ScienceDirect Available online at www.sciencedirect.com Volume XXX, Supplement 1, XX 202X ISSN XXXX Abstracts of RESUSCITATION 2026 17th September – 19th September 2026 in Milan, Italy ISSN 0300-9572 Volume 226, Supplement 1, September 2026
RESUSCITATION Official Journal of the European Resuscitation Council also affiliated with the American Heart Association, the Australian Resuscitation Council, the New Zealand Resuscitation Council, the Resuscitation Council of Southern Africa and the Japan Resuscitation Council EDITOR-IN-CHIEF: Jerry P. Nolan, Bath, UK EDITORS: Shir Lynn Lim, Singapore Michael Parr, Sydney, Australia Gavin D. Perkins, Warwick, UK Jasmeet Soar, Bristol, UK EDITOR EMERITUS: Douglas Chamberlain, Brighton, UK STATISTICAL ADVISOR: Robin Prescott (UK) SOCIAL MEDIA EDITOR: Tommaso Scquizzato (Italy) EDITORIAL BOARD Benjamin Abella (USA) Cristian Abelairas-Gomez (Spain) Lars Andersen (Denmark) Anders Aneman (Denmark) Tom P. Aufderheide (USA) Charles Babbs (USA) Carolina Barbosa Maciel (USA) Ben Beck (Australia) Lance B. Becker (USA) Katherine M. Berg (USA) Robert Berg (USA) Leo Bossaert (Belgium) Martin Botha (South Africa) Bernd W. Böttiger (Germany) Janet Bray (Australia) Clif Callaway (USA) Alain Cariou (France) Pierre Carli (France) Sheldon Cheskes (Canada) Keith Couper (UK) Tobias Cronberg (Sweden) Charles Deakin (UK) Alan De Caen (Canada) Ian Drennan (Canada) Michael Donnino (USA) Jonathan Elmer (USA) Judith Finn (Australia) Cornelia Genbrugge (Belgium) Romergryko Geocadin (USA) Jan-Thorsten Gräsner (Germany) Cornelia Genbrugge (Belgium) Kirstie Haywood (UK) Peter Kudenchuk (USA) Ranjit Lall (UK) Shir Lynn Lim (Singapore) Andrew Lockey (UK) David Lockey (UK) Carsten Lott (Germany) Carolina Maciel (USA) Spyros Mentzelopoulos (Greece) Koen Monsieurs (Belgium) Peter Morley (Australia) Laurie Morrison (Canada) Vincent Mosesso (USA) Vinay Nadkarni (USA) Robert Neumar (USA) Tonia Nicholson (New Zealand) Theresa Olasveengen (Norway) Marcus Ong (Singapore) Joseph P. Ornato (USA) Mary Ann Peberdy (USA) Sarah Perman (USA) Joshua Reynolds (USA) Claudio Sandroni (Italy) Comilla Sasson (USA) Kelly Sawyer (USA) Barney Scholefield (UK) Mypinder Sekhon (Canada) Markus Skrifvars (Finland) Alexis A. Topjian (USA) Joseph Varon (USA) Myron L. Weisfeldt (USA) Myra H. Wyckoff (USA) Feng Xu (China) AMSTERDAM–BOSTON–LONDON–NEW YORK– OXFORD–PARIS–SAN DIEGO–ST LOUIS
Volume 175, Supplement 1 (2022 ) Official Journal of the European Resuscitation Council also affiliated with the American Heart Association, the Australian Resuscitation Council, the New Zealand Resuscitation Council, the Resuscitation Council of Southern Africa, and the Japan Resuscitation Council for online access via your library ScienceDirect Available online at www.sciencedirect.com Abstracts of RESUSCITATION 2022 22 - 24 October 2020 Publication of this Abstract Book is supported by the European Resuscitation Council 16–17 June 2022 Antwerp, Belgium RESUSCITATION 2023 02–04 November 2023 Barcelona, Spain Volume 192, Supplement 1 (2023) RESUSCITATION 2025 23rd October – 25th October 2025 Rotterdam, Netherlands Volume 215, Supplement 3 (2025) Volume 226, Supplement 1 (2026) RESUSCITATION 2026 17th September – 19th September 2026 in Milan, Italy
Vol . 175 Supplement 1 RESUSCITATION June 2022 CONTENTS Resuscitation is abstracted/indexed by: Current Contents, Science Citation Index, Expanded, Index Medicus, PubMed/Medline and EMBASE. Also covered in the abstract and citation database SCOPUS®. Abstracts for ERC 2022 Best of the Best (BOB) 1 Young Investigator 5 Oral 11 Posters 29 Abstracts for ERC 2023 Young Investigator Award Poster presentation 8 Vol. 192 Supplement 1 November 2023 Abstracts for Resuscitation 2025 Best of the Best S1 S6 Oral Abstract Presentation S10 Poster presentation S31 Vol. 215 Supplement 3 November 2025 Vol. 226 Supplement 1 September 2026 Abstracts for Resuscitation 2026 Best of the Best Young Investigator Award Oral Abstract Presentation Poster Abstract Presentation S19
EUROPEAN RESUSCITATION COUNCIL Interdisciplinary Council for Resuscitation Medicine and Emergency Medical Care St ri anicnei n1g9 i8n8E, ut hr eo pEeuar no dp ebaeny oRneds .uCs oc imt apt ri oi sni nCgo3u4n cNi la t( iEo Rn Ca l) Rheassu ps cr iot va it di oend Ctohue nsctial sn, dt ah redE fRoCr' sr epsrui ns cc ii pt aatli oa nc t igvui ti di eesl ianrees: a n d Science Taa cnhtdei vEi enRl i ytCi ati ots eatshmseceiwemnobtr eil fdri cwo sfi dtt uhe deCi eIonsnt res eer lnna ast eut idso ntOoanl r LSe sci aui ei ssncoci nteaCtaionomdn .mT ri tet ae temOenn tR eR seuc socmi t ma t ei onnd a( It Li oCnOs R()C, owShTeRr )e. ET Rh Ce eE xRpCe ratl ss oc os nu tpr pi bour tt es Resuscitation is the official journal of the ERC. Guidelines Bparasecdticoenatnhde CtroaSiTnRin, gthine EaRnCd pbuebyloisnhdeEs uEruorpoep.ean Resuscitation Guidelines that are the standard for resuscitation Training ctAreanr iteni tfi winegos rfpok rrool vfa iyNd are etrissocnwuaehl roRs seausnucdcs cehistesaaft lui tolhlnyp Ccr ooo mfuenspcsli iel ost n, e Caalonsu. ErTsRhe Ce OEc roRguCa rndsi esee. f irns e, sC ot hu er sset aDni dr ea cr tdo rf os ra dn ed l i Ivnesrt yr uocf t oh ri gs hp qr ou va il di tey rt er as ui ns icni tga tai no dn Congresses SEtRatCe-coofn-tghree-asrst. resuscitation science combined with practical training: meet the international experts at the yearly Public awareness Everyone can resuscitate. The ERC established the annual European Restart a Heart day every year on 16th October and encourages professionals and public to receive training and to attempt resuscitation if required. National representation Ad enl ievt ewroyrok f ogfu3i d4 eNl iantei osn, rael sRuesscui tsactiitoant i ot nr a Ci noiunngcai lns d( NqRu Ca lsi)t yr ecpornetsreonl tisn tiht se rEeRs pC eactt ni vaet icoonuanl tl reyv.e l . E a c h N R C o v e r s e e s Board and General Assembly Board (voting members): • President: Federico Semeraro • President-elect: Andrew Lockey • Secretary: Nicolas Mpotos • Treasurer: Bernd Böttiger • Director Guidelines and ILCOR: Robert Greif • Director External Affairs: Nikolaos Nikolaou • Director Science and Research: Gavin Perkins • Director Training and Education: Carsten Lott • Director Congresses: Giuseppe Ristagno • Editor-in-Chief: Jerry P. Nolan • Representative of the Governance Committee: Sue Hampshire • Effective NRC representative: Sule Akin
