severe myocardial and neuronal ultrastructural injury.

Conclusions

In this prolonged porcine CPR model, BVE with real-time monitoring reduced ITP burden, improved hemodynamic and oxygen–metabolic profiles, and decreased markers of cardiac and cerebral injury compared with a conservatively configured MV strategy, suggesting that ventilation delivery may determine organ protection; however, these findings require confirmation in larger translational and clinical studies.

背景心肺复苏（CPR）过程中通气策略对下游心脑损伤的影响尚不确定。方法采用标准化猪心肺复苏模型，将动物随机分为气囊-瓣膜-气管内通气（BVE）和机械通气（MV）两组。通风机设置是预定义的，并保持不变。MV （Oxylog 3000 plus）以受控模式（Vt 6-8 mL·kg - 1, RR 10/min, I:E 1:2, PEEP 0 cmH2O，峰值限制40 cmH2O）在关闭触发器的情况下输送。BVE使用了一个1.6 L的自动充气袋，连接到ETT上，带有一个40 cmH2O的弹出阀；RR以10/min的速度引导，节拍器瞄准I:E 1:2，无PEEP。在基线、心肺复苏术中通气4分钟后（通气后）、ROSC和ROSC后24小时（ROSC-24小时）采集心脏和脑损伤的生物标志物。我们还比较了血液动力学、呼吸力学、氧化应激标志物、炎症细胞因子，并进行了定性组织学检查。结果与MV相比，BVE维持较低的平均气道和胸内压（ITP），并伴有更有利的灌注和氧代谢谱。BVE与较轻的心肌和神经元超微结构损伤相关。结论在延长猪心肺复苏模型中，与保守配置的MV策略相比，实时监测BVE减轻了ITP负担，改善了血液动力学和氧代谢特征，降低了心脑损伤标志物，提示通气可能决定器官保护；然而，这些发现需要在更大的转化和临床研究中得到证实。

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引用次数: 0

Corrigendum to “Influence of an educational program utilizing VAK and Kolb’s learning theories on basic cardiopulmonary resuscitation knowledge and practices among private home nurses in Qatar” [Resuscitation Plus 26 (2025) 101071] “利用VAK和Kolb学习理论的教育项目对卡塔尔私人家庭护士心肺复苏基本知识和实践的影响”的更正[resuscitation Plus 26 (2025) 101071]

IF 2.4 Q3 CRITICAL CARE MEDICINE

Resuscitation plus

Pub Date : 2026-01-01 Epub Date: 2025-12-17 DOI: 10.1016/j.resplu.2025.101188

Mohamed Elsayed Saad Aboudonya , Hoda Diab Fahmy Ibrahim , Safaa R. Osman

引用次数: 0

Training the Denmark national football teams in cardiopulmonary resuscitation – Part of the UEFA and ERC ‘Get Trained, Save Lives’ campaign 对丹麦国家足球队进行心肺复苏术培训——这是欧足联和ERC“接受培训，拯救生命”活动的一部分

IF 2.4 Q3 CRITICAL CARE MEDICINE

Resuscitation plus

Pub Date : 2026-01-01 Epub Date: 2025-11-15 DOI: 10.1016/j.resplu.2025.101162

Fredrik Folke , Jakob Tingsgaard , Persia Shahriari , Victor Kjærulf

Introduction

The ‘Get Trained, Save Lives’ campaign by the Union of European Football Associations (UEFA) and the European Resuscitation Council (ERC) was launched to raise awareness about sudden cardiac arrest and the importance of learning cardiopulmonary resuscitation (CPR). All national football teams qualified for the EUROs 2024 and 2025 were offered 45 min of CPR training in the form of a ‘GO and save A Life’ (GOAL) session. This study aimed to assess whether high-quality CPR could be performed by players and staff of the Danish men’s and women’s national football teams following a GOAL session. As a part of the ‘Get Trained, Save Lives’ campaign, hopefully, this will help to inspire the public to get CPR trained.

