Jisook Lee, Do Kyun Kim, Jin-Tae Kim, Jae Yoon Na, Bobae Park, Soo In Jeong, June Dong Park, Sung Phil Chung, Tae-Youn Kim, Youdong Sohn, Gyuhong Shim, Young Hwa Jung, Yunhee Oh, Chun Song Youn, Mi Jin Lee, Chang Hee Lee, Youngbin Jang, Yong Soo Jang, Gyu Chong Cho, Kyoung-Chul Cha, Ju Sun Heo, Sung Oh Hwang
Clin Exp Emerg Med 2026;13(Suppl 1):S101-S114. Published online May 31, 2026
Pediatric cardiac arrest primarily arises from asphyxia in infants and trauma in older children, contrasting with adult etiologies dominated by cardiac events. This underscores prevention as the cornerstone of pediatric basic life support, through injury mitigation like child restraint systems and water supervision, safe sleep practices including supine positioning on firm surfaces with caregiver smoking cessation to reduce sudden infant death syndrome, plus awareness of child abuse and adolescent suicide prevention. In hospitals, pediatric early warning systems (PEWS) enable early deterioration detection via vital sign scoring for timely intervention. Major updates in the 2025 pediatric basic life support guidelines reflect evidence-driven refinements. First, hospitals should implement PEWS to prompt rapid response teams for at-risk inpatients. Second, all rescuers (lay and healthcare providers) should employ the two-thumb encircling hands technique for infant chest compressions for optimal depth (about 4 cm), rate (100–120/min), and recoil; one-hand heel compression serves as backup if infeasible. Third, lay rescuers may apply automated external defibrillators for nontraumatic out-of-hospital cardiac arrest in children aged 1 year or older, prioritizing prompt attachment after initial cardiopulmonary resuscitation (CPR) cycles to address potential shockable rhythms. Fourth, for infant foreign body airway obstruction, alternate five back blows (over the spine between scapulae) with five chest thrusts (using heel-of-hand on sternum) until cleared or unresponsive, then transition to CPR. These updates aim to enhance bystander intervention, CPR quality, and survival with favorable neurologic outcomes in pediatric cardiac arrest.
Do Kyun Kim, Jin-Tae Kim, Jae Yoon Na, Bobae Park, Jisook Lee, Soo In Jeong, June Dong Park, Sung Phil Chung, Tae-Youn Kim, Youdong Sohn, Gyuhong Shim, Young Hwa Jung, Yunhee Oh, Chun Song Youn, Mi Jin Lee, Chang Hee Lee, Youngbin Jang, Yong Soo Jang, Gyu Chong Cho, Kyoung-Chul Cha, Ju Sun Heo, Sung Oh Hwang
Clin Exp Emerg Med 2026;13(Suppl 1):S115-S141. Published online May 31, 2026
The 2025 Korean pediatric advanced life support guideline update introduces clinically important revisions emphasizing airway strategy, physiologic resuscitation targets, post–cardiac arrest hemodynamics, neuroprotection, and extracorporeal support. In out-of-hospital pediatric cardiac arrest, bag-mask ventilation is now suggested over endotracheal intubation or supraglottic airway placement. In in-hospital arrest, evidence is insufficient to favor bag-mask ventilation versus advanced airways; however, endotracheal intubation or supraglottic airway insertion is reasonable when performed with minimal interruption or when bag-mask ventilation is ineffective. For patients with an advanced airway in place, age-adjusted ventilation rates are proposed to avoid hypoventilation and hyperventilation: 30/min (<1 yr), 20–30/min (1–8 yr), and 10–20/min (8–18 yr in healthcare settings). When invasive arterial monitoring is available during in-hospital cardiac arrest, target diastolic blood pressure is ≥25 mmHg in infants and ≥30 mmHg in children ≥1 year. After return of spontaneous circulation, systolic blood pressure during the first 6 hours should be maintained above the age-specific 10th percentile. Neuroprognostication should be multimodal, incorporating serial examinations, electroencephalography (up to 72 hours), early computed tomography (<24 hours), magnetic resonance imaging (72 hours to 2 weeks), lactate trends, and pupillary reflexes. Extracorporeal cardiopulmonary resuscitation (CPR) is limited to appropriately resourced hospitals and may be considered for selected in-hospital arrests (e.g., cardiac disease) unresponsive to conventional CPR; evidence remains insufficient for out-of-hospital use. These revisions shift pediatric resuscitation toward physiology-guided, resource-stratified, and neuroprotective care.