Geneal Assembly: Board members Science & Education Committees Co-chair Science Co-chair Education BLS Mike Smyth Sander Van Goor ALS Keith Couper Francesc Carmona PLS Marije Hogeveen Vix Monnelly PLS Stephan Katzenschlager Doha Emam IES Kasper G. Lauridsen Timo de Raad ERC Manuals Our WebShop offers the following training manuals in several languages, based on the latest ERC guidelines: • Basic Life Support(BLS) • Immediate Life Support (ILS) • Advanced Life Support (ALS) • Paediatric Basic Life Support ( PBLS ) • European Paediatric Immediate Life Support (EPILS) • European Paediatric Advanced Life Support (EPALS) • Newborn Life Support (NLS) More information More information about the ERC can be obtained from EGualriolepielaaannR1e1suscitation Council vzw 2B 8e l4g5i uNmi e l Tel. +32 3 246 46 66 www.erc.edu ERC’s Articles of Association can be downloaded from the website N PL L S S
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Best of the Best 47 Adapting ERC Adult BLS Education for Visually Impaired Adults: Feasibility and Self-Efficacy Outcomes Mariyana Manusheva, Alexander Manushev, Andrian Georgiev Center for First Aid and Resuscitation Research and Education, First Three Minutes Foundation, Sofia, Bulgaria Purpose: Early bystander basic life support (BLS) and automated external defibrillator (AED) use are key determinants of survival after out-of-hospital cardiac arrest. Standard Adult BLS algorithm and training approaches rely heavily on visual cues, which may limit accessibility for visually impaired individuals. This study describes the development and implementation of a non-visual adaptation of the ERC Adult BLS algorithm and evaluates its feasibility in training visually impaired adults. Methods: A non-visual operational model of the ERC Adult BLS algorithm was developed through iterative training sessions codesigned with visually impaired participants and instructors. The adaptation preserved the original structure and decision logic of the ERC algorithm while replacing visually dependent actions with auditory and tactile procedures. Adaptations included auditory safety assessment, tactile localisation of the sternal compression landmark, structured verbal communication loops, and AED deployment guided entirely by device voice prompts. Fully automatic AEDs with non-polarised pads eliminated visual polarity requirements. Training was delivered in small groups (1:2 instructor-to-participant ratio) using verbal instruction, tactile rehearsal and scenario-based simulation. Self-reported confidence was assessed using an 11-item 4-point Likert questionnaire administered before and after training. Results: Sixty-five visually impaired adults participated. All core steps of the adapted algorithm were performed using auditory and tactile cues without visual information, and training scenarios were completed without safety incidents. Mean confidence scores increased from 2.42 to 3.45, and highconfidence responses (scores 3–4) increased from 43.5% to 90.6%. Improvements were observed in recognition of cardiac arrest (22%→ 84%), chest compressions with correct rate and depth (19%→84%), and AED use (14%→75%). Conclusions: A structured adaptation of the ERC Adult BLS algorithm enabling non-visual execution is feasible and safe in training for visually impaired adults and may support broader inclusion of visually impaired individuals in community resuscitation programmes. Figure (abstract 47). Resuscitation 226S1 (2026) S1–S5 Contents lists available at ScienceDirect Resuscitation journal homepage: www.elsevier.com/locate/resuscitation
214 Experiences of Implementing European Guidelines for PostCardiac Arrest Follow-up in Sweden Johan Israelsson1, Annette Waldemar2, Therese Djärv3, Gunilla Edholm4, Stefan Jutterdal5, Anna Lybeck6, Per Nordberg7, Sten Rubertsson8, Helene Silfver9, Ewa Wallin8, Gisela Lilja10 1Division of Cardiology, Department of Internal Medicine, Kalmar County Hospital, Region Kalmar County, Kalmar, Sweden; 2Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden; 3Department of Emergency Medicine, Karolinska University Hospital, Stockholm, Sweden; 4Department of Cardiology, Sahlgrenska University Hospital, Gothenburg, Sweden; 5The Swedish network for cardiac arrest survivors and their relatives, Oskarshamn, Sweden; 6Department of Clinical Sciences, Anaesthesia and Intensive Care, Skåne University Hospital, Lund University, Lund, Sweden; 7Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden; 8Department of Surgical Sciences, Division of Anaesthesiology and Intensive Care Medicine, Uppsala University, Uppsala, Sweden; 9The Swedish Heart and Lung Association, Stockholm, Sweden; 10Brain Injury After Cardiac Arrest Research Unit, Department of Clinical Sciences Lund, Lund University, Lund, Sweden Purpose of the study: A Swedish digital survey in 2013 revealed substantial shortcomings and variability in post-cardiac arrest followup. This study presents ten years of experience implementing the follow-up guidelines proposed by the European Resuscitation Council (ERC) and the European Society of Intensive Care Medicine (ESICM) in Sweden. Materials and methods: This narrative description covers the implementation process (2015–2025), initiated by the Swedish Resuscitation Council in collaboration with survivors, co-survivors, and healthcare professionals. The process included national adaptations to provide clearer guidance to clinicians, such as suggested referral pathways and screening tools available in Swedish. Complementary resources were also developed, including information booklets and a national peer-support network. Implementation was evaluated through two digital surveys sent to Swedish resuscitation coordinators in 2019 and 2025. Results: Figure 1 illustrates the implementation timeline. The surveys were conducted 3 and 9 years after the introduction of the first Swedish follow-up guidelines. Response rates were identical: 47 of 72 hospitals (63%). At both time points, about half of the hospitals reported having explicit follow-up protocols (49% in 2019; 55% in 2025). Most follow-up visits were scheduled within the recommended three months after discharge (62% in 2019; 74% in 2025), and the content largelyaligned with guideline recommendations. Involvement of occupational therapists (30% vs. 49%) and counsellors (47% vs. 54%) increased over time. The national information booklets were widely used (66% in 2019; 70% in 2025). Furthermore, the peer-support network launched in 2021 had grown to include more than 700 members by early 2026. Conclusions: The Swedish implementation of the ERC/ESICM guidelines appears to have strengthened clinical practice and enhanced support for survivors and co-survivors. These experiences may serve as inspiration for similar initiatives in other settings. 