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Guidelines

Resuscitation

2025 Korean Guidelines for Cardiopulmonary Resuscitation: Part 2. Current status of cardiac arrest and the chain of survival
Sung Oh Hwang, Kyoung-Chul Cha, Woo Jin Jung, Young-Il Roh, Gyo Jin Ahn, Do Kyun Kim, Tae-Youn Kim, Youdong Sohn, Gyuhong Shim, Young Hwa Jung, Yunhee Oh, Chun Song Youn, Mi Jin Lee, Jisook Lee, Chang Hee Lee, Youngbin Jang, Yong Soo Jang, Gyu Chong Cho, Ju Sun Heo, Sung Phil Chung
Clin Exp Emerg Med 2026;13(Suppl 1):S10-S17.   Published online May 29, 2026
DOI: https://doi.org/10.15441/ceem.26.072

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2025 Korean Guidelines for Cardiopulmonary Resuscitation: Part 2. Current status of cardiac arrest and the chain of survival
Clin Exp Emerg Med. 2026;13(Suppl 1):S10-S17.   Published online May 29, 2026
DOI: https://doi.org/10.15441/ceem.26.072
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2025 Korean Guidelines for Cardiopulmonary Resuscitation: Part 2. Current status of cardiac arrest and the chain of survival
Clin Exp Emerg Med. 2026;13(Suppl 1):S10-S17.   Published online May 29, 2026
DOI: https://doi.org/10.15441/ceem.26.072
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In Korea, more than 30,000 out-of-hospital cardiac arrests (OHCAs) occur each year, and the survival rate remains below 10%. Because OHCA is difficult to predict and typically occurs outside medical facilities, effective management requires not only healthcare professionals but also laypersons, including bystanders and first responders. Survival depends on an uninterrupted and efficient sequence of time-critical actions: early recognition of cardiac arrest and activation of emergency services; prompt bystander cardiopulmonary resuscitation (CPR); use of an automated external defibrillator (AED) for shockable rhythms; on-scene and in-hospital advanced life support with comprehensive post–cardiac arrest care; and systematic assessment of neurologic and functional outcomes followed by rehabilitation and recovery. The chain of survival describes these essential steps required to maximize survival after cardiac arrest and comprises five links: (1) early recognition and call for help; (2) immediate bystander CPR; (3) early defibrillation with an AED; (4) advanced life support and post–cardiac arrest care; and (5) rehabilitation and recovery for survivors. The cardiac arrest survival environment represents a societal infrastructure that sustains and optimizes both medical and nonmedical factors across prevention, treatment, and rehabilitation to reduce mortality. Establishing such an environment requires each community to develop integrated medical systems for prevention, treatment, rehabilitation, and recovery, alongside nonmedical strategies, including public awareness initiatives, widespread CPR education and bystander participation, AED dissemination, and coordinated community responsiveness of the emergency medical system.
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Original Articles

Prognostic Significance of Admission Blood Glucose for 30-Day Survival and Neurological Outcomes in Non-Diabetic Out-of-Hospital Cardiac Arrest Patients: A Retrospective Cohort Study
Mei Li, Qinghui Hu, Lifeng Du
In Press, Received August 26, 2025  Accepted December 1, 2025  Available online April 3, 2026  
DOI: https://doi.org/10.15441/ceem.25.193    [Accepted]

