The European Resuscitation Council (ERC) Congress - Resuscitation 2025 was held in Rotterdam as a fully in-person international meeting and served as the official launch platform for the ERC Resuscitation Guidelines 2025. The congress brought together nearly 3000 participants from 77 countries, representing a multidisciplinary community of clinicians, educators, scientists, survivors of out-of-hospital cardiac arrest and their co-survivors, policymakers, and system leaders. The programme featured guideline presentations, scientific abstract sessions, debates, poster discussions, workshops, networking activities, and industry exhibitions, reflecting the breadth of modern resuscitation research and practice. Core themes included epidemiology, systems of care, basic and advanced life support, post-resuscitation management, paediatric and neonatal care, ethics, education, and first aid. Sessions also addressed innovations such as physiology-guided advanced life support, extracorporeal resuscitation, and digital or AI-based detection and decision-support tools, as well as personalised post-cardiac arrest care. Late-breaking studies presented findings on neurophysiology, temperature management, double-sequence defibrillation, and early hypothermia. The congress also highlighted survivorship, rehabilitation, co-survivor perspectives, diversity and equity in resuscitation outcomes, and global training capacity. Young ERC initiatives supported mentorship, research collaboration, and career development for students and early-career professionals. Overall, the congress demonstrated the growing maturity and complexity of resuscitation science by integrating clinical evidence, systems innovation, ethics, education, and equity, while providing a collaborative platform to shape future research priorities and support implementation of the new ERC Guidelines across diverse healthcare contexts.

Introduction Cardiac arrest registries can benchmark, enhance quality of care and provide data for research. Key stakeholders from Emergency Medical Communication Centre (EMCC), Emergency Medical Services (EMS), In-Hospital Care Providers (IHCP) and Recovery and Rehabilitation Providers (RRP) have different perspectives, and registry results and patient cohorts should be tailored to facilitate benchmarking, quality improvement projects and research in all sections of the chain of survival. In this paper, we describe different cohorts of interest, exemplified by data from the Norwegian Cardiac Arrest Registry (NorCAR). Method Data from NorCAR for patients registered in 2022 is presented as descriptive statistics. Results The patient cohort with treatment initiated by EMCC comprised 3591 patients (67/100,000 inhabitants). EMS attended 4150 patients with confirmed cardiac arrest (77/100,000 inhabitants) and started cardiopulmonary resuscitation (CPR) in 3083 patients (57/100,000 inhabitants). The patient cohort eligible for treatment by IHCP consists of 1114 patients admitted to hospital alive or with ongoing CPR, along with 1230 in-hospital cardiac arrest cases. The cohort eligible for rehabilitation and follow-up consists of 1227 patients who were alive 24 h after cardiac arrest, 705 out-of-hospital cardiac arrests and 522 in-hospital cardiac arrests. Conclusion It is essential to clearly define the cohort of interest when engaging with different stakeholders and to provide data that facilitates quality improvement projects in all areas of the chain of survival. We recommend defining several subgroups of cardiac arrest patients to accommodate benchmarking, quality improvement projects and research relevant for all stakeholders involved in resuscitation and care of cardiac arrest patients.