304 Recruitment of Public Housing Areas to Improve Survival after Outof-Hospital Cardiac Arrest in Residential Areas Morten Gram Sell1, André Djerff Lund1,2, Nikolai Louis Kleftås Thaarup1, Annam Sheikh1,2, Anne Juul Grabmayr1, Christian Torp-Pedersen3,4, Christian Hassager5,2, Jesper Kjærgaard5,2, Tine Tjørnhøj-Thomsen6, Annette Kjær Ersbøll6, Gunnar Gislason7,8,2, Fredrik Folke1,8,2, Carolina Malta Hansen1,8,2 1Copenhagen Emergency Medical Services, Ballerup, Denmark; 2Department of Clinical Medicine, University of Clinical Medicine, Copenhagen, Denmark; 3Steno Diabetes Center, Herlev, Denmark; Figure (abstract 214). Best of the Best / Resuscitation 226S1 (2026) S1–S5 S2
4Department of Public Health, University of Copenhagen, Copenhagen, Denmark; 5Rigshospitalet, Copenhagen, Denmark; 6National Institute of Public Health, Copenhagen, Denmark; 7Danish Heart Foundation, Copenhagen, Denmark; 8Herlev and Gentofte Hospital, Herlev, Denmark Purpose: The Cardiac Arrest in Residential Areas with MoBile volunteer responder Activation (CARAMBA) trial is a cluster-randomized trial in public housing areas with traditionally poor outcomes in the greater Copenhagen. The trial is ongoing and testing whether placement of automated external defibrillators (AEDs) and free cardiopulmonary resuscitation (CPR) training of the population increases bystander defibrillation and survival. This study describes the development, implementation, and early outcomes of public housing areas participating in the trial. We assessed the feasibility and adoption of a standardized yet locally driven program for AED deployment and CPR training in the CARAMBA areas. Methods: Of 26 included public housing areas,13 were randomized to intervention (catchment area∼30,000 residents). We aim to provide CPR training to ∼10% of the resident population (230 residents per area). The community engagement strategy consists of six core elements: 1) Partnership with key local stakeholders (e.g. housing administrators and social workers); 2) Public Housing Local Leadership; 3) free 30-minute hands-on courses through the Danish Heart Foundation’s ‘Give Life’ program; 4) Outreach to minority groups; 5) Organizational and institutional training; and 6) Public Awareness activities. Results: All 13 public housing areas were recruited and 75 AEDs were deployed, maintained and registered with the national AED network. Since December 2021, 819 residents (27% of the target population) have completed a CPR course. The CARAMBA team has established contact with 38 minority groups, 22 local organizations and participated in 10 community events including ambulance demonstrations and a QCPR racing game. Participation in free CPR training varied substantially across areas (Figure 1). Conclusion: All eligible public housing areas have been recruited and AEDs have been deployed. Participation in free CPR training varied substantially across areas, highlighting the need for highly tailored local approaches when implementing health-promoting interventions in public housing areas. 453 A Stepped-Care Model for Bystander Support After Out-of-Hospital Cardiac Arrest: Findings from the RescQ Pilot Dr. Uzma Sajjad1,2, Marco Mion1,2, Rupert Simpson1,2, Liz Sharpe1, JeanDavis1, Haroun Butt1,2, Luke Roberts-Andreou3, Justine DiFede3, Gareth Grier4, Paul Swindell5, Stuart Menzies5, Michael Watts6, Nilesh Pareek7,8, Thomas Keeble9,2 1Essex Cardiothoracic Centre, Mid and South Essex NHS Foundation Trust, Basildon, United Kingdom; 2MTRC, Anglia Ruskin School of Medicine, Chelmsford, United Kingdom; 3EEAST, East of England Land Ambulance NHS Trust, Welwyn City Garden, United Kingdom; 4EHAAT, Essex and Herts Air Ambulance Trust, Epping, United Kingdom; 5SCAUK, Sudden Cardiac Arrest UK, London, United Kingdom; 6Blum Health Ltd, London, United Kingdom; 7King’s College Hospital NHS Foundation Trust, London, United Kingdom; 8School of Cardiovascular and Metabolic Medicine & Sciences, British Heart Foundation Centre of Excellence, King’s College London, London, United Kingdom; 9Essex Cardiothoracic Centre, Mid and South Essex NHS Foundation Trust, Basildon, United Kingdom Background: Bystanders involved in out-of-hospital cardiac arrest (OHCA) frequently experience psychological distress, yet scalable postevent support models remain poorly defined. RescQ™is a digitally enabled platform providing on-scene debrief, immediate access to website resources, and optional escalation to Liaison Officer (LO) support. Aim: To evaluate the bystander user journey and escalation to personalised support within the RescQ™pilot. Methods: A prospective regional evaluation of RescQ™ was conducted with paramedic-initiated on-scene registration. Data were analysed for bystanders accessing LO support, including demographics, event characteristics, engagement behaviour, and psychological outcomes (self-reported acute stress, CORE-10, NSESSS) pre-session and at 2-week follow-up. Results: In 11 months, 240 bystanders were registered (45% of regional OHCAs), with 96% accessing the website at least once. Figure (abstract 304). Best of the Best / Resuscitation 226S1 (2026) S1–S5 S3