Yunhee Oh, Youdong Sohn, Mi Jin Lee, Sang-Hoon Na, Jundong Moon, Heeje Yun, Hoon Jung, Chang Hee Lee, Sung Phil Chung, Do Kyun Kim, Tae-Youn Kim, Gyuhong Shim, Young Hwa Jung, Chun Song Youn, Jisook Lee, Youngbin Jang, Yong Soo Jang, Gyu Chong Cho, Kyoung-Chul Cha, Ju Sun Heo, Sung Oh Hwang
Clin Exp Emerg Med 2026;13(Suppl 1):S169-S184. Published online May 31, 2026
The 2025 Korean education and system implementation guidelines were updated using a structured evidence evaluation process and recent systematic reviews. The guidelines present a comprehensive update that aims to bridge the gap between educational theory and clinical performance and emphasize the transition toward high-fidelity, field-based training environments through the implementation of in situ simulation and rapid cycle deliberate practice to foster automaticity in high-quality cardiopulmonary resuscitation (CPR) and team coordination. The integration of real-time feedback devices during training and the adoption of structured “hot” and “cold” debriefing to maximize learning outcomes are critical shifts in this update. Furthermore, these guidelines enhance teamwork competency by recommending the integration of a dedicated CPR coach within the hospital code team. Despite acknowledging the potential of digital health, a cautious approach toward gamified and blended learning is maintained. The guidelines prioritize face-to-face instruction to ensure psychomotor proficiency. From a policy perspective, the 2025 update removes the prehospital termination of resuscitation criteria in alignment with domestic legal constraints and social consensus. In addition to context-based training strategies within hospitals, we discussed the mandatory age for CPR training. We also added recommendations to address the “decoupling” between high automated external defibrillator awareness and low bystander utilization rates in the prehospital setting. In conclusion, the 2025 Korean guidelines emphasize repetitive, evidence-based educational methods and systematic policy refinements to enhance resuscitation quality and survival outcomes across clinical and community settings.
Yong Soo Jang, Gyu Chong Cho, Youngsuk Cho, Sun Gyoung Na, 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, Sung Phil Chung, Kyoung-Chul Cha, Ju Sun Heo, Sung Oh Hwang
Clin Exp Emerg Med 2026;13(Suppl 1):S18-S31. Published online May 31, 2026
The 2025 Korean basic life support guidelines are evidence-based treatment recommendations for basic cardiopulmonary resuscitation (CPR). The 2025 guidelines recommend that after checking the response of a patient suspected of cardiac arrest, call 119 (emergency medical services) immediately and request an automated external defibrillator (AED) before performing procedures to confirm cardiac arrest, such as checking breathing. There is currently insufficient evidence into the clinical effectiveness of dispatcher actively instructing individuals who report an emergency to retrieve and use an AED, but one observational study reported an increase in some survival rates. The guidelines recommend that lay rescuers and emergency medical personnel who have been trained in and are willing to perform artificial ventilation should apply standard CPR including artificial ventilation, and that lay rescuers who are not trained in or do not want to perform artificial ventilation should perform compression-only CPR. The guidelines emphasize high-quality CPR, including effective chest compressions and ventilation. The application of a rapid AED is continuously emphasized, and the anterolateral positioning method is recommended as a priority for ease of application. Healthcare workers are recommended to perform standard CPR with a compression to ventilation ratio of 30:2 for patients suspected of having a high-risk pathogen infection and to wear appropriate personal protective equipment, including a mask or respirator appropriate for the suspected pathogen, gloves, a gown, and eye protection.
Ju Sun Heo, Young Hwa Jung, Ai-Rhan Ellen Kim, Gyuhong Shim, Su Jin Cho, Jung Hyun Lee, Hyun-Joo Seol, Gi-Su Lee, Ah-Young Oh, Hye Jin Myung, Sung Phil Chung, Do Kyun Kim, Tae-Youn Kim, Youdong Sohn, Yunhee Oh, Chun Song Youn, Mi Jin Lee, Jisook Lee, Chang Hee Lee, Youngbin Jang, Yong Soo Jang, Gyu Chong Cho, Kyoung-Chul Cha, Sung Oh Hwang
Clin Exp Emerg Med 2026;13(Suppl 1):S142-S168. Published online May 31, 2026
The 2025 Korean Guidelines for Cardiopulmonary Resuscitation provide updated, evidence-based recommendations to optimize the transition from intrauterine to extrauterine life. While approximately 85% of term newborns initiate spontaneous breathing independently, timely intervention is critical for those requiring assistance. Key updates in the 2025 guidelines emphasize umbilical cord management, recommending deferred cord clamping for at least 60 seconds in vigorous term and preterm infants (<37 weeks). When deferred cord clamping cannot be performed, intact umbilical cord milking may be reasonable for nonvigorous term and late preterm infants (≥35 weeks’ gestation) and for preterm infants born between 28⁰⁄₇ and 36⁶⁄₇ weeks’ gestation who do not require immediate resuscitation. Respiratory support should be initiated within the "golden minute," starting with 21% oxygen for term and late preterm infants (≥35 weeks) and ≥30% for those <32 weeks’ gestation. The guidelines introduce video laryngoscopy as a preferred tool for less experienced providers and recognize supraglottic airways as a viable alternative to face masks or when intubation fails. For advanced resuscitation, a compression to ventilation ratio of 3:1 is maintained, with intravascular epinephrine (0.01–0.03 mg/kg) as the primary pharmacologic intervention. Notably, the use of sodium bicarbonate is no longer recommended. Discussions regarding the discontinuation of resuscitation are now suggested at approximately 20 minutes after birth if no response is observed. These guidelines aim to standardize clinical practice in Korea to improve neonatal survival and long-term neurodevelopmental outcomes.