Right ventricular (RV) dysfunction is common as part of the post-cardiac arrest syndrome in resuscitated patients. Furthermore, RV failure following cardiac arrest has been associated with worse outcomes in retrospective studies, but prospective evidence is lacking. In our recently published sub-study of The Targeted Therapeutic Mild Hypercapnic After Resuscitated Cardiac Arrest (TAME) trial we found, contrary to the original hypothesis, that hypercapnic acidosis dit not increase pulmonary vascular resistance or decrease in RV function. In extension of this we wanted to assess if RV failure was associated with worse outcomes in our study-population. Investigate the association between death at 6 months and right ventricular failure during the initial stages of post-cardiac arrest care. Single center, pre-planned sub-study. Transthoracic echocardiography combined with time-matched invasive heamodynamic measurements during the initial 24 h after admission were used to assess RV function. RV failure was defined as echocardiographic objective evidence of right ventricular dysfunction, cardiac index ≤2.2 L/min/m2 and central venous pressure ≥ 15 mm Hg. Multivariate logistic regression was used to assess the association between RV failure and 6 month mortality. The covariates "Time to ROSC", "Age", "Initial rhythm", "Bystander CPR" and "Ischemic heart disease" were chosen from all relevant variables using the "glmulti" package in R which selects the best fitting model with the lowest Aikaike information criterion. 111 out 137 randomised patients had echocardiography performed and were elligible for this study. Overall, median age was 64, 80 % were male, median time to ROSC was 22 min, 47 % had ST-elevation myocardial infarction and approximately 90 % had a shockable initial rhythm and bystander CPR. Average time from admission to echocardiography was 19 h, and 50 (45 %) patients had signs of RV dysfunction, 30 (27 %) had RV failure, and isolated RV failure occured in only 3 patients. RV failure was associated with an increased 6 month mortality with an odd ratio (OR) of 4.2 (1.2 - 18.1), p = 0.039. RV failure was the only statistically significant haemodynamic parameter associated with death at 6 months in a multivariate analysis, and yielded a model AUC of 0.91 (95 % CI 0.84-0.97). Univariate analysis of other parameters of RV function found that increasing values of tricuspid annular plane excursion (TAPSE), RV fractional area change and stroke volumes were associated with increased probability of survival (p < 0.05), but were not statistically significant in multivariate analysis (p > 0.05). In patients resuscitated from OHCA, right ventricular failure during the initial 24 hours of intensive care was associated with increased mortality at 6 months. This adds valuable prospective data, but requires further validation and investigation in larger studies.Predictors of 6 month mortalityUnivariate logistic regression model

The European Resuscitation Council (ERC) developed the Systems Saving Lives Guidelines, based on the 2025 ILCOR Consensus on Science with Treatment Recommendations (CoSTR). These Guidelines addresses various topics including the Chain of Survival, advocacy, CPR awareness campaigns, Kids Save Lives, resuscitation in low-resource settings, social media, first responders, EMS organisation for cardiac arrest, in-hospital cardiac arrest management, cardiac arrest centres, system performance improvement, survivors and co-survivors, and new technologies and artificial intelligence.

Background In some regions, females are less likely to receive public-initiated resuscitation, potentially due to the need to expose the chest and breasts for proper automated external defibrillator (AED) pad placement. We conducted a scoping review to investigate the breadth of the existing literature and knowledge gaps on bra (brassière) removal and AED pad application. Methods Studies that examined bra removal and outcomes associated with AED pad placement and defibrillation in cardiac arrest were eligible. We searched three databases (Medline, Embase, and Cochrane) from inception to September 26, 2024. Google and Google Scholar (first 20 pages) were searched for grey literature on October 1, 2024. The study followed the scoping review framework by the Joanna Briggs Institute. Results The search identified 287 references. Three studies met the eligibility criteria, including one animal and two manikin studies, of which two were conference abstracts. No studies examined patient outcomes. No adverse events were reported with defibrillation in a pig model with AED pads in direct contact with a bra’s underwire. No difference in time to pad placement or shock delivery was seen with bra removal in simulation. One simulation study reported female manikins were less likely to be completely de-robed, including bra removal, which was attributed to social norms, modesty, and lack of awareness. Conclusion Scant evidence is available on the need for bra removal and outcomes associated with AED application. Further research is needed to explore whether bra removal is imperative for AED pad placement and defibrillation.