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Prognostic Significance of Admission Blood Glucose for 30-Day Survival and Neurological Outcomes in Non-Diabetic Out-of-Hospital Cardiac Arrest Patients: A Retrospective Cohort Study
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Prognostic Significance of Admission Blood Glucose for 30-Day Survival and Neurological Outcomes in Non-Diabetic Out-of-Hospital Cardiac Arrest Patients: A Retrospective Cohort Study
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Objective
To investigate the association between admission blood glucose (BG) and 30-day survival and neurological outcomes in adult, non-diabetic out-of-hospital cardiac arrest (OHCA) patients with return of spontaneous circulation (ROSC).
Methods
We conducted a single-center retrospective cohort study (2014-2023) including 1,128 non-diabetic adults with OHCA who achieved ROSC. Patients were stratified by admission BG into four categories: <80 mg/dL, 80–179 mg/dL, 180–299 mg/dL, and ≥300 mg/dL. Primary outcomes were 30-day survival and favorable neurological status (Cerebral Performance Category [CPC] 1–2). Multivariable logistic regression models adjusted for major confounders (age, sex, initial rhythm, bystander CPR, call-to-arrival time, and extracorporeal CPR) using the 80–179 mg/dL group as the reference. Restricted cubic spline analyses explored potential nonlinear relationships between BG and outcomes.
Results
Patients with mild-to-moderate hyperglycemia (180–299 mg/dL) demonstrated the highest 30-day survival (14.7%) and favorable neurological outcome (10.8%) rates, compared with hypoglycemia (6.6% and 4.7%; both p < 0.05). In adjusted analyses, hypoglycemia (<80 mg/dL) and severe hyperglycemia (≥300 mg/dL) were associated with significantly lower odds of survival (adjusted odds ratio [aOR] = 0.41, 95% CI 0.21–0.79; and aOR = 0.69, 95% CI 0.52–0.91, respectively). Spline analysis revealed a U-shaped association, with optimal survival observed at 140–195 mg/dL.
Conclusion
Admission BG is an easily measurable prognostic biomarker in non-diabetic OHCA. Mild-to-moderate hyperglycemia was associated with the most favorable short-term outcomes, whereas both hypoglycemia and severe hyperglycemia predicted worse survival and neurological recovery.
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Critical Care

Renal dysfunction as a marker of adverse outcomes in early sepsis in the emergency department
Tamar J. van der Aart, Jan C. ter Maaten, Raymond J. van Wijk, Stephan J.L. Bakker, Hjalmar R. Bouma, Marco van Londen
Clin Exp Emerg Med 2026;13(2):178-187.   Published online January 28, 2026
DOI: https://doi.org/10.15441/ceem.25.136

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Renal dysfunction as a marker of adverse outcomes in early sepsis in the emergency department
Clin Exp Emerg Med. 2026;13(2):178-187.   Published online January 28, 2026
DOI: https://doi.org/10.15441/ceem.25.136
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Renal dysfunction as a marker of adverse outcomes in early sepsis in the emergency department
Clin Exp Emerg Med. 2026;13(2):178-187.   Published online January 28, 2026
DOI: https://doi.org/10.15441/ceem.25.136
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Objective
Sepsis is a leading cause of acute kidney injury (sepsis-associated acute kidney injury, SA-AKI) and is associated with multiorgan failure, cardiovascular events, and increased mortality. While research has generally focused on critically ill patients in intensive care units (ICUs), most sepsis cases are managed outside the ICU. This study investigated renal dysfunction as an early risk marker in patients presenting to the emergency department (ED) with severe infection and at risk for early sepsis. Methods This post hoc analysis of patients presenting to the ED used data from the Acutelines cohort (2020–2023). Kaplan-Meier curves and univariable and multivariable Cox regression analyses were performed to assess the association between AKI and all-cause mortality, as well as in-hospital mortality and cardiovascular death, adjusting for potential confounders. Results In total, 2,045 patients presented with sepsis at the ED, of whom 246 (12%) had AKI. The overall mortality rate was 25% over a median follow-up of 346 days. AKI was associated with higher all-cause mortality (38% vs. 26%; P<0.001). After adjustment for sex, age, comorbidities, and sepsis severity, AKI remained independently associated with all-cause mortality (hazard ratio [HR], 1.44; 95% confidence interval [CI], 1.14–1.82; P=0.003), in-hospital mortality (HR, 1.65; 95% CI, 1.16–2.34; P=0.006), and cardiovascular death (HR, 2.50; 95% CI, 1.39–4.48; P=0.001). Similar outcomes were observed in a subanalysis excluding ICU patients. Conclusion SA-AKI at ED presentation is independently associated with increased all-cause, in-hospital, and cardiovascular mortality. These findings underscore the need for earlier recognition across care settings and the implementation of structured follow-up to improve patient outcomes.