Hyo Jin Bang, Chun Song Youn, Min Chul Kim, Yongwhan Lim, Young-Jae Cho, Bitna Chu, June-Sung Kim, Youn-Jung Kim, Byoung-Gil Yoon, Jin Park, Min-Ju Kang, Kyung Woon Jeung, Soo Hyun Kim, Je Hyeok Oh, Taegyun Kim, Sang Hoon Oh, Yong Soo Kim, Changshin Kang, Dong Hun Lee, Jin Hong Min, Hyo Joon Kim, Do Kyun Kim, Tae-Youn Kim, Youdong Sohn, Gyuhong Shim, Young Hwa Jung, Yunhee Oh, Mi Jin Lee, Jisook Lee, Chang Hee Lee, Youngbin Jang, Yong Soo Jang, Gyu Chong Cho, Kyoung-Chul Cha, Ju Sun Heo, Sung Oh Hwang, Sung Phil Chung
Clin Exp Emerg Med 2026;13(Suppl 1):S75-S100. Published online May 31, 2026
This guideline summarizes evidence-based post–cardiac arrest care following the return of spontaneous circulation (ROSC) in adults, incorporating updates from the 2025 Korean Guidelines for Cardiopulmonary Resuscitation and contemporary international evidence. Recommendations were informed by recent randomized controlled trials and systematic reviews, with an emphasis on patient-centered outcomes and practical clinical applications. After ROSC, early evaluation should focus on identifying reversible causes. A 12-lead electrocardiogram should be obtained promptly, with echocardiography and whole-body computed tomography performed when clinically indicated to assess cardiac function and detect noncardiac or occult etiologies. Respiratory management aims to minimize secondary brain injury by preventing hypoxemia and hyperoxemia. High inspired oxygen concentrations may be used initially, followed by titration to an appropriate oxygen saturation level once reliable measurements are available, and ventilation should target normocapnia. Hemodynamic management prioritizes adequate organ perfusion and prompt treatment of shock, including active correction of hypotension. Routine immediate coronary angiography is not recommended in patients without ST-segment elevation. However, urgent angiography is indicated in those with ST-segment elevation, cardiogenic shock, or a high likelihood of ongoing myocardial ischemia. In comatose survivors, temperature control is essential. The selected target temperature should be maintained for at least 24 hours, with active fever prevention for 36 to 72 hours. Additional intensive care unit management includes glucose control and seizure monitoring. Routine prophylactic antibiotics or anticonvulsants are not recommended. Neuroprognostication should use a multimodal approach after confounders, such as sedation and temperature management, are addressed, integrating clinical examination, electrophysiology, biomarkers, and neuroimaging to support individualized decision-making.
Tae-Youn Kim, Gyo Jin Ahn, Kyoung-Chul Cha, Dong-Hyeok Kim, Youdong Sohn, Young Song, Gyuhong Shim, Do Kyun Kim, Yunhee Oh, Jin Wi, Chun Song Youn, Myung-Lyeol Lee, Mi Jin Lee, Byung Kook Lee, Byung Heon Lee, Jisook Lee, Chang Hee Lee, Hannah Lee, Youngbin Jang, Yong Soo Jang, Young Hwa Jung, Woo Jin Jung, Sung Phil Chung, Gyu Chong Cho, Ju Sun Heo, Sung Oh Hwang
Clin Exp Emerg Med 2026;13(Suppl 1):S61-S74. Published online May 31, 2026
The 2025 update of the Korean guidelines for cardiac arrest under special circumstances incorporates new evidence and expert consensus to clarify when clinicians should modify standard resuscitation algorithms. For cardiac arrest caused by acute hyperkalemia, the guidelines suggest administering intravenous insulin with glucose; however, current evidence remains insufficient to recommend for or against routine use of sodium bicarbonate or calcium. In suspected pulmonary embolism–related cardiac arrest, thrombolytic therapy may be considered. In confirmed cases, thrombolysis, surgical embolectomy, or percutaneous mechanical thrombectomy may be appropriate, despite very low certainty of evidence. For opioid-related cardiac arrest, current evidence does not support the routine administration of naloxone in addition to standard advanced life support; however, naloxone may be administered when it is unclear whether the patient is in true cardiac arrest. The guidelines also emphasize managing cardiac arrest in the prone position. If the patient is intubated and immediate repositioning is unsafe or impractical, prone cardiopulmonary resuscitation and defibrillation may be attempted using invasive arterial pressure or end-tidal carbon dioxide monitoring to guide the timing of repositioning. Immediate supination is strongly recommended for non-intubated patients. Additional updates address drowning, severe hypothermia, pregnancy, anaphylaxis, and cardiac arrest during interventional procedures, underscoring the importance of early correction of reversible causes, appropriate airway strategies, and timely consideration of extracorporeal life support in selected cases. Overall, the 2025 recommendations highlight cautious, etiology-directed interventions and explicitly grade recommendation strength and certainty to support context-sensitive clinical decision-making in high-risk and resource-variable settings.