Background The impact on survival and neurological outcomes of head-up cardiopulmonary resuscitation (CPR) remains unclear. This systematic review aimed to examine whether head-up CPR or head-up CPR bundle affects survival and neurological outcomes. Methods In this review registered in PROSPERO (CRD42024541714), we searched Medline, EMBASE, Scopus, Emcare and Cochrane library from inception to February 12, 2025. The inclusion criteria were studies: in adults and children in any setting (in-hospital or out-of-hospital) with cardiac arrest, comparing head-up CPR or head-up CPR bundle with standard or compression-only CPR in supine position, and randomized controlled trials (RCT) and observational studies. We excluded non-human studies and used Cochrane’s Risk of Bias-2 and ROBINS-I tools for risk of bias assessment, and GRADE for outcome assessment. We conducted a narrative synthesis of the findings. Results We identified four observational studies with 10,099 participants and no RCTs. All outcomes were judged to be very-low certainty of evidence, subject to high-risk of bias. Two pre- and post-intervention studies showed no statistically significant difference in survival with a good neurological outcome. The other two studies, which analyzed overlapping cohorts comparing the head-up CPR bundle with conventional CPR, showed mixed results—one found no statistically significant difference in survival to hospital discharge with favorable neurological status, while the other, focusing on patients with nonshockable rhythms, found that the head-up CPR bundle was associated with increased survival with favorable neurological function. Conclusions The available evidence remains limited, highlighted by the absence of RCTs or observational studies with adequate comparisons.

BACKGROUND:Disparity is believed to exist between generic Utstein etiological classifications of 2004 and 2015 when compared with confirmed etiologies, but the impact of this disparity on reported survival outcomes is unknown. OBJECTIVE:This scoping review was proposed with two objectives: 1-to report outcomes based on confirmed etiology of OHCA in comparison with Utstein classified etiologies and 2- to identify outcomes of OHCA by etiology following cause-targeted interventions. METHOD:Medline, Embase, and EBM- Cochrane databases were searched from inception to 2024. Studies were selected if included population was adults with OHCA for whom survival outcomes of OHCA were reported based on the confirmed etiology compared to Utstein etiological classification (2004 or 2015) or reported based on the etiology following cause-targeted interventions. A descriptive review of included studies was conducted. RESULT:The search yielded 24,833 citations. Thirty-nine studies met inclusion criteria. These articles were predominantly published in Europe and North America between 2010-2024. The Utstein etiological classification was used in all studies (Utstein 2004; n = 31, Utstein 2015; n = 8). Survival to discharge was higher for drug overdose induced OHCA than presumed cardiac etiologies (9-83% vs 8.3-63%). For confirmed etiology of drowning, 30-day survival was higher than the rate reported by presumed cardiac etiologies (Utstein 2004) (11.5% vs 8.8%) while survival to discharge was lower following confirmed etiologies of trauma (1.7-5.1% vs 8-12%), hanging (3.3-43% vs 12-61%), respiratory disease (5% vs 9%), and intracranial hemorrhage (ICH) (11% vs 40%) compared with Utestin etiological classifications (2004 or 2015). Thrombolysis therapy resulted in better 30-day survival compared to placebo for OHCA due to presumed pulmonary embolism (16% vs 6%; p = 0.05), and conventional resuscitation resulted in higher survival for OHCA due to drowning (10.5% vs 8.6%) or respiratory disease (6.8% vs 4.54%) versus chest compression only. CONCLUSION:The reported survival outcomes for confirmed non-cardiac etiologies is inconsistent across studies compared with Utstein etiological classifications of 2004 or 2015. Better survival outcomes following few cause-targeted interventions may be attributed to etiologically well-defined patient cohorts. More vigorous case selection based on etiology may refine the reported outcomes and comparisons with interventions across published studies.

Der Europäische Rat für Wiederbelebung (ERC) und die Europäische Gesellschaft für Intensivmedizin (ESICM) haben gemeinsam diese Leitlinie für die Postreanimationsphase von Erwachsenen erstellt, basierend auf dem internationalen ILCOR Konsensus 2020 zur kardiopulmonalen Wiederbelebung. Die behandelten Themen umfassen das Postreanimationssyndrom („post-cardiac arrest syndrome“), die Differenzialdiagnose der Ursachen des Kreislaufstillstands, Kontrolle der Oxygenierung und Beatmung, die koronare Reperfusion, die hämodynamische Überwachung und Behandlung, die Kontrolle von Krampfanfällen, die Temperaturkontrolle, das allgemeine Management der Intensivpflege, die Prognose und das Langzeitergebnis, die Rehabilitation und die Organspende.