Citations

Citations to this article as recorded by  Crossref logo
  • Machine Learning-Based Subtype Classification of Sepsis-Associated Acute Kidney Injury and Differential Responses to Renal Replacement Therapy
    Hongkun Zhang, Shengzhi Wang, Tao Zhang, Baisen Wang, Ziqi Jiang, Zhenqi Guo
    Journal of Intensive Care Medicine.2026;[Epub]     CrossRef
  • 1,861 View
  • 65 Download
  • 1 Web of Science
  • 1 Crossref

Trauma

The impact of patient sex on survival after unintentional trauma in Korea: a retrospective, observational, case-control study
Seung Jin Maeng, Jongkyeong Kang, Myung Chun Kim, Han Zo Choi
Clin Exp Emerg Med 2023;10(3):296-305.   Published online June 2, 2023
DOI: https://doi.org/10.15441/ceem.23.002

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The impact of patient sex on survival after unintentional trauma in Korea: a retrospective, observational, case-control study
Clin Exp Emerg Med. 2023;10(3):296-305.   Published online June 2, 2023
DOI: https://doi.org/10.15441/ceem.23.002
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The impact of patient sex on survival after unintentional trauma in Korea: a retrospective, observational, case-control study
Clin Exp Emerg Med. 2023;10(3):296-305.   Published online June 2, 2023
DOI: https://doi.org/10.15441/ceem.23.002
Close
Objective
This study aimed to describe the relationship between sex and survival in patients experiencing unintentional trauma.
Methods
This retrospective, national population–based observational, case-control study involved a cohort of Korean trauma patients who were transferred to an emergency department by a Korean emergency medical service from January 1 to December 31, 2018. Propensity score matching was used. The primary outcome was survival until hospital discharge.
Results
Of 25,743 patients with severe unintentional trauma, 17,771 were male and 7,972 were female. Prior to propensity score matching, there was no significant difference in survival among male and female patients (92.6% vs. 93.1%, P=0.105). After using propensity score matching to adjust for confounders, there was still no sex difference in survival (male, 93.6% vs. female, 93.1%; P=0.270).
Conclusion
Survival after severe trauma was not influenced by the sex of the patient. Further studies with patients of reproductive age and a larger study population are needed to analyze the effects of sex on survival in patients with trauma.

Citations

Citations to this article as recorded by  Crossref logo
  • Trauma outcomes differences in females: a prospective analysis of 76 000 trauma patients in the Asia-Pacific region and the contributing factors
    Mohamad Iqhbal Bin Kunji Mohamad, Sabariah Faizah Jamaluddin, Norhaiza Ahmad, Arifah Bahar, Zarina Mohd Khalid, Nuraina Aqilah Binti Mohd Zaki, Nurul Azlean Norzan, Sang Do Shin, Goh E. Shaun, Wen-Chu Chiang, Kentaro Kajino, Kyoung Jun Song, Do Ngoc Son
    Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine.2025;[Epub]     CrossRef
  • 7,790 View
  • 131 Download
  • 1 Web of Science
  • 1 Crossref

Emergency Medical Services | Resuscitation

Association between the number of prehospital defibrillation attempts and neurologic outcomes in out-of-hospital cardiac arrest patients without on-scene return of spontaneous circulation
Seulki Choi, Tae Han Kim, Ki Jeong Hong, Joo Jeong, Young Sun Ro, Kyoung Jun Song, Sang Do Shin
Clin Exp Emerg Med 2021;8(1):21-29.   Published online March 31, 2021
DOI: https://doi.org/10.15441/ceem.20.069

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Association between the number of prehospital defibrillation attempts and neurologic outcomes in out-of-hospital cardiac arrest patients without on-scene return of spontaneous circulation
Clin Exp Emerg Med. 2021;8(1):21-29.   Published online March 31, 2021
DOI: https://doi.org/10.15441/ceem.20.069
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Association between the number of prehospital defibrillation attempts and neurologic outcomes in out-of-hospital cardiac arrest patients without on-scene return of spontaneous circulation
Clin Exp Emerg Med. 2021;8(1):21-29.   Published online March 31, 2021
DOI: https://doi.org/10.15441/ceem.20.069
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Objective
Delivery of prehospital defibrillation for shockable rhythms by emergency medical service providers is crucial for successful resuscitation in out-of-hospital cardiac arrest (OHCA) patients. The optimal range of prehospital defibrillation attempts for refractory shockable rhythms is unknown. This study evaluated the association between the number of prehospital defibrillation attempts and neurologic outcomes in OHCA patients.
Methods
A retrospective observational study was conducted using the nationwide OHCA registry. Adult OHCA patients who were treated by emergency medical service providers due to presumed cardiac origin with initial shockable rhythm were enrolled from 2013 to 2016. The final analysis was performed on patients without on-scene return of spontaneous circulation. The number of prehospital defibrillation attempts was categorized as follows: 2–3, 4–5, and ≥6 attempts. The primary outcome was a good neurologic recovery at hospital discharge. Multivariate logistic regression analysis was performed to evaluate the association between neurologic outcomes and the number of prehospital defibrillation attempts.
Results
A total of 4,513 patients were included in the final analysis. The numbers of patients for whom 2–3, 4–5, and ≥6 defibrillation attempts were made were 2,720 (60.3%), 1,090 (24.2%), and 703 (15.5%), respectively. Poorer outcomes were associated with ≥6 defibrillation attempts: survival to hospital discharge (adjusted odds ratio, 0.38; 95% confidence interval, 0.21–0.65) and good neurologic recovery (adjusted odds ratio, 0.42; 95% confidence interval, 0.21–0.84).
Conclusion
Six or more prehospital defibrillation attempts were associated with poorer neurologic outcomes in OHCA patients with an initial shockable rhythm who were unresponsive to on-scene defibrillation and resuscitation.

