Cardiogenic Shock and Cardiac Arrest: Updates, Challenges and Opportunities

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Cardiology".

Deadline for manuscript submissions: 31 October 2025 | Viewed by 754

Special Issue Editor


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Guest Editor
Department of Emergency Medicine, Division of Critical Care Medicine, University of Florida College of Medicine, Gainesville, FL 32610, USA
Interests: cardiac arrest; extracorporeal membrane oxygenation; extracorporeal CPR; cardiopulmonary resuscitation; cardiogenic shock

Special Issue Information

Dear Colleagues,

Cardiac arrest remains a leading global cause of mortality and morbidity, with survival rates stagnating despite advancements in resuscitation science. This Special Issue explores the multifaceted nature of cardiac arrest and the critical need for innovation and scientific advances to improve outcomes.

Cardiac arrest is not a singular event but a complex interplay of pathophysiological mechanisms, patient-specific variables, and system-level factors. Its treatment requires an interdisciplinary approach, integrating expertise from a wide array of clinical specialties and health systems science. Novel therapies, such as extracorporeal cardiopulmonary resuscitation (ECPR), offer promising avenues for improving outcomes in select populations, yet their implementation demands rigorous scientific validation and resource-intensive infrastructure.

This Issue seeks to emphasize gaps in understanding cardiac arrest physiology, including the roles of microcirculatory dysfunction, metabolic derangements, and neurological injury. Contributions highlighting emerging technologies, from precision-targeted interventions to advanced monitoring tools, such as potential game-changers in personalizing care, are welcome.

Dr. Torben K. Becker
Guest Editor

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Keywords

  • cardiac arrest
  • extracorporeal membrane oxygenation
  • extracorporeal CPR
  • cardiopulmonary resuscitation
  • cardiogenic shock
  • resuscitation
  • prognostication

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Published Papers (2 papers)

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6 pages, 5163 KiB  
Case Report
Pseudoaneurysmectomy After Left Ventricular Free Wall Rupture Repair: A Case Report
by B. Ufuk Baldan, Patrick Klein, J. Lauran Stöger, Robert J. M. Klautz and Meindert Palmen
J. Clin. Med. 2025, 14(10), 3393; https://doi.org/10.3390/jcm14103393 - 13 May 2025
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Abstract
Background/Objectives: Left ventricular (LV) pseudoaneurysm is a rare but life-threatening complication after acute myocardial infarction, often resulting from inadequate excision of damaged myocardium and use of only a xenopericardial patch during primary LV free wall rupture repair. Methods: A 62-year-old female [...] Read more.
Background/Objectives: Left ventricular (LV) pseudoaneurysm is a rare but life-threatening complication after acute myocardial infarction, often resulting from inadequate excision of damaged myocardium and use of only a xenopericardial patch during primary LV free wall rupture repair. Methods: A 62-year-old female developed a giant LV pseudoaneurysm one year after initial surgical repair of a free wall rupture with a xenopericardial patch. Imaging confirmed a large pseudoaneurysm with a broad neck and mural thrombus. She underwent pseudoaneurysmectomy, LV reconstruction with a Dacron patch overlaid by a xenopericardial patch, and concomitant mitral and tricuspid valve repair. Results: Surgical exploration revealed a broad-necked pseudoaneurysm and dehisced patch material. The aneurysm was resected, and the LV was reconstructed, resulting in the exclusion of the pseudoaneurysm and improvement of the shape and function. The patient recovered uneventfully and was discharged in good clinical condition with restored LV function. Conclusions: Pseudoaneurysm formation after LV free wall rupture repair is often due to insufficient resection and the use of only a xenopericardial patch. Surgical management with complete excision, Dacron patch reconstruction, and xenopericardial reinforcement facilitates the favorable remodeling of LV geometry and function, and reduces the risk of recurrence. Full article
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24 pages, 1103 KiB  
Systematic Review
Lactate and pH as Independent Biomarkers for Prognosticating Meaningful Post-out-of-Hospital Cardiac Arrest Outcomes: A Systematic Review and Meta-Analysis
by Nishil T. Patel, Casey T. Carr, Charlotte M. Hopson and Charles W. Hwang
J. Clin. Med. 2025, 14(7), 2244; https://doi.org/10.3390/jcm14072244 - 25 Mar 2025
Viewed by 445
Abstract
Background/Objectives: To systematically review the literature and to characterize the utility of lactate and pH for predicting survival and long-term neurological outcomes after out-of-hospital cardiac arrest (OHCA). Methods: PRISMA guidelines were followed. PubMed, Embase, Web of Science, Cochrane Central, and Academic [...] Read more.
Background/Objectives: To systematically review the literature and to characterize the utility of lactate and pH for predicting survival and long-term neurological outcomes after out-of-hospital cardiac arrest (OHCA). Methods: PRISMA guidelines were followed. PubMed, Embase, Web of Science, Cochrane Central, and Academic Search Premier were searched for relevant studies. The population included adults with OHCA. Studies with majority in-hospital cardiac arrest (>50%) and studies predicting return of spontaneous circulation (ROSC) were excluded. Pairs of investigators reviewed the studies for relevance. Data were extracted and risk of bias was assessed using the Newcastle–Ottawa Scale. Meta-analyses were performed to characterize the relationship between lactate and pH with survival and neurological outcomes. Results: We included 21,120 patients over 49 studies. Most studies (78%) included OHCA only. Mean lactate of 7.24 (95%CI:6.05–8.44) was associated with favorable survival (n = 9155; 21 studies), while mean lactate of 7.15 (95%CI:6.37–7.93) was associated with favorable neurological outcome (n = 7534; 21 studies). Mean pH of 7.22 (95%CI:7.10–7.33) was associated with favorable survival (n = 4077; 7 studies), while a mean pH of 7.22 (95%CI:7.17–7.27) was associated with favorable neurological outcome (n = 6701; 13 studies). Poor outcomes were associated with lower pH and higher lactate values. Risk of bias was generally low to medium, while heterogeneity was high. Conclusions: A direct correlation exists between pH with survival and neurological outcome; the likelihood of favorable outcomes increases as pH increases. Conversely, an inverse relationship exists between lactate with survival and neurological outcome; higher lactate is associated with poorer outcomes. For lactate, the threshold for survival was more lenient than for favorable neurological outcome. Full article
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