The European Resuscitation Council (ERC) and the European Society of Intensive Care Medicine (ESICM) have collaborated to produce these post-resuscitation care guidelines for adults, which are based on the International Consensus on Cardiopulmonary Resuscitation Science with Treatment Recommendations (CoSTR) pubished by the International Liaison Committee on Resuscitation (ILCOR). The topics covered include the post-cardiac arrest syndrome, diagnosis of cause of cardiac arrest, control of oxygenation and ventilation, coronary reperfusion, haemodynamic monitoring and management, control of seizures, temperature control, general intensive care management, prognostication, long-term outcome, rehabilitation, and organ donation. The post-resuscitation care of children is described in the ERC Guidelines 2025 Paediatric Life Support.

Importance:Understanding the relationship between patients' clinical characteristics and outcomes is fundamental to medicine. When critically ill patients die after withdrawal of life-sustaining therapy (WLST), the inability to observe the potential for recovery with continued aggressive care could bias future clinical decisions and research. Objective:To quantify the frequency with which experts consider patients who died after WLST following resuscitated cardiac arrest to have had recovery potential if life-sustaining therapy had been continued. Design, Setting, and Participants:This prospective cohort study included comatose adult patients (aged ≥18 years) treated following resuscitation from cardiac arrest at a single academic medical center between January 1, 2010, and July 31, 2022. Patients with advanced directives limiting critical care or who experienced cardiac arrest of traumatic or neurologic etiology were excluded. An international cohort of experts in post-arrest care based on clinical experience and academic productivity was identified. Experts reviewed the cases between August 24, 2022, and February 11, 2024. Exposure:Patients who died after WLST. Main Outcome and Measures:Three or more experts independently estimated recovery potential for each patient had life-sustaining treatment been continued, using a 7-point numerical ordinal scale. In the primary analysis, which involved the patient cases with death after WLST, a 1% or greater estimated recovery potential was considered to be clinically meaningful. In secondary analyses, thresholds of 5% and 10% estimated recovery probability were explored. Results:A total of 2391 patients (median [IQR] age, 59 [48-69] years; 1455 men [60.9%]) were included, of whom 714 (29.9%) survived to discharge. Cases of uncertain outcome (1431 patients [59.8%]) in which WLST preceded death were reviewed by 38 experts who rendered 4381 estimates of recovery potential. In 518 cases (36.2%; 95% CI, 33.7%-38.7%), all experts believed that recovery potential was less than 1% if life-sustaining therapies had been continued. In the remaining 913 cases (63.8%; 95% CI, 61.3%-66.3%), at least 1 expert believed that recovery potential was at least 1%. In 227 cases (15.9%; 95% CI, 14.0%-17.9%), all experts agreed that recovery potential was at least 1%, and in 686 cases (47.9%; 95% CI, 45.3%-50.6%), expert estimates differed at this threshold. Conclusions and Relevance:In this cohort study of comatose patients resuscitated from cardiac arrest, most who died after WLST were considered by experts to have had recovery potential. These findings suggest that novel solutions to avoiding deaths based on biased prognostication or incomplete information are needed.