Citations

Citations to this article as recorded by  Crossref logo
  • Predicting defibrillation outcomes by combining ventricular fibrillation and defibrillation waveforms: a retrospective clinical study
    Liang Wei, Yushun Gong, Jianjie Wang, Bihua Chen, Changlin Yin, Yongqin Li
    Resuscitation.2026; 218: 110906.     CrossRef
  • Factors associated with shock-refractory prehospital cardiac arrest
    Kyung Hun Yoo, Byuk Sung Ko, Won Young Kim, Tae Ho Lim, Hyunggoo Kang, Jaehoon Oh, Juncheol Lee, Sang Kuk Han, Phil Cho Choi, Young Hwan Lee, Sang O. Park, Jong Seok Lee, Ki Young Jeong, Sung Hyuk Choi, Young Hoon Yoon, Su Jin Kim, Kap Su Han, Min Seob Si
    Scientific Reports.2025;[Epub]     CrossRef
  • Temporal trends in the incidence and outcomes of shock-refractory ventricular fibrillation out-of-hospital cardiac arrest
    Abdulrahman Alhenaki, Zainab Alqudah, Brett Williams, Emily Nehme, Ziad Nehme
    Resuscitation Plus.2024; 18: 100597.     CrossRef
  • Impact of sex and role of coronary artery disease in out-of-hospital cardiac arrest presenting with refractory ventricular arrhythmias
    Maria Luce Caputo, Enrico Baldi, Joel Daniel Krüll, Damiano Pongan, Ruggero Cresta, Claudio Benvenuti, Roberto Cianella, Roberto Primi, Alessia Currao, Sara Bendotti, Sara Compagnoni, Francesca Romana Gentile, Luciano Anselmi, Simone Savastano, Catherine
    Frontiers in Cardiovascular Medicine.2023;[Epub]     CrossRef
  • 7,982 View
  • 113 Download
  • 5 Web of Science
  • 4 Crossref

Resuscitation | Trauma

Prognostic factors related with outcomes in traumatic out-of-hospital cardiac arrest patients without prehospital return of spontaneous circulation: a nationwide observational study
Gwang Soo Jun, Jae Guk Kim, Hyun Young Choi, Gu Hyun Kang, Wonhee Kim, Yong Soo Jang, Hyun Tae Kim
Clin Exp Emerg Med 2020;7(1):14-20.   Published online March 31, 2020
DOI: https://doi.org/10.15441/ceem.19.057

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Prognostic factors related with outcomes in traumatic out-of-hospital cardiac arrest patients without prehospital return of spontaneous circulation: a nationwide observational study
Clin Exp Emerg Med. 2020;7(1):14-20.   Published online March 31, 2020
DOI: https://doi.org/10.15441/ceem.19.057
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Prognostic factors related with outcomes in traumatic out-of-hospital cardiac arrest patients without prehospital return of spontaneous circulation: a nationwide observational study
Clin Exp Emerg Med. 2020;7(1):14-20.   Published online March 31, 2020
DOI: https://doi.org/10.15441/ceem.19.057
Close
Objective
To evaluate the prognostic factors associated with the sustained return of spontaneous circulation (ROSC) and survival to hospital discharge in traumatic out-of-hospital cardiac arrest (TOHCA) patients without prehospital ROSC.