Twenty-three bystanders (9.6%) escalated to LO support. Most engaged with website resources prior to escalation (74%), with 71% accessing the platform within 24 hours. LO users were commonly active participants (65% performed CPR), and most were known to the patient (70%). LO support was delivered via telephone (61%), video (30%), or faceto-face (9%), with a mean duration of 52 ± 34 minutes. Psychological measures improved from pre-session to 2-week follow-up (acute stress 8 ± 1 to 5 ± 1; CORE-10 17 ± 3 to 12 ± 2; NSESSS 3.1 to 2.0). Acceptability was high, with 86% reporting ease of access to LO support and helpfulness scores of 9.7/10 (LO) and 9.2/10 (website). One-third required onward referral to counselling or peer support through SCAUK. Conclusion: Most OHCA bystanders engaged with low-intensity digital support, while a smaller subgroup required escalation to personalised care. Both website and LO support were feasible, highly acceptable, and perceived as helpful. Early access to structured support may address immediate psychological needs and reduce reliance on higher-intensity services, supporting a scalable stepped-care model. 547 Transthoracic Impedance Waveform Analysis for Detection of Ventilation Quality during Cardiopulmonary Resuscitation Aurora Magliocca1,2, Giulia Merigo2,1, Chiara Crivellari3, Francesca Fumagalli4, Davide Danilo Zani5, Giuseppe Ristagno6,2 1Agenzia Regionale Emergenza Urgenza –AREU, Milan, Italy; 2Department of Pathophysiology and Transplantation, Milan University, Milan, Italy; 3Department of anesthesia, Milan Bicocca University, Monza, Italy; 4Mario Negri Institute for Pharmacological Research, Milan, Italy; 5Department of Veterinary Medicine and Animal Sciences, Milan University, Lodi, Italy; 6S.C. Ricerca Innovazione e Trasferimento Tecnologico, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy Purpose of the study: Ventilation is a fundamental component of cardiopulmonary resuscitation (CPR), however is difficult to deliver and monitor in the prehospital setting, despite its association with outcomes (1). This study aims to characterize transthoracic impedance (TTI) ventilation waveforms obtained from different pad positions during chest-compression pauses in 30:2 CPR to assess ventilation quality and describe respiratory mechanics. Methods: This translational study used a porcine cardiac arrest model followed by 30:2 CPR; and included healthy volunteers. TTI was recorded with a modified HeartStart Intrepid defibrillator (Philips) using anterolateral (AL), anteroposterior (AP), and latero-lateral (LL) pad positions. Airway flow and pressure were measured by spirometry. Defibrillator files from 16 pigs receiving bag-valve ventilation during CPR were manually analyzed for inspiratory and expiratory TTI amplitudes, tidal volume, airway pressure, respiratory mechanics and EtCO2. TTI was assessed in healthy volunteers with AL and AP pad positions. Results: In the experimental study TTI amplitude varied significantly according to defibrillation pad position, with the LL configuration showing the highest amplitudes, followed by AL and AP (TTI Ai median [IQR]: LL 0.39 [0.27–0.54] Ω; AL 0.23 [0.15–0.35] Ω; AP 0.17 [0.14–0.22] Ω, p < 0.0001, Figure 1A). Inspiratory TTI amplitude increased across tidal volume quartiles in all configurations, with a linear increase observed in the AL, and a threshold effect of AP pads, Figure 1D–E. Over ventilation pauses, respiratory system compliance decreased, driving pressure increased whereas tidal volume remained unchanged Figure 1F–I. In healthy volunteers, TTI amplitude correlated strongly with tidal volume and was higher with AL than AP pad positioning Figure 1J. Conclusions: TTI waveform analysis reliably detects ventilation quality during CPR, with pad position significantly affecting signal amplitude and monitoring accuracy. Reference 1. Idris AH, et al. Bag-Valve-Mask Ventilation and Survival From Outof-Hospital Cardiac Arrest: A Multicenter Study. Circulation. 2023 Dec 5;148(23):1847–1856. Best of the Best / Resuscitation 226S1 (2026) S1–S5 S4
Figure (abstract 547). Best of the Best / Resuscitation 226S1 (2026) S1–S5 S5
Young Investigator Award 198 2025 Revised Utstein-Style Recommended Guidelines for Uniform Reporting of Data from Drowning Resuscitation: An ILCOR Advisory Statement Niklas Breindahl1, Freddy Lippert2, Janet Bray3, Gavin Perkins4, Joost Bierens5, Tracy McCallin6, Ahamed Idris7, Roberto Barcala Furelos8, Yohei Okada9, FengXu10, Jiaqi Zheng10, Taku Iwami11, Therese Djärv12, Anthony Lagina13, Cody Dunne14, David Szpilman15, Andreas Claesson16, Ogilvie Thom17, Jonathon Webber18, Colleen Saunders19, Matthew Fader20, JazLawes21, Baljit Singh22, Tom Mecrow23 1TrygFonden’s Drowning Research Unit, Prehospital Center Region Zealand, Næstved, Denmark; 2Emergency Medical Services, Falck, Copenhagen, Denmark; 3Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia; 4Warwick Clinical Trials Unit, University of Warwick, Coventry, United Kingdom; 5Department of Anesthesiology, Erasmus University Medical Center, Rotterdam, Netherlands; 6University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA; 7Department of Emergency Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA; 8Faculty of Education and Sport Sciences, University of Vigo, Pontevedra, Spain; 9Department of Emergency Medicine, National University of Singapore, Singapore, Singapore; 10School of Public Health, Shandong University, Jinan, Shandong Province, China; 11Department of Preventive Services, Kyoto University, Kyoto, Japan; 12Department of Clinical Science and Education, Karolinska Institutet, Stockholm, Sweden; 13Wayne State University School of Medicine, Detroit, USA; 14Cumming School of Medicine, University of Calgary, Calgary, Canada; 15Brazilian Society of Lifesaving (SOBRASA), Rio de Janeiro, Brazil; 16Karolinska Institutet and Stockholm South General Hospital, Stockholm, Sweden; 17College of Medicine and Dentistry, James Cook University, Brisbane, Australia; 18University of Auckland, Auckland, New Zealand; 19Division of Emergency Medicine, University of Cape Town, Cape Town, South Africa; 20Swedish Sea Rescue Society (SSRS), Västra Frölunda, Sweden; 21Surf Life Saving Australia, Sydney, Australia; 22All India Institute of Medical Sciences (AIIMS), New Delhi, India; 23Royal National Lifeboat Institution (RNLI), Poole, United Kingdom Purpose: Drowning accounts for approximately 300,000 deaths annually worldwide [1], yet inconsistent data reporting limits comparability and advances in care [2–4]. The Drowning Utstein Template provides a framework for standardized reporting but remains complex and variably applied [2,5]. This study aims to update the template by identifying a feasible, clinically relevant dataset for drowning resuscitation that will serve as an extension of the existing Utstein Out-of-Hospital Cardiac Arrest Registry template. Materials and Methods: A modified Delphi process was conducted involving international experts in drowning, resuscitation, and prehospital care. A preliminary template, based on the 2015 Utstein Template and recent literature, was evaluated over three rounds. In round 1, participants proposed additional variables. In round 2, variables were rated for importance and availability and excluded if ≥50% of the participants voted “Rarely available” or “Sometimes available” OR“Not important” or “Somewhat important.” In round 3, participants vote on inclusion, with ≥85% agreement required for consensus. A final face-to-face Utstein meeting will take place in June 2026 to refine and agree on a final set of variables, including definitions and categories. Results: A total of 23 drowning resuscitation experts were selected using purposive sampling. Following round 1, 121 unique variables were included in the preliminary template. In round 2, 58/121 variables (48%) achieved the predefined threshold and will be submitted to Delphi Round 3 for final voting. All variables will be discussed during the Utstein meeting in June. Conclusions: This study will provide an updated Drowning Utstein Template that will serve as an extension of the existing Utstein Out-ofHospital Cardiac Arrest Registry template, aiming to improve the feasibility, standardization, and international comparability of drowning resuscitation data, ultimately supporting future research and improving patient outcomes. Resuscitation 226S1 (2026) S6–S9 Contents lists available at ScienceDirect Resuscitation journal homepage: www.elsevier.com/locate/resuscitation
267 Wearable-Based Automated Cardiac Arrest Detection: Algorithm Performance in Shockable and Non-Shockable Cardiac Rhythms Catharina Jansen1, Roos Edgar1, Lente Pol1, Niels Scholte2, Kambiz Ebrahimkheil3, Ruud van Kaam1, Rypko Beukema1, Marc Brouwer1, Peter Stas3, Eric Boersma2, Astrid Hoedemaekers1, Niels van Royen1, Judith Bonnes1 1Radboudumc, Nijmegen, Netherlands; 2Erasmus MC, Rotterdam, Netherlands; 3Corsano Health, Den Haag, Netherlands Purpose: Unwitnessed out-of-hospital cardiac arrest (CA) has poor survival chances due to delayed recognition. To enable early detection, in the DETECT-1 study, we developed a photoplethysmography (PPG)– based cardiac arrest detection algorithm. We now studied its performance in patients with ventricular fibrillation (VF), pulseless electrical activity (PEA) and asystole in a hospital setting. Methods: We included patients who underwent ventricular fibrillation (VF) induction during subcutaneous implantable cardioverter-defibrillator (S-ICD) implantation, patients with VF during ventricular tachycardia (VT) ablation, and intensive care unit (ICU) patients in whom life-sustaining treatment was withdrawn. Patients wore a PPG wristband throughout the procedures. The collected data were analysed for CA alarms using the DETECT-1 algorithm. Sensitivity for CA detection and false CA alerts were assessed. Results: Twenty-five patients were included (6 S-ICD implantation, 1 VT ablation, and 18 ICU patients), accounting for 27 CAs: 9 based on VF and 18 PEA/asystole. The DETECT-1 algorithm correctly identified all CAs, resulting in a sensitivity of 100% (95% confidence interval 87– 100%). The algorithm produced three false positive alarms during 140 hours of PPG recordings, including two in ICU patients and one during VT ablation. Conclusions: The PPG-based cardiac arrest detection algorithm demonstrated excellent sensitivity across ventricular fibrillation, PEA, and asystole in a hospital setting. Ongoing efforts focus on optimizing the cardiac arrest detection model to reduce false-positive alerts and evaluate its performance under real-world conditions. 283 Restart a Heart Live: Evaluating a Scalable School-Based CPR Education Intervention using the RE-AIM Implementation Framework K.H. Benjamin Leung1,2, Susan Gardner3, Dominika Skrocka3, Julie Starling4, Steven Short1, Wendy Hardyman5, Gareth Clegg1,3,6 1Scottish Ambulance Service, Edinburgh, United Kingdom; 2Unity Health Toronto, Toronto, Canada; 3Save A Life for Scotland, Edinburgh, United Kingdom; 4Welsh Ambulance Service University NHS Trust, Cardiff, United Kingdom; 5Cardiff Metropolitan University, Cardiff, United Kingdom; 6The University of Edinburgh, Edinburgh, United Kingdom Purpose: Restart a Heart Live (RSAH-Live) is a livestream-based CPR and automated external defibrillator (AED) education event developed in the United Kingdom. It aims to increase participation in school-based resuscitation training and reduce structural barriers to participation by providing a low-cost, low-resource entry point for schools while complementing existing instructor-led training programmes. Methods: RSAH-Live was delivered as a one-day structured livestream on October 1, 2025, combining CPR and AED demonstrations with classroom practice supported by downloadable teaching materials, locally available equipment or improvised manikins. RSAHLive was evaluated using the RE-AIM implementation framework (Reach, Effectiveness, Adoption, Implementation, Maintenance), supported by data such as livestream analytics, registration counts, geographic mapping and post-event surveys. Participation across socioeconomic deprivation levels in Scotland was assessed using the Scottish Index of Multiple Deprivation (SIMD). Results: Reach: A total of 101 599 individuals from 840 schools across the United Kingdom participated, with a mean of 121 viewers per school (Table). Effectiveness: Post-event feedback reported high engagement, 71% of respondents reporting feeling confident or moderately confident to do CPR after RSAH-Live. Adoption: In Scotland, participation across SIMD quintiles was reasonably proportional to their share of national population (Figure), suggesting that the intervention successfully reached viewers across the deprivation Figure (abstract 283). Young Investigator Award / Resuscitation 226S1 (2026) S6–S9 S7
gradient rather than being concentrated in more affluent communities. Implementation: The intervention required minimal marginal cost once developed and could be delivered simultaneously to large audiences. Schools required only internet access and basic classroom facilitation, reducing logistical and resource barriers compared to instructor-dependent training. Maintenance: RSAH-Live will be delivered annually and is designed to complement existing instructor-led CPR and AED training programmes. Conclusion: RSAH-Live demonstrated strong reach, equitable adoption across socioeconomic groups and highly scalable implementation. Livestream delivery provided a low-threshold entry point for schools and may represent an effective strategy to further population CPR training while reinforcing established approaches. 320 Why AED Placement Matters: Linking Location Type to Real-World Utilization Julie Kjoelbye Brand1,2, Victor Kjaerulf1,2, Persia Shahriari1,2, Carolina Malta Hansen1,2,3, Fredrik Folke1,2,3 1Copenhagen Emergency Medical Services, University of Copenhagen, Copenhagen, Denmark; 2Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark; 3Department of Cardiology, Herlev and Gentofte, University of Copenhagen, Copenhagen, Denmark Purpose of the study: Community first responders (CFRs) in Denmark are guided to the nearest accessible automated external defibrillator (AED) when responding to an out-of-hospital cardiac arrest (OHCA). More than 26,400 AEDs (438 AEDS per 100,000 Table (abstract 283). Figure (abstract 320). Young Investigator Award / Resuscitation 226S1 (2026) S6–S9 S8