Methods

We collected data from a two-minute CPR quality assessment following GOAL sessions in June 2024 and June 2025. All players and staff of the Denmark national football teams were invited to participate in the study, with missing data as the only exclusion criterion. Participants were provided CPR manikins that recorded CPR quality metrics on chest compressions and rescue breaths. CPR quality scores were compared between male and female players, players with different field positions, and players and staff.

Results

We included 88 participants (24 male players, 23 female players, and 41 staff members). The results showed that 60 % of participants met compression rate recommendations, 93 % met compression depth recommendations, 90 % met chest recoil recommendations, 91 % met hands-off time recommendations, and 85 % met rescue breath recommendations.

The combined CPR quality score was 90 points (range: 0–100 points). Female players achieved a slightly higher score than male players (95 vs. 84 points, p-value <0.05), while there was no significant difference in CPR quality scores between different field positions and between players and staff.

Conclusion

The study showed that high-quality CPR was performed by players and staff of the Denmark men’s and women’s national football teams following GOAL sessions. As part of the ‘Get Trained, Save Lives’ campaign, this will hopefully inspire citizens to get CPR trained.

由欧洲足球协会联盟（UEFA）和欧洲复苏委员会（ERC）发起的“接受培训，拯救生命”运动旨在提高人们对心脏骤停的认识以及学习心肺复苏（CPR）的重要性。所有获得2024年和2025年欧洲杯参赛资格的国家足球队都接受了45分钟的心肺复苏术训练，训练内容为“GO and save a Life”（GOAL）。本研究旨在评估丹麦男子和女子国家足球队的球员和工作人员在GOAL训练后是否可以进行高质量的心肺复苏术。作为“接受培训，拯救生命”运动的一部分，希望这将有助于激励公众接受心肺复苏术培训。方法：我们收集了2024年6月和2025年6月GOAL会议后2分钟CPR质量评估的数据。丹麦国家足球队的所有球员和工作人员都被邀请参加这项研究，数据缺失是唯一的排除标准。为参与者提供了记录心肺复苏术质量指标的胸部按压和人工呼吸模型。比较男女球员、不同场位球员、球员与工作人员的心肺复苏术质量得分。结果共纳入88名参与者，其中男球员24名，女球员23名，工作人员41名。结果显示，60%的参与者符合压缩率建议，93%符合压缩深度建议，90%符合胸部后坐力建议，91%符合放手时间建议，85%符合抢救呼吸建议。综合心肺复苏质量评分为90分（范围：0-100分）。女性运动员的CPR质量得分略高于男性运动员（95分比84分，p值<；0.05），而不同场地位置之间以及运动员与工作人员之间的CPR质量得分无显著差异。结论在GOAL训练结束后，丹麦男足和女足国家队队员和工作人员进行了高质量的心肺复苏术。作为“接受培训，拯救生命”活动的一部分，这有望激励市民接受心肺复苏术培训。

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引用次数: 0

Artificial Intelligence in cardiopulmonary resuscitation training – A scoping review 人工智能在心肺复苏训练中的应用综述

IF 2.4 Q3 CRITICAL CARE MEDICINE

Resuscitation plus

Pub Date : 2026-01-01 Epub Date: 2025-11-22 DOI: 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。

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引用次数: 0

Enhanced community first responder support system: protocol of a randomized trial to improve bystander cardiopulmonary resuscitation quality for out-of-hospital cardiac arrest patients 增强社区急救支持系统：提高院外心脏骤停患者的旁观者心肺复苏质量的随机试验方案

IF 2.4 Q3 CRITICAL CARE MEDICINE

Resuscitation plus

Pub Date : 2026-01-01 Epub Date: 2025-11-19 DOI: 10.1016/j.resplu.2025.101167

Alexander E. White , Sungwon Yoon , Stephanie Fook-Chong , Tonje S. Birkenes , Wei Ming Ng , Phyo Thet Naing Win , Benjamin S.H. Leong , Nurul Asyikin Jalil , Helge Myklebust , Marcus E.H. Ong , Fahad Javaid Siddiqui