Tae-Youn Kim, Gyo Jin Ahn, Kyoung-Chul Cha, Dong-Hyeok Kim, Youdong Sohn, Young Song, Gyuhong Shim, Do Kyun Kim, Yunhee Oh, Jin Wi, Chun Song Youn, Myung-Lyeol Lee, Mi Jin Lee, Byung Kook Lee, Byung Heon Lee, Jisook Lee, Chang Hee Lee, Hannah Lee, Youngbin Jang, Yong Soo Jang, Young Hwa Jung, Woo Jin Jung, Sung Phil Chung, Gyu Chong Cho, Ju Sun Heo, Sung Oh Hwang
Clin Exp Emerg Med 2026;13(Suppl 1):S32-S60. Published online May 31, 2026
The 2025 Korean advanced life support guidelines were updated using a structured evidence evaluation process informed by recent randomized controlled trials and systematic reviews. The guideline development group prioritized patient-important outcomes and assessed the certainty of the evidence to formulate graded recommendations. For drug administration during adult cardiac arrest, intravenous access is the preferred initial route, with intraosseous access recommended when intravenous access cannot be rapidly established. Epinephrine remains the recommended vasopressor. Routine administration of vasopressin, either alone or in combination with corticosteroids, is not recommended for in-hospital or out-of-hospital cardiac arrest. In the absence of specific indications, the routine use of buffering agents and calcium is discouraged owing to insufficient evidence of their benefits and potential harm. Defibrillation recommendations were refined based on emerging evidence. In adults with refractory ventricular fibrillation or pulseless ventricular tachycardia after multiple unsuccessful defibrillation attempts, vector change or double sequential defibrillation may be considered in selected settings when performed by experienced teams with appropriate equipment. Airway management guidelines recommend cricothyroidotomy as a rescue technique when conventional airway management strategies fail. For patients receiving cardiopulmonary resuscitation while on mechanical ventilation, specific ventilator settings during chest compressions are recommended to optimize ventilation and minimize interference with high-quality cardiopulmonary resuscitation. The guidelines also address cardiopulmonary resuscitation–induced consciousness, allowing the cautious use of sedatives and/or analgesic agents when awareness interferes with resuscitation quality or safety. Overall, the guidelines emphasize evidence-based practice and individualized clinical decision-making.
Seon Hee Woo, Chang Hee Lee, Mi Yeon Kim, Yongin Kim, Chang Je Park, Myung-Lyeol Lee, Taehun Lee, Kyeongmin Jang, Jun-Ho Jung, Hyun-Kyung Ji, Sung Phil Chung, Do Kyun Kim, Tae-Youn Kim, Youdong Sohn, Gyuhong Shim, Young Hwa Jung, Yunhee Oh, Chun Song Youn, Mi Jin Lee, Jisook Lee, Youngbin Jang, Yong Soo Jang, Gyu Chong Cho, Kyoung-Chul Cha, Ju Sun Heo, Sung Oh Hwang
Clin Exp Emerg Med 2026;13(Suppl 1):S185-S194. Published online May 29, 2026
The 2025 Korean Guidelines for Cardiopulmonary Resuscitation include a first aid section developed through a systematic review and evidence appraisal. The revision aimed to strengthen prehospital first aid response capacity while reflecting the Korean healthcare system, field feasibility, and relevant legal and institutional contexts. The guidelines provide evidence-based recommendations for seven priority emergencies: adult chest pain suggestive of myocardial infarction, suspected acute ischemic stroke, asthma-related dyspnea, anaphylaxis, seizures, shock, and syncope. Core principles emphasize early recognition, prompt activation of emergency medical services, minimizing delays to definitive care, and safe condition-specific interventions. Key recommendations include assisting with patient-prescribed medications when appropriate (e.g., nitroglycerin, inhaled bronchodilators, and epinephrine autoinjectors), using structured stroke screening tools, preventing aspiration through proper positioning and withholding oral intake in patients at risk of dysphagia, administering oxygen only for hypoxemia, and initiating cardiopulmonary resuscitation in patients who are unconscious and not breathing normally. Seizure management focuses on safety and emergency medical services activation criteria, while care for shock and syncope emphasizes patient positioning and post-event assessment. These recommendations provide practical, evidence-based guidance for improving patient safety and outcomes in prehospital settings.
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
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.
Sung Phil Chung, 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, Kyoung-Chul Cha, Ju Sun Heo, Sung Oh Hwang
Clin Exp Emerg Med 2026;13(Suppl 1):S1-S9. Published online May 21, 2026
In response to the expanding body of research on cardiopulmonary resuscitation (CPR) and updates from the International Liaison Committee on Resuscitation, the 2020 Korean CPR guidelines have been revised. This article presents the development process and summarizes the major updates in the 2025 Korean CPR guidelines. Seven task forces were established, with members nominated by professional societies involved in CPR. Each task force formulated key clinical questions and conducted systematic evidence reviews using the GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) methodology. The 2025 CPR guidelines were finalized on the basis of the reviewed evidence and consensus discussions. The major updates are as follows: (1) addition of rehabilitation and recovery to the chain of survival; (2) inclusion of guidance for dispatchers on the use of automated external defibrillators; (3) recommendation that trained rescuers provide rescue breaths in cases of drowning-related cardiac arrest; (4) suggestion of double sequential defibrillation or vector-change defibrillation for refractory ventricular fibrillation; (5) revision of the target temperature range for post-resuscitation temperature management from 32–36 to 33–37.5 °C; (6) recommendation of public access defibrillation for children aged ≥1 year; (7) suggestion to use supraglottic airway devices and video laryngoscopy in neonatal resuscitation; (8) recommendation for the use of feedback devices in CPR training; and (9) addition of a first aid section addressing cardiac arrest–related emergencies. These guidelines reflect the most current evidence, and their implementation and dissemination are expected to improve survival after cardiac arrest.