inhabitants) have been signed to the Danish AED Network with detailed information on type of AED location. However, it remains unknown if significant disparities exist according to the most common AED placements, which AEDs are most often referred to in the CFR system and which AEDs are actually used at the OHCA. Materials and methods: Data on AED referral, AED usage and AED locations and accessibility was collected from 2020 to 2025 from the CFR system and from the Danish AED Network. The AED location types were divided into 18 categories (e.g. educational facilities, transportation sites and companies). Results: We included 26,416 AEDs, 51,922 CFR AED referrals, and 3,099 cases where an AED had been used. Overall, most AEDs were deployed at companies (n = 5,785, 21.9%), in residential areas (n = 4,008, 15.2%), and at public buildings (n = 2,357, 8.9%). The locations with most frequent AED referrals were in residential areas (n = 9,948, 19.2%), at companies (n = 6,066, 11.7%), and at shops (n = 5,776, 11.1%). The percentage of used AEDs was highest for AEDs placed at shops (20.7%), at sports locations (16.4%), and in residential areas (14.5%). The odds for an AED being used at a specific location can be found in Figure 1. Conclusions: The majority of deployed AEDs and AED referrals occurred in company and residential settings. However, the percentage of used AEDs was highest at shops, and an AED is most likely to be used, when deployed in a recreational area, at sports facilities, or at hotels/restaurants. These novel findings can support future strategic AED deployment. Young Investigator Award / Resuscitation 226S1 (2026) S6–S9 S9
Oral Abstract Presentation 52 Accomplishments of the Cardiac Arrest Center (CAC) Certification inGermany Nadine Rott1,2, Lina Reinsch2, Bernd W. Böttiger2,3,4, Hans-Jörg Busch2,5, Norbert Frey6, Malte Kelm7, Karl H. Scholz2,8 1University of Cologne, Department of Anaesthesiology and Intensive Care Medicine, Faculty of Medicine, Cologne, Germany; 2German Resuscitation Council (GRC), Ulm, Germany; 3Faculty of Medicine, University of Cologne, Cologne, Germany; 4University of Pécs, Faculty of Health Sciences, Institute of Emergency Care, Pedagogy of Health and Nursing Sciences, Pécs, Hungary; 5Department of Emergency Medicine, Faculty of Medicine, University Hospital, University of Freiburg, Freiburg, Germany; 6Department of Cardiology, Angiology, and Pulmonology, Medical Department III, Heidelberg University Hospital, Heidelberg, Germany; 7Department of Cardiology, Pulmonology and Angiology, University Hospital Düsseldorf, Düsseldorf, Germany; 8Department of Cardiology and Pneumology, University Medical Center Göttingen, Göttingen, Germany Background: Cardiac-Arrest-Centers (CAC) are hospitals with a special certification for treatment of patients with out-of-hospitalCardiac-Arrest (OHCA). In 2017, the first structural criteria for CACs were established in Germany and in 2019, the certification process began. The number of certifications has steadily increased subsequently[1]. The newly updated European Resuscitation Council (ERC) guidelines for resuscitation recommend that adult patients with nontraumatic OHCA should be cared for in a CAC whenever possible. Methods: The certification process is based on a continuous revision-based criteria catalogue and overseen by a panel of experts, including representatives from the German Resuscitation Council (GRC) and the German Cardiac Society (DGK)[1]. First observational studies were conducted in Germany assessing the patient outcome in CAC certified centers. Results: Presently, there are 282 certified CACs across Germany, Austria, and Switzerland, and 115 with recertification (Fig. 1). Research findings have demonstrated the effectiveness of certified CACs for patients with OHCA. A German multicenter, retrospective cohort study examined 784 patients: 368 before and 416 after CAC certification in 3 pilot-hospitals. Overall, the survival after CAC certification remained similar (35% vs. 35%, p > 0.99), after certification a significantly better neurological recovery (CPC1/2) was Fig. 1. (abstract 52): Timeline Cardiac-Arrest-Center(CAC) Certifications in German-speaking countries, GRC. Resuscitation 226S1 (2026) S10–S18 Contents lists available at ScienceDirect Resuscitation journal homepage: www.elsevier.com/locate/resuscitation
demonstrated (71% vs. 87%, p < 0.01)[2]. Another retrospective study showed improved survival after certification in patients with Cardiac Arrest Survival Score >15%, explaining this with improvement in formal qualification of the staff in procedures in immediate/advanced life support and in the collaboration between neurology, cardiology, emergency departments and intensive care units as well as raised awareness of necessity of structured care among senior staff[3]. Conclusion: The CAC certification is a successful certification, with continuously rising numbers, showing improved outcomes in patients with cardiac arrest and the certification process is still growing in Germany. References 1. https://doi.org/10.1007/s10049-024-01363-w 2. DOI:10.1016/j.resuscitation.2023.110069 3. https://doi.org/10.1161/JAHA.124.038688 74 Occlusive Myocardial Infarction-Identification Following Cardiac Arrest: Can Artificial Intelligence Influence Human DecisionMaking? Claudio Silwanis1,2, Max Groche1,2, Johannes Eder1,2, Maximilian Huss1,2, Anna Neunteufel1,2, Benedikt Kirchweger1,2, Philipp Pichler1,2, Alexander Nahler1, Alexander Fellner1, Stefan Rechberger1, Clemens Steinwender1,2,3, Thomas Lambert1,2 1Kepler University Hospital, Department of Cardiology and Medical Intensive Care, Linz, Austria; 2Johannes Kepler University Linz, Medical Faculty, Altenberger