Introduction

The earliest and impactful intervention for out-of-hospital cardiac arrest (OHCA) patients is cardiopulmonary resuscitation (CPR) delivered by a community first responder (CFR). However, the CFRs often fail to meet the established performance targets for compression rate and depth throughout the event, thereby defeating the purpose of instituting the CFR system. While telephone CPR has been shown to help, certain aspects cannot be improved with a voice-only guidance. Therefore, a trial has been designed to evaluate an enhanced CFR support system (eCSS) intervention that comprises (a) audio/video communication between a CFR and dispatcher, in addition to (b) relaying compression depth and rate data to the dispatcher in real time through a battery-operated Bluetooth-enabled motion sensor-mounted CPR card connected to a smart phone through an application over 5G mobile phone network. Both these features of eCSS will allow the dispatchers to better guide the CFR, ensuring high-quality CPR. The control group will have voice-only dispatcher assistance as per the current standard of care.

Objective

This protocol paper describes the rationale, methodology, and run-in period recruitment experience of the trial, where all non-pregnant adult suspected OHCA patients will be eligible for the study, on whom CFR provides CPR engaging the eCSS. CFRs will be recruited from a volunteers’ registry maintained by the Singapore Civic Defence Force, the largest publicly funded EMS agency. This trial protocol has been registered in the ClinicalTrials.gov registry [ID NCT06530433].

院外心脏骤停（OHCA）患者最早和有效的干预措施是由社区第一响应者（CFR）提供的心肺复苏（CPR）。然而，在整个事件过程中，CFR往往不能达到既定的压缩率和深度的性能目标，从而违背了建立CFR系统的目的。虽然电话CPR已被证明有帮助，但某些方面无法通过语音指导来改善。因此，设计了一项试验来评估增强型CFR支持系统（eCSS）干预措施，该措施包括(a) CFR和调度员之间的音频/视频通信，以及(b)通过5G移动电话网络应用程序连接到智能手机上，通过电池供电的蓝牙运动传感器安装的CPR卡将压缩深度和速率数据实时中继到调度员。eCSS的这两个特点将使调度员能够更好地指导CFR，确保高质量的CPR。根据目前的护理标准，对照组将只有语音调度员协助。目的：本方案文件描述了该试验的基本原理、方法和磨合期招募经验，其中所有未怀孕的成年OHCA疑似患者将符合研究条件，CFR为其提供心肺复苏术并结合eCSS。cfr将从新加坡民防部队（新加坡最大的公共医疗服务机构）维护的志愿者名册中招募。该试验方案已在ClinicalTrials.gov注册中心注册[ID NCT06530433]。

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引用次数: 0

Clinician perspectives on utilizing time-limited trials among patients with an out-of-hospital cardiac arrest: A qualitative study 在院外心脏骤停患者中利用时间限制试验的临床医生观点：一项定性研究

IF 2.4 Q3 CRITICAL CARE MEDICINE

Resuscitation plus

Pub Date : 2026-01-01 Epub Date: 2025-12-01 DOI: 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.

院外心脏骤停具有很高的死亡率和发病率。预测骤停后患者的神经恢复是一项重大挑战。在患者预后不确定的情况下，有时间限制的试验可能是一种适当的策略。我们试图了解临床医生在院外心脏骤停的情况下如何考虑时间限制试验。方法在2021年至2024年期间，邀请参与心脏骤停患者冷却时间对疗效影响试验的临床医生参与嵌入定性研究。进行了半结构化访谈，向临床医生提供了时间限制试验的定义，并要求他们反思院外心脏骤停患者对时间限制试验的认识和应用。我们采用归纳和演绎的主题内容分析方法。结果来自11家医院的20名临床医生中，内科医生14人，学术医疗中心13人，男性12人。在这项研究中，临床医生报告了与既定定义一致的时间限制试验的意识。当存在临床不确定性时，它们被认为是合适的，以实现目标的和谐护理。感知到的障碍是资源稀缺和平衡继续维持生命治疗的能力与不明确的好处的伦理挑战。它们被认为在提供者-决策者错位的情况下是有用的，这是我们研究中的一个新发现。结论院外心脏骤停的时间限制试验可以使医疗治疗与患者的意愿相一致，有助于解决临床医生在护理患者时遇到的伦理困境。进一步的研究应探索在临床实践中规范使用限时试验。