Soo Hyun Kim, Kyu Nam Park, Chun Song Youn, Minjung Kathy Chae, Won Young Kim, Byung Kook Lee, Dong Hoon Lee, Tae Chang Jang, Jae Hoon Lee, Yoon Hee Choi, Je Sung You, In Soo Cho, Su Jin Kim, Jong-Seok Lee, Yong Hwan Kim, Min Seob Sim, Jonghwan Shin, Yoo Seok Park, Young Hwan Lee, HyungJun Moon, Won Jung Jeong, Joo Suk Oh, Seung Pill Choi, Kyoung-Chul Cha, Korean Hypothermia Network investigators
Clin Exp Emerg Med 2020;7(4):250-258. Published online December 31, 2020
Objective High-quality intensive care, including targeted temperature management (TTM) for patients with postcardiac arrest syndrome, is a key element for improving outcomes after out-of-hospital cardiac arrest (OHCA). We aimed to assess the status of postcardiac arrest syndrome care, including TTM and 6-month survival with neurologically favorable outcomes, after adult OHCA patients were treated with TTM, using data from the Korean Hypothermia Network prospective registry.
Methods We used the Korean Hypothermia Network prospective registry, a web-based multicenter registry that includes data from 22 participating hospitals throughout the Republic of Korea. Adult comatose OHCA survivors treated with TTM between October 2015 and December 2018 were included. The primary outcome was neurological outcome at 6 months.
Results Of the 1,354 registered OHCA survivors treated with TTM, 550 (40.6%) survived 6 months, and 413 (30.5%) had good neurological outcomes. We identified 839 (62.0%) patients with preClinsumed cardiac etiology. A total of 937 (69.2%) collapses were witnessed, shockable rhythms were demonstrated in 482 (35.6%) patients, and 421 (31.1%) patients arrived at the emergency department with prehospital return of spontaneous circulation. The most common target temperature was 33°C, and the most common target duration was 24 hours.
Conclusion The survival and good neurologic outcome rates of this prospective registry show great improvements compared with those of an earlier registry. While the optimal target temperature and duration are still unknown, the most common target temperature was 33°C, and the most common target duration was 24 hours.
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External validation of the 2020 ERC/ESICM prognostication strategy algorithm after cardiac arrest Chun Song Youn, Kyu Nam Park, Soo Hyun Kim, Byung Kook Lee, Tobias Cronberg, Sang Hoon Oh, Kyung Woon Jeung, In Soo Cho, Seung Pill Choi Critical Care.2022;[Epub] CrossRef
Effects of Sodium Nitroprusside Administered Via a Subdural Intracranial Catheter on the Microcirculation, Oxygenation, and Electrocortical Activity of the Cerebral Cortex in a Pig Cardiac Arrest Model Hyoung Youn Lee, Yong Hun Jung, Najmiddin Mamadjonov, Kyung Woon Jeung, Min Chul Kim, Kyung Seob Lim, Chang‐Yeop Jeon, Youngjeon Lee, Hyung Joong Kim Journal of the American Heart Association.2022;[Epub] CrossRef
The association of different target temperatures in targeted temperature management with neurological outcome after out-of-hospital cardiac arrest based on a prospective multicenter observational study in Korea (the KORHN-PRO registry): IPTW analysis Hyo Joon Kim, Chun Song Youn, Kyu Nam Park, Young-Min Kim, Byung Kook Lee, Kyung Woon Jeung, Won Young Kim, Seung Pill Choi, Soo Hyun Kim, Jignesh K. Patel PLOS ONE.2022; 17(7): e0271605. CrossRef
Association between insulin administration method and six-month neurological outcome in survivors of out-of-hospital cardiac arrest who underwent targeted temperature management Dong Hun Lee, Byung Kook Lee, Yong Soo Cho, Yong Hun Jung, Hyoung Youn Lee, Kyung Woon Jeung, Chun Song Youn, Soo Hyun Kim, Simone Savastano PLOS ONE.2022; 17(12): e0279776. CrossRef
Augmented-Medication CardioPulmonary Resuscitation (AMCPR) trial: a study protocol for a randomized controlled trial Dong Kun Oh, June-sung Kim, Seung Mok Ryoo, Youn-Jung Kim, Sang Min Kim, Seok In Hong, Bora Chae, Won Young Kim Clinical and Experimental Emergency Medicine.2022; 9(4): 361. CrossRef
Cardiopulmonary Resuscitation and Rescue Therapies Heidi J. Dalton, Robert A. Berg, Vinay M. Nadkarni, Patrick M. Kochanek, Samuel A. Tisherman, Ravi Thiagarajan, Peta Alexander, Robert H. Bartlett Critical Care Medicine.2021; 49(9): 1375. CrossRef
Objective The National Early Warning Score (NEWS), based on the patients’ vital signs, detects clinical deterioration in critically ill patients and is used to reduce the incidence of in-hospital cardiac arrest. However, although mortality prediction based on vital signs may be difficult in older patients, the effectiveness of the NEWS has not yet been evaluated in this population. This study aimed to test the hypothesis that an elevated NEWS at admission increases the mortality risk in older patients admitted to the emergency department (ED).