Straße 69, Linz, Austria; 3Clinical Research Institute for Cardiovascular and Metabolic Diseases, Medical Faculty, Johannes Kepler University, Altenberger Strasse 69, Linz, Austria Purpose of the study: Accurate electrocardiogram (ECG) analysis following return of spontaneous circulation (ROSC) presents significant challenges, particularly for identifying occlusive myocardial infarction (OMI) cases needing immediate reperfusion therapy. This study evaluated whether artificial intelligence (AI)–based ECG interpretation tools influence physicians’ diagnostic accuracy in post-ROSC OMI recognition. Materials and methods: This prospective experimental study analysed 69 post-ROSC ECGs (23 STEMI, 23 non-STEMI high-risk, 23 non-ischemic) evaluated by 18 participants across six professional categories – junior doctors (JD), emergency physicians (EP), medical students (MS), paramedics (PM), cardiology residents (CR), and senior cardiologists (SC) – at two timepoints (T1, T2), generating 2,484 interpretations. Initially (T1), participants diagnosed OMI presence using ECGs alone. Subsequently (T2), they re-evaluated identical ECGs with Queen of Hearts (QoH) neural network assistance. OMI presence was determined by coronary angiography in all cases. Results: Initially (T1), overall sensitivity reached 76.23% (72.88– 79.36), specificity 81.45% (76.94–85.41), positive predictive value (PPV) 89.15% (86.78–91.14), and negative predictive value (NPV) 63.15% (59.77–66.40). With AI assistance (T2), participants demonstrated unchanged sensitivity at 76.23% (72.88–79.36), improved specificity of 89.86% (86.17–92.83), PPV of 93.76% (91.63–95.38), and NPV of 65.40% (62.21–68.46). Overall area under the receiver operating characteristic curve (AUROC) improved from 0.854 (0.830–0.877) at baseline to 0.892 (0.872–0.911) with AI support (p = 0.016; figure 1), with comparable gains observed across all participant subgroups [AUROC T1 vs. T2: JD 0.861 vs. 0.906 (p = 0.192); EP 0.844 vs. 0.891 (p = 0.185); MS 0.838 vs. 0.889 (p = 0.180); PM 0.805 vs. 0.846 (p = 0.328); CR 0.906 vs. 0.934 (p = 0.291); SC 0.910 vs. 0.916 (p = 0.831); figure 2]. Both evaluator certainty and inter-observer agreement showed significant enhancement in every professional category. Conclusions: AI-supported ECG analysis substantially enhances diagnostic performance, confidence, and consistency, particularly for less experienced clinicians. QoH served as an effective decisionsupport tool that augments clinical judgment in post-resuscitation care. 255 Outcomes After the Use of Resuscitative Endovascular Balloon Occlusion of the Aorta During Conventional and Head-up Cardiopulmonary Resuscitation in a Porcine Model of Cardiac Arrest Nicolas Segond1,2, Johanna Moore2,3, Bayert Salverda2,3, Mithun Suresh3,4, Pouria Pourzand5,3, Anja Metzger2,3, Guillaume Debaty6, Keith Lurie3,2 1Grenoble Alpes University, Grenoble, France; 2University of Minnesota, Minneapolis, USA; 3Hennepin Healthcare Research Institute, Minneapolis, USA; 4Saint Cloud Hospital, Saint Cloud, USA; 5Lehigh Valley Health Network, Bethlehem, USA; 6Grenoble Alpes University, Grenoble, USA Purpose of the study: To compare the 24-hour neurological outcome after conventional (C) plus Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA), head-up cardiopulmonary resuscitation (AHUP-CPR) alone, or AHUP-CPR+REBOA. Secondary survival endpoints and key hemodynamic parameters were also assessed. Materials and methods: In this ongoing, prospective, controlled, randomized study, 21 Yorkshire pigs have been studied to date. After anesthesia, preparation and induction of ventricular fibrillation, pigs Oral Abstract Presentation / Resuscitation 226S1 (2026) S10–S18 S11
were randomized in three groups: C-CPR+REBOA, AHUP-CPR-alone and AHUP-CPR+REBOA. After 10 minutes of untreated VF,18 minutes of C-CPR or AHUP-CPR (combination of an impedance threshold device, active compression-decompression and progressive head and thorax elevation) was provided. REBOA was inflated after 15 min of CPR. The primary endpoint was 24-hours favorable neurological outcome (FN24), defined as a Performance Category Scale (CPC) 1 or 2. Measured physiological parameters included: decompression aortic blood pressure (DBP), coronary perfusion pressure (CorPP), EtCO2 and cerebral oximetry before (14 min) and after (17 min) REBOA inflation. As this study is ongoing, no statistical analysis was performed. Results: After 17 min of CPR, CorPPs were 1.3 ± 10.2 mmHg with C-CPR+REBOA, 16.8 ± 22.8 with AHUP alone, and 25.8 ± 17.2 with AHUP+REBOA and, DBPs were 19.0 ± 9.2 with C-CPR+REBOA, 29.6 ± 23.3 with AHUP alone, and 41.5 ± 17.2 with AHUP+REBOA. ROSC was achieved in 2/7 with C-CPR, 3/7 AHUP alone, and 6/7 with AHUP +REBOA. After ROSC, median (Q1; Q3) survival times were 0 (Q1: 0; Q3: 1.75) with C-CPR, 2.5 (0; 24) with AHUP, and 7 (1; 24) hours with AHUP +REBOA. FN-24 was 0/7 with C-CPR+REBOA, 2/7 with AHUP alone and 2/7 with AHUP+REBOA. Conclusion: In this ongoing study, AHUP-CPR, with or without REBOA, provided increased survival rates and hemodynamics compared to C-CPR+REBOA. Potential differences between outcomes with AHUP-CPR+/−REBOA are still being assessed. 361 Cardiac Arrest Recovery Enablement through Supported Selfmanagement (CARESS) Feasibility Study: Interim Results from a Facilitator-Led, Online, Complex Intervention for Survivors and Co-Survivors Nathan Pearson1,2, Gordon McGregor1,2, Stuart Ennis2,1, Harbinder Sandhu2, Shilpa Patel2, Sofie Power2, Jeanne Reilly3, Paul Swindell4, Keith Couper2,5, Julie Bruce2, David Ellard2, Dave Cleland3, Stuart Menzies4, Rebecca Kandiyali2, Anower Hossain2, Kirstie Haywood2 1University Hospitals Coventry and Warwickshire NHS Trust, Coventry, United Kingdom; Figure (abstract 255). Table (abstract 255). Oral Abstract Presentation / Resuscitation 226S1 (2026) S10–S18 S12