Methods
We analyzed Korean nationwide data from the Out-of-Hospital Cardiac Arrest Surveillance, and included adult TOHCA patients without prehospital ROSC from January 2012 to December 2016. The primary outcome was sustained ROSC (>20 minutes). The secondary outcome was survival to discharge. Multivariate analysis was performed to investigate factors associated with the outcomes of TOHCA patients.

Results
Among 142,905 cases of OHCA, 8,326 TOHCA patients were investigated. In multivariate analysis, male sex (odds ratio [OR], 1.326; 95% confidence interval [CI], 1.103–1.594; P=0.003), and an initial shockable rhythm (OR, 1.956; 95% CI, 1.113–3.439; P=0.020) were significantly associated with sustained ROSC. Compared with traffic crash, collision (OR, 1.448; 95% CI, 1.086–1.930; P=0.012) was associated with sustained ROSC. Fall (OR, 0.723; 95% CI, 0.589– 0.888; P=0.002) was inversely associated with sustained ROSC. Male sex (OR, 1.457; 95% CI, 1.026–2.069; P=0.035) and an initial shockable rhythm (OR, 4.724; 95% CI, 2.451–9.106; P<0.001) were significantly associated with survival to discharge. Metropolitan city (OR, 0.728; 95% CI, 0.541–0.980; P=0.037) was inversely associated with survival to discharge. Compared with traffic crash, collision (OR, 1.745; 95% CI, 1.125–2.708; P=0.013) was associated with survival to discharge.

Conclusion
Male sex, an initial shockable rhythm, and collision could be favorable factors for sustained ROSC, whereas fall could be an unfavorable factor. Male sex, non-metropolitan city, an initial shockable rhythm, and collision could be favorable factors in survival to discharge.

