Cardiac Arrest: From Prevention to Survivorship—Advancing the Chainmail of Survival

Dear Colleagues,

Cardiac arrest necessitating cardiopulmonary resuscitation (CPR) remains one of the leading causes of death worldwide and continues to pose major challenges for healthcare systems, communities and policymakers. Although remarkable progress has been achieved in resuscitation science over recent decades, survival and neurological outcomes remain highly variable, reflecting persistent gaps in prevention, recognition, treatment and post-resuscitation care.

The modern concept of the Chainmail of Survival recognizes that successful cardiac arrest care extends far beyond individual medical interventions. Rather than relying solely on a linear chain of actions, optimal outcomes depend on a resilient network of interconnected components, including public health initiatives, community engagement, emergency medical services, hospitals, rehabilitation services, researchers, educators and policymakers. Strengthening each link within this network is essential to improve survival and quality of life for patients affected by cardiac arrest.

At the same time, rapid advances in clinical medicine, technology, artificial intelligence, precision diagnostics, extracorporeal life support and implementation science are transforming the prevention, diagnosis, treatment and long-term management of cardiac arrest and CPR. These developments create new opportunities to improve outcomes across the entire continuum of care, from risk identification and prevention to rehabilitation and survivorship.

This Special Issue of the Journal of Clinical Medicine aims to provide a platform for high-quality research and expert perspectives addressing contemporary challenges and innovations in cardiac arrest care. We welcome original research articles and reviews that contribute to advancing the science and practice of resuscitation.

Potential topics include (but are not limited to) the following:

• Prevention and prediction of sudden cardiac arrest;
• Population health and public health approaches to cardiac arrest prevention;
• The Chainmail of Survival and systems-based approaches to improving outcomes;
• Systems Saving Lives initiatives and community-wide interventions;
• Epidemiology and global disparities in cardiac arrest care;
• Citizen responder systems and community engagement;
• Public access defibrillation and innovative first-response models;
• Dispatcher-assisted CPR;
• Advances in basic life support and advanced life support;
• Monitoring technologies and physiological-guided resuscitation;
• Artificial intelligence, machine learning and digital health applications;
• Extracorporeal cardiopulmonary resuscitation (ECPR);
• Mechanical circulatory support and advanced post-cardiac arrest therapies;
• Post-resuscitation care and targeted temperature management;
• Neurological prognostication and neuroprotective strategies;
• Biomarkers and emerging diagnostic approaches;
• Precision medicine in resuscitation and critical care;
• Resuscitation in special circumstances and low-resource settings;
• Registry science, quality improvement and implementation research;
• Cardiac arrest survivorship, rehabilitation and quality of life;
• Family-centered care and patient-reported outcomes;
• Future directions in resuscitation science and guideline development.

By bringing together clinicians, researchers, educators, healthcare leaders and policymakers, this Special Issue seeks to strengthen the Chainmail of Survival and advance the global effort to improve outcomes after cardiac arrest.

We look forward to receiving your contributions.

Prof. Dr. Sebastian Schnaubelt
Guest Editor

Manuscript Submission Information

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• cardiac arrest
• cardiopulmonary resuscitation (CPR)
• emergency medicine
• emergency department
• critical care
• basic life support (BLS)
• advanced life support (ALS)
• chain of survival
• chainmail of survival