Background Public-access defibrillation is a key step in the chain of survival. Emergency Medical Services dispatchers can help the public locate and use public-access Automated External Defibrillators (AEDs), but there is little information about effectiveness of dispatcher instructions for AED use. This scoping review investigates evidence about the effect of dispatch instruction for public-access AED retrieval and use on process and patient outcomes. Methods The research team searched MEDLINE, EMBASE and Cochrane libraries, performed bibliography searches and reviewed ‘related articles’ identified by PubMed and Google Scholar. We reported patient outcomes including survival to hospital discharge, and process outcomes including rates of and time to AED retrieval and use, and competent AED use. Results We identified 21 articles: eight clinical observational studies and 13 simulation studies. The only study reporting on clinical outcomes reported that AED application following dispatcher assistance was associated with statistically significant increases in survival to hospital discharge (adjusted odds ratio [AOR] 3.01, 95% confidence interval [CI] 1.56–5.82) and survival with favourable neurological outcome (AOR 5.46, 95% CI 1.95–15.3), but shock delivery itself was not. Clinical studies reported that dispatch instruction facilitated AED retrieval and use. In simulations, dispatch instruction resulted in an overall shorter time to first shock but, if measuring only the time interval after the AED had arrived, dispatch instructions introduced delay to first shock. Dispatch instruction also resulted in competent AED use more frequently. There were conflicting results about the benefits of video dispatch instructions. Discussion There is little high-quality evidence about the effect of dispatcher instruction for AED retrieval and use on patient outcomes.

The 2025 European Resuscitation Council (ERC) Guidelines present the most up-to-date evidence-based guidelines for the practice of resuscitation across Europe. The ERC Guidelines 2025 are based on evidence produced by the International Liaison Committee on Resuscitation (ILCOR) in the form of systematic reviews, scoping reviews, and evidence updates, published as the ILCOR Consensus on Science with Treatment Recommendations. The certainty of evidence of these ILCOR treatment recommendations was used to issue the ERC Guidelines 2025 Recommendations. In some cases, the ERC made good practice statements when evidence was absent for certain topics. If no ILCOR review was available, the ERC writing groups conducted their own reviews to provide recommendations. The ERC Guidelines 2025 cover the epidemiology of cardiac arrest, the role that systems play in saving lives, adult basic life support, adult advanced life support, resuscitation in special circumstances, post resuscitation care, newborn resuscitation and support of transition of infants at birth, paediatric basic and advanced life support, resuscitation ethics, education for resuscitation, and first aid. These guidelines are a framework of recommendations for the approach to out-of-hospital and in-hospital resuscitation; the implementation is achieved locally taking local legislation and health care regulations into consideration.

BACKGROUND:Current Utstein etiological classifications for out-of-hospital cardiac arrest (OHCA) are heterogenous and inaccurate when compared with robust sources. This heterogeneity may influence reporting incidence and outcomes and patient enrollment in observational studies and clinical trials. Circumstance-related factors may contribute to cardiac arrest; however, the role of these factors in improving the etiological classification of OHCA is unknown. OBJECTIVE:This scoping review was proposed to explore current evidence to identify the role of contributing factors, triggers, and prodromal symptoms of out-of-hospital cardiac arrest in the reported etiology of cardiac arrest based on emergency medical services data, medical records, or autopsy reports. METHOD:We searched Medline, Embase, and EMB review-Cochrane databases from 1946 to 2024. Studies were selected if the included population was adults with OHCA for whom the initial etiology was assigned, and any contributing factors, triggers, or prodromal symptoms of OHCA were reported. A descriptive review of the included studies was conducted. RESULT:The search yielded 24,833 citations. Seventy studies met the inclusion criteria. These studies were published predominantly in Europe and Asia between 2010 and 2024 and classified as contributing factors (n = 24), exercise (n = 13), environmental triggers (n = 24), and prodromal symptoms (n = 9). The etiology of cardiac arrest initially assigned to cardiac or obvious non-cardiac classification may be precipitated by seizures (n = 8), trauma (n = 7), alcohol or drug intoxication (n = 6), Covid-19 infection (n = 5), myocardial infarction (n = 4), suicide (n = 4), antipsychotic medications (n = 4), and illicit drug use (n = 3). Exercise and environmental factors (e.g., particulate matter (PM) 2.5µ and ambient temperature) may trigger cardiac arrest predominantly due to cardiac etiologies. Based on EMS data, approximately 50% of patients with OHCA experienced symptoms prior to cardiac arrest which suggested cardiac and non-cardiac etiologies. CONCLUSION:Many circumstance-related factors may directly or indirectly contribute to cardiac arrest etiology classification. Listing these factors in the reporting template may help prehospital personnel and data abstractors gather enough information to identify more accurately the etiology of OHCA.