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引用次数: 0

Feasibility and safety of automated chest compression during helicopter rescue with hoisting 直升机吊装救援中自动胸部按压的可行性和安全性

IF 2.4 Q3 CRITICAL CARE MEDICINE

Resuscitation plus

Pub Date : 2026-01-01 Epub Date: 2026-01-02 DOI: 10.1016/j.resplu.2025.101212

Alexandre Carron , Vivien Brenckmann , Alexandre Behouche , Pierre Bouzat , Lilian Barlet , Juliette Meyzenc , Marc Blancher , Katell Berthelot , Guillaume Debaty , Nicolas Segond

Background

Out-of-hospital cardiac arrest (OHCA) in mountainous environments presents substantial logistical challenges, particularly in maintaining high-quality chest compressions during helicopter evacuations. Prolonged interruptions, especially during hoisting, may critically impact neurological outcomes. This study aimed to assess the feasibility and effectiveness of a mechanical chest compression (MCC) device compared to manual compressions during a simulated helicopter hoisting scenario.

Methods

This was a prospective, crossover simulation study involving complete mountain rescue teams. Each team completed two scenarios: one using an MCC device (LUCAS-3®) and one using manual chest compressions. Hoisting was performed at two heights (15 m and 30 m). The primary outcome was chest compression fraction (CCF). Secondary outcomes included, compression depth and rate, and overall safety of the procedure. Results are reported as mean ± standard deviation.

Results

CCF was significantly higher in the MCC group compared to the manual group (96.6 % ± 0.3 vs. 73.9 % ± 6.6; p = 0.03). Compression rate was more consistently maintained within recommended ranges (103.0 ± 1.4 cpm vs 136.5 ± 8.7 cpm; p = 0.03 ). The guidelines-recommended range for chest compressions was significantly higher with the MCC device (89.5 % ± 9.6 vs 7.5 % ± 6.3; p = 0.03). No adverse safety events were observed.

Conclusion

In a simulated mountain rescue setting, the use of a mechanical chest compression device during helicopter hoisting appears feasible, safe and seems to improve chest compression fraction and the rate of guideline-compliant chest compressions.

山区环境中的院外心脏骤停（OHCA）带来了巨大的后勤挑战，特别是在直升机疏散期间保持高质量的胸部按压。长时间的中断，特别是在吊装期间，可能严重影响神经系统预后。本研究旨在评估在模拟直升机吊装场景中，机械胸部按压（MCC）装置与手动按压相比的可行性和有效性。方法本研究是一项前瞻性交叉模拟研究，涉及完整的山地救援队。每个团队完成两种方案：一种使用MCC装置（LUCAS-3®），另一种使用手动胸外按压。吊装在两个高度（15米和30米）进行。主要终点为胸压分数（CCF）。次要结果包括压缩深度和速率，以及手术的总体安全性。结果以均数±标准差报告。结果MCC组sccf明显高于手工组（96.6%±0.3 vs. 73.9%±6.6;p = 0.03）。压缩率更一致地维持在推荐范围内（103.0±1.4 cpm vs 136.5±8.7 cpm; p = 0.03）。指南推荐的MCC装置胸外按压范围明显更高（89.5%±9.6 vs 7.5%±6.3;p = 0.03）。未观察到不良安全事件。结论在模拟山地救援环境中，在直升机吊装过程中使用机械胸压装置是可行的、安全的，并且似乎可以提高胸压率和胸腔镜胸压的符合率。

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引用次数: 0

Implementation of high-performance CPR by basic life support (BLS) personnel: a pilot study in Thailand 基本生命支持（BLS）人员实施高性能CPR：泰国的一项试点研究

IF 2.4 Q3 CRITICAL CARE MEDICINE

Resuscitation plus

Pub Date : 2026-01-01 Epub Date: 2025-11-18 DOI: 10.1016/j.resplu.2025.101164

Sattha Riyapan , Wittawat Chokvanich , Tipa Chakorn , Bongkot Somboonkul , Jirayu Chantanakomes , Nattida Phinyo , Pannaphat Konwitthayasin , Kanpaphop Buangam , Panisara Saengsung