Citations

Citations to this article as recorded by  Crossref logo
  • Re-evaluating the traumatic cardiac arrest paradigm: the case for early rhythm assessment and targeted compressions
    A. A. Garner, R. Lynham
    Canadian Journal of Emergency Medicine.2026;[Epub]     CrossRef
  • Reporting of Utstein-recommended variables in prehospital traumatic cardiac arrest: a scoping review
    Saeed Khayat Kakhki, Majid Daneshfar, Alireza Namaei Qasemnia, Mehrdad Yousefnezhad, Matina Rajaee
    BMC Emergency Medicine.2026;[Epub]     CrossRef
  • Signs of life and clinical outcomes in patients with traumatic out-of-hospital cardiac arrest: a nationwide multicenter observational study
    Ikutaro Yamashita, Ryo Yamamoto, Masaru Suzuki, Nobuya Kitamura, Takashi Tagami, Hideo Yasunaga, Shotaro Aso, Munekazu Takeda, Tomoyoshi Tamura, Junichi Sasaki
    The Journal of Emergency Medicine.2026;[Epub]     CrossRef
  • Prehospital Management of Adults With Traumatic Out-of-Hospital Circulatory Arrest—A Joint Position Statement
    Amelia M. Breyre, Nicholas George, Alexander R. Nelson, Charles J. Ingram, Thomas Lardaro, Wayne Vanderkolk, John W. Lyng
    Annals of Emergency Medicine.2025; 85(3): e25.     CrossRef
  • Prehospital Trauma Compendium: Prehospital Management of Adults with Traumatic Out-of-Hospital Circulatory Arrest – A Joint Position Statement and Resource Document of NAEMSP, ACS-COT, and ACEP
    Amelia M. Breyre, Nicholas George, Alexander R. Nelson, Charles J. Ingram, Thomas Lardaro, Wayne Vanderkolk, John W. Lyng
    Prehospital Emergency Care.2025; : 1.     CrossRef
  • Prehospital factors of survival to hospital admission in blunt traumatic out-of-hospital cardiac arrest: a nationwide 11-year study
    Thanakorn Laksanamapune, Welawat Tienpratarn, Chaiyaporn Yuksen, Danaiporn Suktarom, Phunyapat Pankeaw, Irada Somawong, Sittichok Leela-Amornsin
    Resuscitation Plus.2025; 26: 101086.     CrossRef
  • Description of the Public Safety Medical Response and Patient Encounters Within and During the Indianapolis (USA) Spring 2020 Civil Unrest
    Thomas P. Arkins, Mark Liao, Daniel O’Donnell, Nancy Glober, Gregory Faris, Elizabeth Weinstein, Michael W. Supples, Julia Vaizer, Benton R. Hunter, Thomas Lardaro
    Prehospital and Disaster Medicine.2024; 39(1): 73.     CrossRef
  • Retrospective Evaluation of Falls From Height Cases Admitted to the Pre-Hospital Emergency Healthcare System
    Ramiz Yazıcı
    Anatolian Journal of Emergency Medicine.2024; 7(3): 127.     CrossRef
  • Traumatic cardiac arrest – a nationwide Danish study
    Signe Amalie Wolthers, Theo Walther Jensen, Niklas Breindahl, Louise Milling, Stig Nikolaj Blomberg, Lars Bredevang Andersen, Søren Mikkelsen, Christian Torp-Pedersen, Helle Collatz Christensen
    BMC Emergency Medicine.2023;[Epub]     CrossRef
  • Prehospital traumatic cardiac arrest: a systematic review and meta-analysis
    Niek Johannes Vianen, Esther Maria Maartje Van Lieshout, Iscander Michael Maissan, Wichor Matthijs Bramer, Dennis Den Hartog, Michael Herman Jacob Verhofstad, Mark Gerrit Van Vledder
    European Journal of Trauma and Emergency Surgery.2022; 48(4): 3357.     CrossRef
  • A novel scoring system using easily assessible predictors of return of spontaneous circulation and mortality in traumatic out-of-hospital cardiac arrest patients: A retrospective cohort study
    I-Ming Kuo, Yi-Fu Chen, Chih-Ying Chien, Yi-Wen Hong, Shih-Ching Kang, Chih-Yuan Fu, Chih-Po Hsu, Chien-Hung Liao, Chi-Hsun Hsieh
    International Journal of Surgery.2022; 104: 106731.     CrossRef
  • Characteristics and outcome of traumatic cardiac arrest at a level 1 trauma centre over 10 years in Sweden
    Daniel Ohlén, Magnus Hedberg, Paula Martinsson, Erik von Oelreich, Therese Djärv, Malin Jonsson Fagerlund
    Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine.2022;[Epub]     CrossRef
  • Association between emergency medical service transport time and survival in patients with traumatic cardiac arrest: a Nationwide retrospective observational study
    Hiromichi Naito, Tetsuya Yumoto, Takashi Yorifuji, Tsuyoshi Nojima, Hirotsugu Yamamoto, Taihei Yamada, Kohei Tsukahara, Mototaka Inaba, Takeshi Nishimura, Takenori Uehara, Atsunori Nakao
    BMC Emergency Medicine.2021;[Epub]     CrossRef
  • 8,988 View
  • 148 Download
  • 14 Web of Science
  • 13 Crossref
Impact of early coronary angiography on the survival to discharge after out-of-hospital cardiac arrest
Jikyoung Shin, Eunsil Ko, Won Chul Cha, Tae Rim Lee, Hee Yoon, Sung Yeon Hwang, Tae Gun Shin, Min Seob Sim, Ik Joon Jo, Keun Jeong Song, Joong Eui Rhee, Yeon Kwon Jeong, Jin-Ho Choi
Clin Exp Emerg Med 2017;4(2):65-72.   Published online June 30, 2017
DOI: https://doi.org/10.15441/ceem.16.167