2University of Warwick, Coventry, United Kingdom; 3Patient and Public Involvement Partner, Coventry, United Kingdom; 4Sudden Cardiac Arrest UK, Essex, United Kingdom; 5University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom Purpose: Cardiac arrest is associated with persistent psychosocial morbidity and reduced quality-of-life in both survivors and cosurvivors. However, post-hospital discharge care is highly variable. We describe the testing of CARESS: a co-designed complex psychosocial intervention comprising separate survivor (including exercise rehabilitation) and co-survivor pathways to address unmet needs. Methods: A single-arm multi-centre feasibility study with an embedded process evaluation. Participants were recruited (June 2025– March 2026) through three NHS hospitals, and two charity partners. Eligibility: 1) adult survivors; discharged home within 30-days of the arrest; recruited within 12-months post-arrest; and 2) co-survivors of survivors meeting the above-criteria. Both facilitator-led pathways include a one-to-one session followed by seven, weekly, 1-hour group support sessions. They seek to develop knowledge and understanding about life after cardiac arrest, skills to support self-management and enable peer connections. Feasibility outcomes included: recruitment and retention rates (target n = 30 per pathway); acceptability and feasibility of intervention delivery and data collection procedures. Quantitative data were analysed descriptively, summarising feasibility outcomes. A purposive sample of participants, recruiters and facilitators were interviewed for the process evaluation with results reported elsewhere. Results: From those consented, 27/30 (90%) survivors and 14/16 (88%) co-survivors are participating in the programme. To date we have delivered 4/5 and 1/2 survivor and co-survivor pathways, respectively. Interim findings suggest strong retention and overall attendance for survivors (average 89%). Retention and attendance was also good for co-survivors (range 64% (wellbeing) to 93%). Introduction (week 1), anxiety (week 2), communication (week 6), and moving forward positively (week 7) sessions were best attended on both pathways (>90%). Conclusions: Interim results support the feasibility of recruiting to and delivering the survivor pathway. However, despite acceptable retention and attendance, further work to address recruitment challenges for co-survivors is necessary. Further testing of the survivor pathway in a randomised controlled trial is needed. 433 Early Implementation of a Hub-and-Spoke Survivorship Pathway for Out-of-Hospital Cardiac Arrest Survivors: a 12-Month Process Evaluation of the REVIVE Project Laura Calabrese1, Marco Mion2, Roberto Primi1, Sara Bendotti1, Leila Ulmanova1, Alice Mandrini1, Alessia Currao1, Arianna Morena1, Leonardo Fogagnolo3, Dossi Filippo3, Federica Pizzi3, Cristian Fava4, Daniele Ghiraldin5, Alessio Battioni5, Elena Madonini6, Diego Maffeo7, Cinzia Dossenza8, Silvia Affinito9, Giovanni Bertazzoli10, Marta Pellegrino10, Cecilia Fantoni11, Matteo Della Torre12, Silvia Frattini12, Giole Papi12, Angelica Praderio13, Luca Tarantino14, Simone Savastano1, Enrico Baldi1 1Fondazione IRCCS Policlinico San Matteo, Pavia, Italy; 2Anglia Ruskin School of Medicine & MTRC, Chelmsford, United Kingdom; 3Ospedale di Circolo e Fondazione Macchi di Varese, Varese, Italy; 4Ospedale Carlo Poma, Mantova, Italy; 5Ospedali Civili, Brescia, Italy; 6Ospedali Sant’Anna di Como e Sant’Antonio Abate di Cantù, Cantù, Italy; 7Poliambulanza, Brescia, Italy; 8Ospedale Maggior di Crema, Crema, Italy; 9Ospedale di Legnano, Legnano, Italy; 10Ospedale Maggiore di Lodi, Lodi, Italy; 11Ospedale Humanitas Mater Domini, Castellanza, Italy; 12Ospedale di Cremona, Cremona, Italy; 13Ospedale di Manerbio, Manerbio, Italy; 14Ospedale di Chiari, Chiari, Italy Background/objectives: Due to rising survival rates, survivorship after out-of-hospital cardiac arrest (OHCA) is becoming increasingly important. However, survivors often experience cognitive deficits, psychological distress, fatigue and a reduced quality of life, issues which are frequently overlooked in routine follow-up (1). Despite guidelines recommending multidisciplinary pathways, support remains fragmented. The REVIVE project (2) implemented a huband-spoke survivorship pathway in Lombardy, to optimise regional resources, evaluate the early implementation over a 12-month period (Jan–Dec 2025), characterise operational processes and bottlenecks, and generate insights for optimisation ahead of a full feasibility assessment. Methods: REVIVE links the Pavia hospital as hub to 21 spoke hospitals. Adult OHCA survivors with a CPC 1–2/mRS ≤3 were considered eligible. Post-discharge assessments (T0-T4) used standardised tools to assess cognition, mood and psychological recovery, via in-person, telephone or online modalities. Progression was tracked in a database; descriptive statistics and chi-square/Fisher tests compared hub/spoke and university/non-university centres. Barriers/facilitators were identified via a cohort flowchart. Results: Of 1,663 screened patients, 127 (7.6%) were eligible (80% male, median age 63 [IQR 54–73]); 96 (75.6%) were contacted, and 64 (66.7% of contacted; 50.4% of eligible) completed T0 assessment. Hub outperformed spokes in eligibility (19.5% vs 6.6%, p = 0.001), contact (92.3% vs 71.3%, p = 0.026), and assessment (100% vs 55.6%, p = 0.001). Main barriers: missing contacts (16.5%), non-response (8.6%), refusal/ lack of interest (6.3%). Conclusions: REVIVE achieved 50.4% coverage in the first year, proving that it is achievable to use hub-and-spoke coordination, flexible modalities and tracking, despite gaps in identification and contact. Further refinements, such as discharge checklists, psychoeducation and hybrid assessments, could improve uptake and establish REVIVE as a regional benchmark for OHCA survivorship care. References 1. Nolan JP, et al. Resuscitation. 2025;215:110809. 2. Mandrini A, et al. J Clin Med. 2025;14:3631. 487 Lectin Pathway Activation as an Early Indicator of Neurological Injury after Cardiac Arrest in a Porcine Model Francesca Fumagalli1, Francesca Callegari1, Daria De Giorgio1, Aurora Magliocca2, Stefano Fumagalli1, Elisa R. Zanier1, Giuseppe Ristagno3 1Istituto di ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy; 2Università degli Studi di Milano, Milan, Italy; 3Grande Ospedale Metropolitano Niguarda, Milan, Italy Purpose of the study: Cardiac arrest (CA) triggers a profound systemic inflammatory response that contributes to post-resuscitation organ injury and poor neurological recovery. Among the mechanisms involved, activation of the complement system through the lectin pathway (LP) has emerged as an important mediator in several ischemic conditions [1]. However, its role following CA remains insufficiently characterized. Oral Abstract Presentation / Resuscitation 226S1 (2026) S10–S18 S13
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