Methods We conducted a single-center retrospective study, including patients admitted to the ED between November 2016 and February 2017. We included patients aged >65 years who were admitted to the ED for any medical problem. The NEWS was calculated at the time of ED admission. The primary outcome was in-hospital mortality.
Results In total, 3,169 patients were included in this study. Median age was 75 years (interquartile range [IQR], 70 to 80 years), and 1,557 (49.1%) patients were male. The in-hospital mortality rate was 5.1% (161 patients). Median NEWS was higher in non-survivors than in survivors (5 [IQR, 3–8] vs. 1 [IQR, 0–3], P<0.001). Multivariate logistic analysis showed that the NEWS was associated with in-hospital mortality, after adjusting for other confounders. The area under the curve of the NEWS for predicting in-hospital mortality was 0.820 (95% confidence interval, 0.806 to 0.833).
Conclusion Our results show that the NEWS at admission is associated with in-hospital mortality among patients aged >65 years.
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Objective The objective of this study was to test the hypothesis that hemoglobin concentration after return of spontaneous circulation (ROSC) is associated with neurologic outcome after cardiac arrest in patients treated with targeted temperature management.
Methods We studied consecutive adult patients with out-of-hospital cardiac arrest treated with targeted temperature management between January 2009 and December 2015. We quantified the association between post ROSC hemoglobin concentrations and good neurologic outcome (defined as Cerebral Performance Category of 1 and 2) at hospital discharge using multivariate logistic regression analysis.
Results A total of 246 subjects were ultimately included in this study. The mean age was 54 years (standard deviation, 17); 168 (68%) subjects were male. Eighty-seven (35%) subjects had a good neurologic outcome at hospital discharge. Hemoglobin concentrations were higher in the good outcome group than in the poor outcome group (14.4±2.0 vs. 12.8±2.5 g/dL, P<0.001). Multivariate logistic regression analysis showed that hemoglobin concentrations were associated with good neurologic outcome at hospital discharge after adjusting for other confounding factors (adjusted odds ratio, 1.186; 95% confidence interval, 1.008 to 1.395).
Conclusion These results show that hemoglobin concentrations after ROSC are associated with neurologic outcome at hospital discharge. Future research to examine the association between hemoglobin levels and neurologic outcome after cardiac arrest is warranted.
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PROLOGUE (PROgnostication using LOGistic regression model for Unselected adult cardiac arrest patients in the Early stages): Development and validation of a scoring system for early prognostication in unselected adult cardiac arrest patients Dae Hee Bae, Hyoung Youn Lee, Yong Hun Jung, Kyung Woon Jeung, Byung Kook Lee, Chun Song Youn, Byung Soo Kang, Tag Heo, Yong Il Min Resuscitation.2021; 159: 60. CrossRef
Change of Hemoglobin Levels in the Early Post-cardiac Arrest Phase Is Associated With Outcome Christoph Schriefl, Christian Schoergenhofer, Florian Ettl, Michael Poppe, Christian Clodi, Matthias Mueller, Juergen Grafeneder, Bernd Jilma, Ingrid Anna Maria Magnet, Nina Buchtele, Magdalena Sophie Boegl, Michael Holzer, Fritz Sterz, Michael Schwameis Frontiers in Medicine.2021;[Epub] CrossRef
Glycated Hemoglobin is Associated with Glycemic Control and 6-Month Neurologic Outcome in Cardiac Arrest Survivors Undergoing Therapeutic Hypothermia Byung Kook Lee, Dong Hun Lee, Kyung Woon Jeung, Seong-Woo Yun, Clifton W. Callaway, Jon C. Rittenberger Neurocritical Care.2020; 32(2): 448. CrossRef
Patrick J. Coppler, Benjamin S. Abella, Clifton W. Callaway, Minjung Kathy Chae, Seung Pill Choi, Jonathan Elmer, Won Young Kim, Young-Min Kim, Michael Kurz, Joo Suk Oh, Joshua C. Reynolds, Jon C. Rittenberger, Kelly N. Sawyer, Chun Song Youn, Byung Kook Lee, David F. Gaieski, on behalf of the Korean Hypothermia Network Investigators and the National Post-Arrest Research Consortium
Clin Exp Emerg Med 2018;5(2):100-106. Published online April 30, 2018
Objective A growing interest in extracorporeal cardiopulmonary resuscitation (ECPR) as a rescue strategy for refractory adult out-of-hospital cardiac arrest (OHCA) currently exists. This study aims to determine current standards of care and practice variation for ECPR patients in the USA and Korea.
Methods In December 2015, we surveyed centers from the Korean Hypothermia Network (KORHN) Investigators and the US National Post-Arrest Research Consortium (NPARC) on current targeted temperature management and ECPR practices. This project analyzes the subsection of questions addressing ECPR practices. We summarized survey results using descriptive statistics.
Results Overall, 9 KORHN and 4 NPARC centers reported having ECPR programs and had complete survey data available. Two KORHN centers utilized extracorporeal membrane oxygenation only for postarrest circulatory support in patients with refractory shock and were excluded from further analysis. Centers with available ECPR generally saw a high volume of OHCA patients (10/11 centers care for >75 OHCA a year). Location of, and providers trained for cannulation varied across centers. All centers in both countries (KORHN 7/7, NPARC 4/4) treated comatose ECPR patients with targeted temperature management. All NPARC centers and four of seven KORHN centers reported having a standardized hospital protocol for ECPR. Upper age cutoff for eligibility ranged from 60 to 75 years. No absolute contraindications were unanimous among centers.