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Impact of early coronary angiography on the survival to discharge after out-of-hospital cardiac arrest
Clin Exp Emerg Med. 2017;4(2):65-72.   Published online June 30, 2017
DOI: https://doi.org/10.15441/ceem.16.167
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Impact of early coronary angiography on the survival to discharge after out-of-hospital cardiac arrest
Clin Exp Emerg Med. 2017;4(2):65-72.   Published online June 30, 2017
DOI: https://doi.org/10.15441/ceem.16.167
Close
Objective
Acute myocardial infarction is a major cause of out-of-hospital cardiac arrest (OHCA). Coronary angiography (CAG) enables diagnostic confirmation of coronary artery disease and subsequent revascularization, which might improve the prognosis of OHCA survivors. Non-randomized data has shown a favorable impact of CAG on prognosis for this population. However, the optimal timing of CAG has been debated.
Methods
The clinical outcomes of 607 OHCA patients registered in CAPTURES (Cardiac Arrest Pursuit Trial with Unique Registration and Epidemiologic Surveillance), a nationwide multicenter registry performed in 27 hospitals, were analyzed. Early CAG was defined as CAG performed within 24 hours of emergency department admission. The primary outcome was survival to discharge, with neurologically favorable status defined by cerebral performance category scores ≤2.
Results
Compared to patients without CAG (n=469), patients who underwent early CAG (n=138) were younger, more likely to be male, and more likely to have received bystander cardiopulmonary resuscitation, pre-hospital defibrillation, and revascularization (P<0.01 for all). Analysis of 115 propensity score-matched pairs showed that early CAG is associated with a 2.3-fold increase in survival to discharge with neurologically favorable status (P<0.001, all). Survival to discharge increased consistently according to the time interval between emergency department visit and CAG (P<0.05).
Conclusion
Early CAG of OHCA patients was associated with better survival and favorable neurologic outcomes at discharge. However, there was no clear time threshold for CAG that predicted survival to discharge.

Citations

Citations to this article as recorded by  Crossref logo
  • Coronary Angiography in Patients With Out-of-Hospital Cardiac Arrest Without ST-Segment Elevation on Electrocardiograms: A Comprehensive Review
    Sachin Kumar, Bahaa Abdelghaffar, Meghana Iyer, Ghaith Shamaileh, Raunak Nair, Weili Zheng, Beni Verma, Venu Menon, Samir R. Kapadia, Grant W. Reed
    Journal of the Society for Cardiovascular Angiography & Interventions.2023; 2(1): 100536.     CrossRef
  • Impact of emergent coronary angiography after out-of-the-hospital cardiac arrest without ST-segment elevation – A systematic review and meta-analysis
    Nuno Alves, Mauro Mota, Madalena Cunha, Joana Maria Ribeiro
    International Journal of Cardiology.2022; 364: 1.     CrossRef
  • ST-Elevation Myocardial Infarction Complicated by Out-of-Hospital Cardiac Arrest
    Marinos Kosmopoulos, Jason A. Bartos, Demetris Yannopoulos
    Interventional Cardiology Clinics.2021; 10(3): 359.     CrossRef
  • 2020 Korean Guidelines for Cardiopulmonary Resuscitation. Part 5. Post-cardiac arrest care
    Young-Min Kim, Kyung Woon Jeung, Won Young Kim, Yoo Seok Park, Joo Suk Oh, Yeon Ho You, Dong Hoon Lee, Minjung Kathy Chae, Yoo Jin Jeong, Min Chul Kim, Eun Jin Ha, Kyoung Jin Hwang, Won-Seok Kim, Jae Myung Lee, Kyoung-Chul Cha, Sung Phil Chung, June Dong
    Clinical and Experimental Emergency Medicine.2021; 8(S): S41.     CrossRef
  • Post-cardiac arrest syndrome
    N.V. Bragina, T.G. Markova, V.I. Gorbachev
    Anesteziologiya i reanimatologiya.2021; (4): 140.     CrossRef
  • Gender difference in the clinical outcomes of patients with out-of-hospital cardiac arrest
    Gun Tak Lee, Sung Yeon Hwang, Ik Joon Jo, Tae Rim Kim, Hee Yoon, Won Chul Cha, Min Seob Sim, Sang Do Shin, Tae Gun Shin, Jin-Ho Choi
    Medicine.2021; 100(48): e27855.     CrossRef
  • Coronary Angiography in Patients With Out-of-Hospital Cardiac Arrest Without ST-Segment Elevation
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Case Report

Toxicology

A case of survival after chlorfenapyr intoxication with acute pancreatitis
Jae Eun Ku, Young Seon Joo, Je Sung You, Sung Phil Chung, Hahn Shick Lee
Clin Exp Emerg Med 2015;2(1):63-66.   Published online March 31, 2015
DOI: https://doi.org/10.15441/ceem.15.004