AIM:To perform an updated systematic review and meta-analysis of oxygen and carbon dioxide targets in patients with sustained return of spontaneous circulation after cardiac arrest. METHODS:Searches were conducted in MEDLINE, Embase, and Evidence-Based Medicine Reviews from August 2019 to March 2025 for randomised trials comparing specific oxygen or carbon dioxide targets in post-cardiac arrest patients. Two investigators independently reviewed trials for relevance, extracted data, and assessed risk of bias. Data were pooled using random-effects models. The certainty of evidence was evaluated using GRADE methodology. RESULTS:Fifteen manuscripts from 12 trials were included. All trials were limited to adult patients, primarily including out-of-hospital cardiac arrests. Five trials evaluated oxygen targets in the prehospital setting, while six evaluated oxygen targets and three evaluated carbon dioxide targets in the intensive care unit setting. Risk of bias was assessed as moderate for most outcomes. Meta-analyses found no differences in survival or favourable functional outcomes when comparing restrictive to liberal oxygen targets in either setting. There was also no difference in outcomes when comparing mild hypercapnia to normocapnia. The certainty of evidence was rated as low to moderate. CONCLUSIONS:Among patients resuscitated from cardiac arrest, neither restrictive oxygen targets nor mild hypercapnia, compared to conventional targets, improved survival or functional outcomes.

Aim: To evaluate the impact of defibrillation pad size, orientation, and position on clinical outcomes in adult and paediatric cardiac arrest with a shockable rhythm through a systematic review of available evidence. Methods: A systematic review was registered with PROSPERO (CRD42024512443). Searches were performed across PubMed, EMBASE, and the Cochrane Library up to March 31st, 2025. Studies involving adults or children with cardiac arrest and comparing pad sizes or positions were included. Risk of bias was assessed using the RoB 2.0 and ROBINS-I tools, and the certainty of evidence was evaluated using GRADE methodology. Results: Of 7855 screened studies, four met inclusion criteria, e.g. 1 randomized clinical trial (RCT) and 3 observational studies in adults, covering 1334 adult cardiac arrest patients. Evidence on pad size, deriving from an observational study enrolling 314 patients, was sparse and inconclusive, with no significant differences in defibrillation success between large and small pads (OR 0.82[0.42–1.60]). For pad orientation, no evidence was found. For pad placement, one RCT including 280 patients suggested a potential survival benefit from vector-change defibrillation using anterior-posterior (AP) pad placement in refractory ventricular fibrillation (VF), compared to the standard anterior-lateral (AL) placement (adj. RR 1.71[1.01–2.88]). Data from two observational studies including 739 patients were conflicting and limited by high risk of bias. Conclusion: Evidence remains inconclusive to support the superiority of any specific pad size, orientation or position for improving survival or neurological outcomes in cardiac arrest. However, vector-change to the AP position may offer benefit in cases of refractory VF. High-quality RCTs are needed to further inform clinical practice.

Out-of-hospital cardiac arrest (OHCA) remains a critical health concern, where prompt access to automated external defibrillators (AEDs) significantly improves survival. This scoping review broadly investigates the feasibility and impact of dronedelivered AEDs for OHCA response. METHODS:PubMed, Cochrane, and Web of Science were searched from inception to August 6, 2024, with eligibility broadly including empirical data. The charting process involved iterative data extraction for thematic analysis. RESULTS:We identified 306 titles and, after duplicate removal, title/abstract screening, and full text review, included 39 studies. These were divided into three categories: 1) Real-world observational studies (n = 3), 2) Test flights/simulation studies and qualitative analyses (n = 15), and 3) Computer/prediction models (n = 21). Real-world studies demonstrated the feasibility of drone AED delivery, with a time advantage of 01:52 - 03:14 min over ambulances observed in 64-67 % of cases. Test flight/simulation and qualitative studies consistently reported feasibility and positive bystander experiences. Computer/prediction models exhibited considerable heterogeneity, yet all indicated significant time savings for AED delivery compared to traditional EMS methods. Moreover, seven studies estimated improved survival rates, with five assessing cost-effectiveness and favouring drone systems. Regional factors such as EMS response times, volunteer responder programmes, terrain, weather, and budget constraints influenced the system's effectiveness. CONCLUSION:Across all categories, studies confirmed the feasibility of drone-delivered AED systems, with significant potential for reducing time to AED arrival compared to EMS arrival. Prediction models suggested enhanced survival alongside costeffectiveness. Further research, including more extensive real-world studies and regulatory advancements, is imperative to integrate drones effectively into OHCA response systems.