Background

High-performance cardiopulmonary resuscitation (HP-CPR) is a structured, pit-crew-style resuscitation model that has been shown to improve performance in advanced life support (ALS) systems. However, its applicability in volunteer-based basic life support (BLS) settings remains uncertain. This study aimed to describe the implementation of HP-CPR training for BLS personnel in Bangkok, Thailand, and to evaluate its impact on BLS performance using video-based process indicators, as well as to report patient- and system-level characteristics before and after the intervention.

Methods

We conducted a single-centre, before-and-after study of adults with non-traumatic out-of-hospital cardiac arrest (OHCA) managed by the Siriraj EMS Centre between July 2022 and January 2025. HP-CPR training for BLS personnel was delivered over a fivemonth period. The primary outcome was BLS performance, assessed through predefined process indicators using video review. Secondary outcomes included system-level characteristics and clinical outcomes.

Results

Of 423 patients screened, 214 met the inclusion criteria (110 pre-intervention; 104 post-intervention). Video recordings were available for 39 cases. Post-training, significant improvements were observed in two performance indicators: “counting during CPR” (0.0 % vs. 66.7 %, p < 0.01) and the “hover technique” (0.0 % vs. 62.5 %, p < 0.01). Other indicators, including uninterrupted CPR, assisted ventilation, AED use, and data handover, improved but did not reach statistical significance. Secondary outcomes—including AED use, CPR initiation by BLS, prehospital return of spontaneous circulation (ROSC), and survival outcomes—showed no significant differences between phases.

Conclusion

Following HP-CPR training, improvements were observed in selected BLS process indicators. However, further research is needed with larger sample sizes to assess the long-term impact of HP-CPR training in volunteer-based EMS systems.

背景：高性能心肺复苏（HP-CPR）是一种结构化的、工作人员式的复苏模式，已被证明可以提高高级生命支持（ALS）系统的性能。然而，它在基于志愿者的基本生命支持（BLS）设置中的适用性仍然不确定。本研究旨在描述对泰国曼谷BLS人员实施HP-CPR培训的情况，并使用基于视频的过程指标评估其对BLS绩效的影响，同时报告干预前后患者和系统层面的特征。方法：我们在2022年7月至2025年1月期间对Siriraj EMS中心管理的非创伤性院外心脏骤停（OHCA）成人进行了单中心前后研究。对劳工统计局人员的HP-CPR培训为期5个月。主要结果是BLS绩效，通过使用视频回顾的预定义过程指标进行评估。次要结局包括系统级特征和临床结局。结果筛选的423例患者中，214例符合纳入标准（干预前110例，干预后104例）。录像记录了39个案件。训练后，两项表现指标有显著改善：“心肺复苏计数”（0.0% vs. 66.7%, p < 0.01）和“悬停技术”（0.0% vs. 62.5%, p < 0.01）。其他指标，包括不间断心肺复苏、辅助通气、AED使用和数据切换，均有所改善，但未达到统计学意义。次要结局-包括AED使用，BLS启动CPR，院前自发循环恢复（ROSC）和生存结局-在各阶段之间没有显着差异。结论HP-CPR培训后，所选BLS过程指标有所改善。然而，需要进一步的研究以更大的样本量来评估HP-CPR培训在以志愿者为基础的EMS系统中的长期影响。

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引用次数: 0

Challenges in perioperative code status management: a national survey among Swiss anaesthetists 围手术期代码状态管理的挑战：瑞士麻醉师的全国调查

IF 2.4 Q3 CRITICAL CARE MEDICINE

Resuscitation plus

Pub Date : 2026-01-01 Epub Date: 2025-11-22 DOI: 10.1016/j.resplu.2025.101174

Samuel K. Zumbrunn , Flavio Gössi , Benjamin Bissmann , Armon Arpagaus , Sebastian Gross , Christoph Becker , Simon A. Amacher , Roaul Sutter , Kai Tisljar , Ariane Rossi , Marc Lüthy , Luzius A. Steiner , Thierry Girard , Sabina Hunziker

Aim

To evaluate current practices and beliefs among anaesthetists regarding perioperative code status discussions and management in surgical patients.