Conclusion A wide variability in practice patterns exist between centers performing ECPR for refractory OHCA in the US and Korea. Standardized protocols and shared research databases might inform best practices, improve outcomes, and provide a foundation for prospective studies.
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Objective The objective of this study was to test the hypothesis that an elevated high-sensitivity C-reactive protein (hs-CRP)/albumin ratio at admission increases the risk of mortality in older patients admitted to the hospital via the emergency department (ED).
Methods We performed a retrospective analysis of patients admitted to the ED with any medical problem between May 2013 and October 2013 who were older than 65 years. The hs-CRP and albumin levels were measured at the time of admission to the ED. The primary outcome was all-cause in-hospital mortality. Multivariate logistic analysis was performed.
Results A total of 811 patients were finally included in this study. The mean age was 76±7 years, and 438 subjects (54%) were male. The in-hospital mortality rate was 9.0% (73 patients). The hs-CRP/albumin ratio was higher in nonsurvivors than in survivors (34.2±37.6 vs. 16.2±25.5, P<0.001). Multivariate logistic analysis showed that the hs-CRP/albumin ratio was associated with all-cause in-hospital mortality after adjusting for other confounding factors (odds ratio, 1.011; 95% confidence interval [CI], 1.003 to 1.020). The prognostic value of the hs-CRP/albumin ratio for predicting mortality (area under the curve, 0.728; 95% CI, 0.696 to 0.758) was greater than that of hs-CRP alone (area under the curve, 0.706; 95% CI, 0.674 to 0.738; P<0.001).
Conclusion The hs-CRP/albumin ratio at admission to the ED is associated with all-cause in-hospital mortality among patients older than 65 years. The hs-CRP/albumin ratio may serve as a surrogate marker of disease severity.
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The C-reactive protein Albumin ratio was not consistently associated with cardiovascular and all-cause mortality in two community-based cohorts of 70-year-olds Per Wändell, Axel Carl Carlsson, Anders Larsson, Johan Ärnlöv, Tobias Feldreich, Toralph Ruge Scandinavian Journal of Clinical and Laboratory Investigation.2023; 83(7): 439. CrossRef
Prognostic Usefulness of Basic Analytical Data in Chronic Obstructive Pulmonary Disease Exacerbation Sandra Martínez-Gestoso, María-Teresa García-Sanz, José-Martín Carreira, Juan-José Nieto-Fontarigo, Uxío Calvo-Álvarez, Liliana Doval-Oubiña, Sandra Camba-Matos, Lorena Peleteiro-Pedraza, Iria Roibás-Veiga, Francisco-Javier González-Barcala Open Respiratory Archives.2023; 5(4): 100271. CrossRef
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Lower Plasma Albumin, Higher White Blood Cell Count and High-Sensitivity C-Reactive Protein are Associated with Femoral Artery Intima-Media Thickness Among Newly Diagnosed Patients with Type 2 Diabetes Mellitus Nga Phi Thi Nguyen, Thuc Luong Cong, Thi Thanh Hoa Tran, Binh Nhu Do, Son Tien Nguyen, Binh Thanh Vu, Lan Ho Thi Nguyen, Manh Van Ngo, Hoa Trung Dinh, Hoang Duong Huy, Nghia Xuan Vu, Kien Nguyen Trung, Duong Ngoc Vu, Nghia The Pham, Tuan Dinh Le International Journal of General Medicine.2022; Volume 15: 2715. CrossRef
C-Reactive Protein and Serum Albumin Ratio: A Feasible Prognostic Marker in Hospitalized Patients with COVID-19 Vicente Giner-Galvañ, Francisco Pomares-Gómez, José Quesada, Manuel Rubio-Rivas, Javier Tejada-Montes, Jesús Baltasar-Corral, María Taboada-Martínez, Blanca Sánchez-Mesa, Francisco Arnalich-Fernández, Esther Del Corral-Beamonte, Almudena López-Sampalo, Pa Biomedicines.2022; 10(6): 1393. CrossRef
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Evaluation of the factors affecting long-term mortality in geriatric patients followed up in intensive care unit due to hospital-acquired pneumonia Semih Aydemir, Derya Hoşgün Medicine.2022; 101(38): e30645. CrossRef
The predictive value of C-reactive protein to albümin ratio for ascending aort progression in patients with ascending aortic diameter of 40–50 mm Ahmet Dolapoglu, Eyüp Avci, Tuncay Kiris Journal of Cardiothoracic Surgery.2022;[Epub] CrossRef
A Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Prediction Model From Standard Laboratory Tests Vafa Bayat, Steven Phelps, Russell Ryono, Chong Lee, Hemal Parekh, Joel Mewton, Farshid Sedghi, Payam Etminani, Mark Holodniy Clinical Infectious Diseases.2021; 73(9): e2901. CrossRef