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A case of survival after chlorfenapyr intoxication with acute pancreatitis
Clin Exp Emerg Med. 2015;2(1):63-66.   Published online March 31, 2015
DOI: https://doi.org/10.15441/ceem.15.004
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A case of survival after chlorfenapyr intoxication with acute pancreatitis
Clin Exp Emerg Med. 2015;2(1):63-66.   Published online March 31, 2015
DOI: https://doi.org/10.15441/ceem.15.004
Close
Chlorfenapyr is a moderately hazardous insecticide. There have been previous reports of chlorfenapyr intoxication, but none have reported patient survival or an association with pancreatitis. A 61-year-old woman was brought to the emergency department with vomiting after ingesting 10 mL chlorfenapyr in a suicide attempt 1 hour before. The patient was treated with gastric lavage and activated charcoal, then transferred to the intensive care unit. Initial laboratory data were unremarkable except for elevated amylase/lipase levels (134/222 U/L), which were even higher 7 days later and remained elevated for 2 weeks. Abdominal computed tomography showed diffuse pancreatic swelling. The patient improved with conservative care and was discharged to home 19 days after admission. This is the first reported case of survival after chlorfenapyr intoxication. We recommend early aggressive management in the emergency department and close monitoring in the intensive care unit to detect and treat potentially fatal deterioration after chlorfenapyr intoxication.

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Original Article

Experimental study | Critical Care

Rapid rewarming after therapeutic hypothermia worsens outcome in sepsis
You Hwan Jo, Kyuseok Kim, Jae Hyuk Lee, Kwang Pil Rim, In Soo Cho
Clin Exp Emerg Med 2014;1(2):120-125.   Published online December 31, 2014
DOI: https://doi.org/10.15441/ceem.14.015

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Rapid rewarming after therapeutic hypothermia worsens outcome in sepsis
Clin Exp Emerg Med. 2014;1(2):120-125.   Published online December 31, 2014
DOI: https://doi.org/10.15441/ceem.14.015
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Rapid rewarming after therapeutic hypothermia worsens outcome in sepsis
Clin Exp Emerg Med. 2014;1(2):120-125.   Published online December 31, 2014
DOI: https://doi.org/10.15441/ceem.14.015
Close
Objective
This study was performed to investigate the effect of the rewarming rate on survival and acute lung injury in sepsis.
Methods
Male Sprague-Dawley rats underwent cecal ligation and incision. After 1 hour of sepsis induction, normothermia (37°C±0.5°C, NT group) or hypothermia (32°C±0.5°C) was induced. Hypothermia was maintained for 4 hours and rats were divided into two groups according to the rewarming rate: RW1 group, 1 hour of rewarming; and RW2 group, 2 hours of rewarming. In the survival study, rats were observed for 12 hours after sepsis induction (n=6 per group). In the second experiment, rats were sacrificed 7 hours after sepsis induction, and lung tissues and plasma were harvested (n=10 per group).
Results
In the survival study, the RW2 group survived longer than the RW1 group (P<0.05), but the RW1 and NT groups showed no significant difference in survival duration (P>0.05). The histological lung injury score and malondialdehyde concentrations in the lung tissues were significantly higher in the RW1 group than in the RW2 group (P<0.05). Plasma interleukin (IL)-6 concentration and the ratio of IL-6 to IL-10 were higher in the RW1 group than in the RW2 group (P<0.05).
Conclusion
Rapid rewarming after therapeutic hypothermia results in a shorter survival period and acute lung injury in sepsis, which could be associated with the inflammatory responses.

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  • 119 Download
  • 5 Web of Science
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Review Article

Critical Care

Early management of sepsis
Jean-Louis Vincent, Adriano José Pereira, James Gleeson, Daniel De Backer
Clin Exp Emerg Med 2014;1(1):3-7.   Published online September 30, 2014
DOI: https://doi.org/10.15441/ceem.14.005

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Early management of sepsis
Clin Exp Emerg Med. 2014;1(1):3-7.   Published online September 30, 2014
DOI: https://doi.org/10.15441/ceem.14.005
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Early management of sepsis
Clin Exp Emerg Med. 2014;1(1):3-7.   Published online September 30, 2014
DOI: https://doi.org/10.15441/ceem.14.005
Close

Increased awareness of the signs and symptoms of sepsis and an emphasis on the importance of early treatment have helped to improve survival rates from this serious and frequent condition in recent years. With no specific, effective anti-sepsis therapies available, management focuses on early source control with adequate and appropriate antibiotics and removal of any source of infection, rapid resuscitation, hemodynamic stabilization and organ support. Use of dedicated teams to care for patients with sepsis can help optimize early management.

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CEEM : Clinical and Experimental Emergency Medicine