Methods

A nationwide web-based survey was conducted in Switzerland among anaesthetists providers. Primary endpoint: proportion of participants routinely discussing code status with medium-risk patients based on the American Society of Anesthesiologists (ASA) physical status classification system (ASA 3–4). Secondary endpoints: proportion of code status discussions in low-risk (ASA 1–2) and high-risk (ASA 5) patients; perioperative intensive care unit (ICU) admissions, severe complications, therapy limitations and management of patients with Do Not Resuscitate (DNR) orders.

Results

Of 496 respondents, 474 were included. 56.8 % (n = 269) of anaesthetists reported routinely discussing code status with medium-risk patients (ASA 3–4). Factors associated with routine code status discussion included greater experience (mean [±SD] 20.7 [±10.6] vs. 17.4 [10.8] years, adjusted OR 1.03 [95 % CI 1.02–1.05], p < 0.001), more exposure to cardiopulmonary resuscitation (CPR) (≥50 CPRs: 169/269 [62.8 %] vs. 93/205 [45.4 %]; adjusted OR 2.99 [95 % CI 1.39–6.42], p = 0.005), and awareness of institutional teaching (48/243 [19.8 %] vs. 13/180 [7.2 %], adjusted OR 2.93 [95 % CI 1.51–5.68], p = 0.001), though only 14.4 % reported such training. 76.3 % (n = 318) of anaesthetists reported discussing code status preoperatively with patients who have DNR orders. While 70.4 % (n = 285) supported respecting DNR orders perioperatively, 21.3 % (n = 86) felt they should not apply.

Conclusion

Code status discussions are commonly reported for medium-risk patients, but formal education is limited. Experience and clinical exposure increase the likelihood of such discussions. Enhanced training and clearer guidelines are needed to support consistent ethical management of code status in the perioperative setting.

目的评价麻醉医师对手术患者围术期麻醉规范、状态讨论和管理的现状和看法。方法在瑞士对麻醉师和麻醉师提供者进行了一项全国性的网络调查。主要终点：根据美国麻醉医师协会（ASA）身体状态分类系统（ASA 3-4），与中等风险患者例行讨论代码状态的参与者比例。次要终点：低危（ASA 1-2）和高危（ASA 5）患者中代码状态讨论的比例；围手术期重症监护病房（ICU）入院、严重并发症、治疗限制和不复苏（DNR）命令患者的管理。结果496名被调查者中，有474人入选。56.8% （n = 269）的麻醉师报告常规地与中危患者讨论编码状态（ASA 3-4）。与常规代码状态讨论相关的因素包括更丰富的经验（平均[±SD] 20.7[±10.6]对17.4[10.8]年，调整后OR为1.03 [95% CI 1.02-1.05], p < 0.001），更多地接触心肺复苏（CPR）(≥50 CPR: 169/269[62.8%]对93/205 [45.4%]；调整OR 2.99 [95% CI 1.39-6.42], p = 0.005)，对机构教学的认识（48/243[19.8%]对13/180[7.2%]，调整OR 2.93 [95% CI 1.51-5.68], p = 0.001），尽管只有14.4%的人报告了这种培训。76.3% （n = 318）的麻醉师报告术前与有DNR命令的患者讨论代码状态。70.4% （n = 285）的患者支持围手术期遵守DNR指令，21.3% （n = 86）的患者认为不应遵守DNR指令。结论中危患者普遍存在编码状态讨论，但正规教育有限。经验和临床接触增加了这种讨论的可能性。需要加强培训和更明确的指导方针，以支持围手术期对代码状态的一致道德管理。

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引用次数: 0

Racial differences in cardiac arrest survival: insights from Minnesota metro data and the University of Minnesota extracorporeal cardiopulmonary resuscitation cohort 心脏骤停存活的种族差异：来自明尼苏达州地铁数据和明尼苏达大学体外心肺复苏队列的见解