Predictive Value of C-Reactive Protein to Albumin Ratio in ST-Segment Elevation Myocardial Infarction Patients Treated With Primary Percutaneous Coronary Intervention Halit Acet, Tuncay Güzel, Bayram Aslan, Mehmet Ali Isik, Faruk Ertas, Sibel Catalkaya Angiology.2021; 72(3): 244. CrossRef
Predicting Poor Outcome of COVID-19 Patients on the Day of Admission with the COVID-19 Score Luke Tseng, Erin Hittesdorf, Mitchell F. Berman, Desmond A. Jordan, Nina Yoh, Katerina Elisman, Katherine A. Eiseman, Yuqi Miao, Shuang Wang, Gebhard Wagener, Samuel A. Tisherman Critical Care Research and Practice.2021; 2021: 1. CrossRef
Determinants of prognosis in geriatric patients followed in respiratory ICU; either infection or malnutrition Guler Eraslan Doganay, Mustafa Ozgur Cirik Medicine.2021; 100(36): e27159. CrossRef
Novel Systemic Inflammation Markers to Predict COVID-19 Prognosis Amirali Karimi, Parnian Shobeiri, Arutha Kulasinghe, Nima Rezaei Frontiers in Immunology.2021;[Epub] CrossRef
Abnormal routine blood tests as predictors of mortality in acutely admitted patients Rasmus Roenhoej (Rønhøj), Rasmus B. Hasselbalch, Martin Schultz, Mia Pries-Heje, Louis L. Plesner, Lisbet Ravn, Morten Lind, Birgitte N. Jensen, Thomas Hoei-Hansen (Høi-Hansen), Nicholas Carlson, Christian Torp-Pedersen, Lars S. Rasmussen, Line J.H. Rasmu Clinical Biochemistry.2020; 77: 14. CrossRef
C-reactive protein/albumin ratio designates advanced heart failure among outpatients with heart failure Oguzhan Yucel, Hakan Günes, Murat Kerkütlüoglu, MehmetBirhan Yılmaz International Journal of the Cardiovascular Academy.2020; 6(2): 51. CrossRef
Serum C-reactive protein to albumin ratio and mortality associated with peritoneal dialysis Siyi Liu, Panlin Qiu, Laimin Luo, Lei Jiang, Yanbing Chen, Caixia Yan, Xiaojiang Zhan Renal Failure.2020; 42(1): 600. CrossRef
Differential diagnostic factors of type 1 and type 2 myocardial infarction in patients with elevated cardiac troponin levels Youngho Seo, Jinhui Paik, Seunglyul Shin, Ahjin Kim, Soo Kang Clinical and Experimental Emergency Medicine.2020; 7(3): 213. CrossRef
Serum Albumin and C-Reactive Protein as Predictors of Adverse Outcomes in Critically Ill Children: A Prospective Observational Pilot Study Neha Bhandarkar, Sushma Save, Sandeep B. Bavdekar, Pankhuri Sisodia, Saumil Desai The Indian Journal of Pediatrics.2019; 86(8): 758. CrossRef
Risk assessment models for potential use in the emergency department have lower predictive ability in older patients compared to the middle-aged for short-term mortality – a retrospective cohort study Martin Schultz, Line Jee Hartmann Rasmussen, Nicolas Carlson, Rasmus Bo Hasselbalch, Birgitte Nybo Jensen, Lotte Usinger, Jesper Eugen-Olsen, Christian Torp-Pedersen, Lars Simon Rasmussen, Kasper Karmark Iversen BMC Geriatrics.2019;[Epub] CrossRef
Predictive utility of the C-reactive protein to albumin ratio in early allograft dysfunction in living donor liver transplantation: A retrospective observational cohort study Jaesik Park, Soo Jin Lim, Ho Joong Choi, Sang Hyun Hong, Chul Soo Park, Jong Ho Choi, Min Suk Chae, Yun-Wen Zheng PLOS ONE.2019; 14(12): e0226369. CrossRef
The High-Sensitivity C-Reactive Protein/Albumin Ratio Predicts Long-Term Oncologic Outcomes after Curative Resection for Hepatocellular Carcinoma Tak Oh, Young-Rok Choi, Jai Cho, Yoo-Suk Yoon, Ho-Seong Han, In Park, Jung-Hee Ryu Journal of Clinical Medicine.2018; 7(6): 139. CrossRef
Use of the prognostic biomarker suPAR in the emergency department improves risk stratification but has no effect on mortality: a cluster-randomized clinical trial (TRIAGE III) Martin Schultz, Line Jee Hartmann Rasmussen, Malene H. Andersen, Jakob S. Stefansson, Alexander C. Falkentoft, Morten Alstrup, Andreas Sandø, Sarah L. K. Holle, Jeppe Meyer, Peter B. S. Törnkvist, Thomas Høi-Hansen, Erik Kjøller, Birgitte Nybo Jensen, Mor Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine.2018;[Epub] CrossRef
The C-Reactive Protein/Albumin Ratio as a Predictor of Mortality in Critically Ill Patients Ji Eun Park, Kyung Soo Chung, Joo Han Song, Song Yee Kim, Eun Young Kim, Ji Ye Jung, Young Ae Kang, Moo Suk Park, Young Sam Kim, Joon Chang, Ah Young Leem Journal of Clinical Medicine.2018; 7(10): 333. CrossRef
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