Impact of ECPR initiation time and age on survival in out-of-hospital cardiac arrest patients: a nationwide observational study
Are we giving our older patients with out-of-hospital cardiac arrest (OHCA) a fair shot? ⏱️ Current guidelines say an ECPR initiation time of up to 60 minutes is acceptable, but is that really the case for everyone? This is a question clinicians grapple with every day at the bedside.
A new nationwide observational study from South Korea tackles this head-on, analyzing data from 483 adult patients who received ECPR for non-traumatic OHCA. The study found that while both age and time to ECPR independently predict survival, the combination of the two is critical. The key takeaway? The "golden hour" for ECPR may not apply to our elderly patients.
The results are practice-changing and frankly, a wake-up call. The study found that in patients over 65, the probability of survival plummeted to less than 10% when ECPR was delayed beyond just 21 minutes. For their younger counterparts, a 10% survival rate was maintained for nearly twice as long, up to 38 minutes . This finding suggests that for older patients, the effective window for ECPR is much shorter than previously thought . The authors recommend a sense of urgency, urging clinicians to activate ECPR in carefully selected elderly patients almost immediately upon hospital arrival .
This isn't just about a new number; it's about re-evaluating our clinical protocols and embracing an age-specific approach to resuscitation. Tune in as we break down the data and discuss what this means for your next OHCA case.
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Pressure-controlled ventilation versus volume-controlled ventilation for adult patients with acute respiratory failure: A systematic review and meta-analysis
When it comes to saving lives in the ICU, every breath counts. But what’s the best way to deliver that breath—pressure-controlled ventilation (PCV) or volume-controlled ventilation (VCV)?
In this episode, we dive into a new systematic review and meta-analysis that put these two ventilator modes head-to-head in over 1,100 patients with acute respiratory failure. The findings may surprise you: while both modes showed no major differences in barotrauma or overall mortality, PCV hinted at a slight edge in reducing deaths among patients with ARDS.
What does this mean for frontline clinicians? Could PCV be the more patient-friendly option when seconds matter? Join us as we unpack the data, discuss the implications for practice, and explore where future research needs to go.
Tune in for a deep dive into ventilator strategies that could shape critical care worldwide.
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Is high-flow nasal oxygen as effective as non-invasive ventilation in acute cardiogenic pulmonary Edema?
When a patient crashes with acute cardiogenic pulmonary edema, emergency teams need fast, effective solutions. For years, non-invasive ventilation (NIV) has been the gold standard — but could high-flow nasal cannula (HFNC) be just as good?
In this episode, we break down a prospective, randomized trial published in the American Journal of Emergency Medicine (Dec 2025) that compared HFNC head-to-head with NIV in the ED. The results? No difference in survival, respiratory rates, or dyspnea scores between the two therapies.
We’ll explore:
Why HFNC may rival NIV for managing ACPE
The surprising equivalence in clinical outcomes at 30, 60, and 120 minutes
Patient comfort and tolerability — where HFNC may hold the edge
What this means for ED practice, protocols, and future airway management
If you’re an emergency physician, intensivist, or resuscitationist, this study has big implications: it suggests you may have more flexibility — and your patients, more comfort — than ever before.
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Efficacy of ketamine versus etomidate for rapid sequence intubation, among critically ill patients in terms of mortality and success rate: A systematic review and meta-analysis of randomized controlled trials
When a patient is crashing and every second counts, airway decisions can mean life or death. For decades, clinicians have fiercely debated: should you reach for etomidate, the hemodynamic workhorse, or ketamine, the pressure-friendly multitasker?
In this episode, we dive deep into a new systematic review and meta-analysis that just might end the controversy once and for all. The surprising truth? Survival doesn’t change no matter which drug you choose.
We’ll unpack:
Why this finding is a game-changer for emergency physicians, intensivists, and resuscitationists.
What the evidence really says about mortality, intubation success, and cardiac arrest risk.
The nuances of post-induction hypotension and why it might not be the dealbreaker it once seemed.
How this study frees you to make airway decisions based on patient context and clinical judgment—not dogma.
Whether you’re on the front lines of the ED, running codes in the ICU, or training the next generation of airway masters, this episode will leave you with clarity, confidence, and a renewed perspective on one of emergency medicine’s longest-running debates.
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Early use of norepinephrine in high-risk patients undergoing major abdominal surgery: a randomized controlled trial
When major abdominal surgery pushes patients to the brink, timing is everything, especially with norepinephrine. Could giving it earlier to high-risk patients prevent dangerous drops in blood pressure and reduce complications?
A new randomized controlled trial, published in Anesthesiology (2025), put this to the test, comparing early, low-dose norepinephrine infusion against standard care in high-risk surgical patients. The results may surprise you: early norepinephrine not only stabilized blood pressure faster but also significantly reduced postoperative complications without increasing adverse events.
In this episode, we break down what “early” really means, why the trial’s pragmatic design matters, and how this could reshape perioperative hemodynamic management in major surgery.
Key takeaways: • Early norepinephrine led to more stable intraoperative blood pressure • Reduced risk of postoperative complications in high-risk patients • No significant increase in adverse events compared to standard care
This isn’t just about drugs, it’s about redefining timing in critical surgical care.
Want to dig deeper? Check out the full study: Trocheris-Fumery O, Flet T, Scetbon C, et al. Early Use of Norepinephrine in High-Risk Patients Undergoing Major Abdominal Surgery: A Randomized Controlled Trial. Anesthesiology. 2025. doi:10.1097/ALN.0000000000005704
Welcome to the ResusX:Podcast. Each episode features an amazing talk from the ResusX conference. This is a podcast dedicated to your sickest patients, and it'll all FOAMed. For more great content including our monthly grand rounds, newsletters and more go to www.ResusX.com now.
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