IF 2.4 Q3 CRITICAL CARE MEDICINE

Resuscitation plus

Pub Date : 2026-01-01 Epub Date: 2025-11-20 DOI: 10.1016/j.resplu.2025.101166

Despoina Koukousaki , Rebecca Freese , Lucinda Hodgson , Marinos Kosmopoulos , Rajat Kalra , Tamas Alexy , Alejandra Gutierrez , Demetris Yannopoulos

Aims

The study explores the association between race, survival and neurological outcomes among out-of-hospital cardiac arrest (OHCA) patients listed in Minnesota metro and the University of Minnesota Extracorporeal Cardiopulmonary Resuscitation (UMN-ECPR) program.

Methods

This retrospective study included OHCA patients with initial shockable rhythm from two distinct cohorts: the Minnesota metro CARES cohort, treated with conventional CPR and the UMN-ECPR database (2016–2023). Race was categorized as white or non-white. Good neurological outcome was defined as a Cerebral-Performance-Category score of 1–2. Logistic regression analyses examined survival by race, with primary models adjusted for age and gender and exploratory models further adjusted for witnessed status, location, bystander CPR, return-of-spontaneous-circulation, CPR duration.

Results

Of 2,700 OHCA patients in the CARES cohort, primarily treated with conventional CPR, 16.5 % were non-white. Compared to white patients, non-whites were younger (mean age 54.0 vs. 64.4 years), more often female (32.8 % vs. 23.6 %), and less likely to receive bystander CPR (52.2 % vs. 60 %). Non-white patients had lower age- and gender-adjusted odds of survival to discharge (OR: 0.64; 95 % CI, 0.5–0.82; p < 0.001) and favorable neurological outcome (OR: 0.48; 95 % CI, 0.35–0.64; p < 0.001). Among 414 ECPR patients (22.7 % non-white), non-white patients were younger (mean age 51 vs. 58.8 years) with lower bystander CPR rates (65.2 % vs. 74.8 %). There were no significant differences in age- and gender-adjusted survival (OR: 1.17; 95 % CI, 0.69–2; p = 0.554) or neurological outcome (OR: 1.07; 95 % CI, 0.61–1.88; p = 0.818).

Conclusion

Non-white race was linked to worse outcomes in the conventional CPR cohort but not in the ECPR cohort.

目的：本研究探讨明尼苏达州metro和明尼苏达大学体外心肺复苏（UMN-ECPR）项目中列出的院外心脏骤停（OHCA）患者的种族、生存率和神经系统预后之间的关系。方法本回顾性研究纳入了来自两个不同队列的OHCA患者：明尼苏达州metro CARES队列，接受常规CPR治疗和UMN-ECPR数据库（2016-2023）。种族分为白人和非白人。良好的神经系统预后定义为大脑表现分类得分为1-2。Logistic回归分析按种族检验生存率，主要模型调整了年龄和性别，探索性模型进一步调整了目击状态、地点、旁观者CPR、自然循环恢复、CPR持续时间。结果在CARES队列中，主要接受常规CPR治疗的2700例OHCA患者中，16.5%为非白人。与白人患者相比，非白人患者更年轻（平均年龄54.0岁对64.4岁），女性患者更多（32.8%对23.6%），接受旁观者CPR的可能性更低（52.2%对60%）。非白人患者的年龄和性别调整生存率较低（OR: 0.64; 95% CI, 0.5-0.82; p < 0.001），神经系统预后良好（OR: 0.48; 95% CI, 0.35-0.64; p < 0.001）。在414例ECPR患者（22.7%非白人）中，非白人患者较年轻（平均年龄51岁对58.8岁），旁观者CPR率较低（65.2%对74.8%）。年龄和性别调整生存率（OR: 1.17; 95% CI, 0.69-2; p = 0.554）或神经预后（OR: 1.07; 95% CI, 0.61-1.88; p = 0.818）无显著差异。结论非白种人与常规CPR组较差的预后相关，而与ECPR组无关。

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引用次数: 0