Age-Specific Differences in the Duration of Prehospital Cardiopulmonary Resuscitation Administered by Emergency Medical Service Providers Necessary to Achieve Favorable Neurological Outcome After Out-of-Hospital Cardiac Arrest.

Funada A ，Goto Y ，Tada H ，Teramoto R ，Shimojima M ，Hayashi K ，Yamagishi M ... -  《-》

Relationship between cardiopulmonary resuscitation duration and outcomes in children with drowning-induced cardiac arrest.

Due to the difficulty in making the decision to discontinue resuscitation efforts, clinicians often perform prolonged cardiopulmonary resuscitation (CPR) in children who have drowned. This study investigated the relationship between out-of-hospital CPR duration and neurological outcomes in children with drowning-induced cardiac arrest. This retrospective cohort study used data from the All-Japan Utstein Registry from 2013 to 2021. We included patients aged ≤18 years with drowning-induced cardiac arrest who underwent CPR via emergency medical services. The study's primary outcome was a favorable neurological outcome (Cerebral Performance Category score of 1 or 2) at 1 month. We also calculated the dynamic proportion of 1-month outcomes as a function of out-of-hospital CPR duration. Moreover, we determined the sensitivity, specificity, and positive predictive value of 33 min of out-of-hospital CPR, which is the time point at which primary analysis showed a plateau in the neurological outcomes. Of 14,849 children included in the registry, 992 cases of drowning-induced cardiac arrest were analyzed. The median out-of-hospital CPR duration was 20 (range, 2-164) min, with only 35 (3.5 %) patients showing favorable neurological outcomes at 1 month. The proportion of favorable neurological outcomes decreased rapidly for up to 33 min of out-of-hospital CPR and then plateaued to 0.3 %; only three patients achieved favorable neurological outcomes after 33 min of CPR. An out-of-hospital CPR duration of >33 min was associated with poor neurological outcomes (sensitivity, 0.17 [95 % confidence interval: 0.15-0.20]; specificity, 0.91 [0.77-0.98]; and positive predictive value, 0.98 [0.95-1.00]). Prehospital EMS-initiated CPR duration for children with drowning-induced cardiac arrest was inversely associated with one-month favorable neurological outcomes. Favorable neurological outcomes after >33 min of out-of-hospital CPR were extremely rare, though accurately predicting the outcome remains challenging.

Komori A ，Iriyama H ，Abe T 《-》

Survival After Out-of-Hospital Cardiac Arrest Before and After Legislation for Bystander CPR.

Li S ，Qin C ，Zhang H ，Maimaitiming M ，Shi J ，Feng Y ，Huang K ，Bi Y ，Wang M ，Zhou Q ，Jin Y ，Zheng ZJ ... -  《JAMA Network Open》

A Machine Learning-Based Decision Support System for the Prognostication of Neurological Outcomes in Successfully Resuscitated Out-of-Hospital Cardiac Arrest Patients.

Lee S ，Lee KS ，Park SH ，Lee SW ，Kim SJ ... -  《-》

Bystander Response and Out-of-Hospital Cardiac Arrest Outcomes (Bro. Study) in 3 Gulf Countries: Protocol for a Prospective, Observational, International Collaboration Study.

: Globally, there is significant variation in the out-of-hospital cardiac arrest (OHCA) survival rate. Early links in the chain of survival, including bystander cardiopulmonary resuscitation (CPR) and the use of an automated external defibrillator at the scene, are known to be of crucial importance, with strong evidence of increased survival rate with good neurological outcomes. The data from the Middle East are limited and report variable rates of bystander CPR and survival. It is crucial to get prospective, reliable data on bystander response in these regions to help plan interventions to improve bystander response and outcomes. This international collaborative study aims to describe the characteristics, including bystander interventions and outcomes, of OHCAs brought to hospitals enrolled in the study from Abu Dhabi, United Arab Emirates; Doha, Qatar; and Muscat, Oman. It also aims to describe the strength of the association between bystander response and OHCA outcomes, including the return of spontaneous circulation, survival to hospital admission, survival to discharge, and good neurological outcome at discharge in the local context of low bystander CPR rates. This multicenter, prospective, noninterventional observational study (Bro. Study) will be conducted at the emergency departments of 4 participating tertiary care hospitals in 3 countries. The data will be collected prospectively according to the Utstein style (a set of internationally accepted guidelines for uniform reporting of cardiac arrests) on demographic variables (age, sex, nationality, country, participating center, and comorbidities), peri-cardiac arrest variables (location, witnessed or not, bystander CPR, use of automated external defibrillator, time of emergency medical services arrival, initial rhythm, number of shocks, and time of prehospital CPR), and outcome variables (return of spontaneous circulation, survival to discharge, and neurological outcome at discharge and 3 months). Univariate and multivariate analysis with logistic regression models will be used to measure the strength of the association of bystander interventions with outcomes using SPSS (version 22). Data collection began in November 2023 and will continue for 2 years, with publication expected by early 2026. Bystander response to an OHCA is critical to a favorable outcome. The reliable, baseline bystander CPR data will be a cornerstone in the team's next planned projects, which are to qualitatively identify the barriers to bystander CPR, conduct a scoping review of community interventions in the Gulf and other Asian countries, and design and implement strategies to help improve the bystander CPR rate in the community. DERR1-10.2196/58780.

Farooq M ，Al Jufaili M ，Hanjra FK ，Ahmad S ，Dababneh EH ，Al Nahhas O ，Bashir K ... -  《JMIR Research Protocols》