Background: Rapid public defibrillation with automated external defibrillators (AEDs) is critical to improving out-of-hospital cardiac arrest survival. Concerns about AED theft and vandalism have led to implementing security measures, including locked cabinets. This scoping review, conducted as part of the evidence review for the International Liaison Committee on Resuscitation, explores the impact of securing AEDs in locked cabinets. Methods: Searches of Medline, Embase, Cochrane, CINAHL (from database inception to 25/5/2024) and Google Scholar (first 200 articles). Studies of any type or design, published with an English abstract, examining the impact of locked AED cabinets were included. The included studies were grouped by outcomes, and an iterative narrative synthesis was performed. Results: We screened 2,096 titles and found 10 relevant studies: 8 observational studies (4 published as conference abstracts) and 2 simulation studies. No study reported patient outcomes. Studies reported data on between 36 and 31,938 AEDs. Most studies reported low rates (<2%) of theft/missing/vandalism, including AEDs that were accessible 24/7. The only study comparing unlocked and locked cabinets showed minimal difference in theft and vandalism rates (0.3% vs. 0.1%). Two simulation studies showed significantly slower AED retrieval when additional security measures, included locked cabinets, were used. A survey of first responders reported half (25/50) were injured while accessing an AED that required breaking glass to access. Conclusion: The limited literature suggests that vandalism and the loss of AEDs are rare and occur in locked and unlocked cabinets. Research on this topic is needed that focuses on real-life retrieval and patient outcomes.

AimTo determine whether targeting mild hypercapnia (PaCO2 7 kPa) would yield improved cerebral blood flow and metabolism compared to normocapnia (PaCO2 5 kPa) with and without targeted temperature management to 33 °C (TTM33) in a porcine post-cardiac arrest model.Methods39 pigs were resuscitated after 10 minutes of cardiac arrest using cardiopulmonary bypass and randomised to TTM33 or no-TTM, and hypercapnia or normocapnia. TTM33 was managed with intravasal cooling. Animals were stabilized for 30 minutes followed by a two-hour intervention period. Hemodynamic parameters were measured continuously, and neuromonitoring included intracranial pressure (ICP), pressure reactivity index, cerebral blood flow, brain-tissue pCO2 and microdialysis. Measurements are reported as proportion of baseline, and areas under the curve during the 120 min intervention period were compared.ResultsHypercapnia increased cerebral flow in both TTM33 and no-TTM groups, but also increased ICP (199% vs. 183% of baseline, p = 0.018) and reduced cerebral perfusion pressure (70% vs. 84% of baseline, p < 0.001) in no-TTM animals. Cerebral lactate (196% vs. 297% of baseline, p < 0.001), pyruvate (118% vs. 152% of baseline, p < 0.001), glycerol and lactate/pyruvate ratios were lower with hypercapnia in the TTM33 group, but only pyruvate (133% vs. 150% of baseline, p = 0.002) was lower with hypercapnia among no-TTM animals.ConclusionIn this porcine post-arrest model, hypercapnia led to increased cerebral flow both with and without hypothermia, but also increased ICP and reduced cerebral perfusion pressure in no-TTM animals. The effects of hypercapnia were different with and without TTM.(Institutional protocol number: FOTS, id 14931)