Evidence map›Paper›PMID 40161289›Full record

ArticleResuscitation plus2025

Management and outcome of patients with cardiac arrest after avalanche accidents in the Swiss Alps: A retrospective analysis.

Jürgen Knapp, Daniel Höftmann, Roland Albrecht, Sven Straumann, Mathieu Pasquier, Urs Pietsch

Abstract read
In one paragraph

Article in Resuscitation plus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Emergency care for avalanche buried patients - a narrative review.Scandinavian journal of trauma, resuscitation and emergency medicine · 2026
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Jürgen KnappDepartment of Anaesthesiology and Pain Medicine, Bern University Hospital, Inselspital, University of Bern, Bern, Switzerland.
Daniel HöftmannDepartment of Anaesthesiology and Pain Medicine, Bern University Hospital, Inselspital, University of Bern, Bern, Switzerland.
Roland AlbrechtSwiss Air-Rescue (Rega), Zurich, Switzerland.
Sven StraumannDepartment of Anaesthesiology and Pain Medicine, Bern University Hospital, Inselspital, University of Bern, Bern, Switzerland.
Mathieu PasquierDepartment of Emergency Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
Urs PietschSwiss Air-Rescue (Rega), Zurich, Switzerland.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Aim: Our aim is to evaluate the management and outcome of avalanche victims in cardiac arrest (CA), focusing on the adherence to international management guidelines and to identify ways to improve the future care of avalanche victims through retrospective evaluation of the missions. Methods: We analysed a retrospective cohort of all avalanche victims in CA treated by Swiss Air-Rescue Rega between 2010 and 2024. Data regarding the avalanche burial (type of burial, burial duration, presence of a patent airway) were evaluated, as were helicopter operational data, data on prehospital medical care [cardiopulmonary resuscitation (CPR) efforts, airway management, core temperature], transport destination, data from further in-hospital treatment if applicable [core temperature, type of rewarming, serum potassium levels, extracorporeal life support (ECLS)] as well as patient outcome. Results: 147 patients could be evaluated. 50 (34%) were declared dead without CPR efforts. CPR was started in 97 patients (66%), of whom 19 achieved ROSC (13%). Only 4 of these patients survived to hospital discharge (3%), 3 of whom had a good neurological outcome (2%). 34 patients (23%) were transported to hospital while CPR was ongoing, of whom in 11 (7%) ECLS was tried to initiate. None of these patients survived to hospital discharge. 27 patients (18%) were not treated in accordance with the guidelines. 22 of these (15%) were (potentially) undertreated (mainly in the sense of transport to a non-ECLS centre, although an ECLS centre would have been correct), 5 (3%) were overtreated (mainly in the sense of transport under ongoing CPR, although not indicated). 61% were tracheally intubated. On admission, core temperature was 1.9 °C (95% confidence interval 1.1-2.7) lower than the temperature measured on scene. Conclusions: Patients who suffer a CA in avalanche accidents have a very poor outcome. A high proportion of patients were not tracheally intubated during transport, cooled down further during resuscitation and transport or were not transported to ECLS centres although indicated. On the other hand, the outcome of ECLS patients is extremely poor.

Indexed as

AccidentalAsphyxiaAvalancheCardiopulmonary resuscitationExtracorporeal life supportHelicopter emergency medical serviceHypothermiaOutcome

Identifiers

PMID40161289
PMCPMC11951987

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.