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Cardiopulmonary Resuscitation—from Research to Clinical Implementation
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Cardiopulmonary Resuscitation—from Research to Clinical Implementation

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

Deadline for manuscript submissions: 20 November 2025 | Viewed by 1980

Special Issue Editor

Prof. Dr. Endre Zima

E-Mail Website
Guest Editor
1. Heart and Vascular Center, Semmelweis University, 1122 Budapest, Hungary
2. Institute of Anaesthesiolgy and Perioperative Care, Semmelweis University, 1085 Budapest, Hungary
Interests: cardiopulmonary resuscitation; post-cardiac arrest intensive care; therapeutic hypothermia; outcome prognostication; arrhythmias; AED and defibrillator waveform development; ICD/IPG/CRT therapy; acute and intensive cardiac care; invasive hemodynamic monitoring; anesthesia
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

The management of cardiac arrest has gone through a huge evolution in the past twenty years. However, the rate of survival is still very poor, with approximately only 10% of patients leaving the hospitals alive after a successful cardiopulmonary resuscitation. Several factors influence the survival rate after cardiac arrest, including the state of science and scientific novelties in the research of cardiopulmonary resuscitation, as well as the implementation and proper management of effective therapeutic steps. This Special Issue aims to focus on hot topics affecting the survival of cardiac arrest from multiple aspects, including basic science and clinical implementation. The other topic addressed is the debate on the exact target temperature after cardiac arrest, which is also of great interest among resuscitation specialists.

We welcome original research articles and reviews within the scope of clinical medicine.

Prof. Dr. Endre Zima
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • cardiopulmonary resuscitation
  • cardiac arrest
  • basic life support
  • advanced life support
  • special circumstances
  • target temperature management
  • eCPR-ECLS
  • survival

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Published Papers (3 papers)

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Research

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14 pages, 2046 KiB  
Article
Cardiac Arrest Mortality Across Time and Space: A National Analysis with Forecasts to 2035
by Noman Khalid, Muhammad Abdullah, Sabrina Clare Higgins, Bilal Ahmad, Hasan Munshi, Mahnoor Hasnat, Muhammad Adil Afzal, Rajkumar Doshi, Rahul Vasudev, Shamoon E. Fayez, Julius M. Gardin and Julio A. Panza
J. Clin. Med. 2025, 14(14), 4851; https://doi.org/10.3390/jcm14144851 - 8 Jul 2025
Viewed by 359
Abstract
Background: Cardiac arrest remains a significant public health challenge with variable mortality trends across different demographics and regions, affecting healthcare planning and intervention strategies. We conducted this study to analyze cardiac arrest-related mortality trends from 1999 to 2023 and predict future trends [...] Read more.
Background: Cardiac arrest remains a significant public health challenge with variable mortality trends across different demographics and regions, affecting healthcare planning and intervention strategies. We conducted this study to analyze cardiac arrest-related mortality trends from 1999 to 2023 and predict future trends up to 2035. Methods: This study analyzed data from 1999 to 2023, focusing on cardiac arrest as the primary cause of death (ICD-10: I46). Age-adjusted mortality rates (AAMRs) were standardized according to the 2000 U.S. Census. Joinpoint regression was utilized to calculate annual percentage change (APC), and an ARIMA model with Python 3.10 was used for mortality predictions. Results: A total of 365,608 cardiac arrest-related deaths were recorded in the USA from 1999 to 2023. There was a sharp decline in mortality rate until 2001 (APC: −10.35, p < 0.05), followed by a slowed decline until 2013 (APC: −2.91, p < 0.05), and then a gradual uptrend. Males exhibited a higher AAMR (5.8, 95% CI: 5.8–5.9) compared to females (4.2, 95% CI: 4.1–4.2). African Americans had the highest AAMR (8.9, 95% CI: 8.9–9), followed by Caucasians (4.8, 95% CI: 4.8–4.9) and American Indians (3.5, 95% CI: 3.3–3.7). The South region of the US had the highest AAMR, followed by the Northeast, Midwest, and West. Alabama exhibited the highest AAMR, followed by Nevada and Hawaii. Predictive analysis suggests a potential stable slow downtrend in mortality rates by 2035 (AAMR: 4.28, 95% CI: −1.8–10.4). Conclusions: The observed trends and future predictions underscore the importance of targeted public health interventions and healthcare planning to address cardiac arrest mortality. Full article
(This article belongs to the Special Issue Cardiopulmonary Resuscitation—from Research to Clinical Implementation)
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13 pages, 489 KiB  
Article
Correlation Between End-Tidal Carbon Dioxide and Regional Cerebral Oxygen Saturation During Cardiopulmonary Resuscitation
by Mateusz Putowski, Magdalena Dudzikowska, Wojciech Wieczorek, Michal Pruc, Lukasz Szarpak and Zbigniew Siudak
J. Clin. Med. 2025, 14(11), 3747; https://doi.org/10.3390/jcm14113747 - 27 May 2025
Viewed by 649
Abstract
Background/Objectives: Near-infrared spectroscopy (NIRS) enables the non-invasive assessment of cerebral oximetry, offering insights into the efficacy of oxygen supply to the brain. NIRS, when combined with other monitoring techniques such as capnography, may play a crucial role in advanced patient monitoring during sudden [...] Read more.
Background/Objectives: Near-infrared spectroscopy (NIRS) enables the non-invasive assessment of cerebral oximetry, offering insights into the efficacy of oxygen supply to the brain. NIRS, when combined with other monitoring techniques such as capnography, may play a crucial role in advanced patient monitoring during sudden cardiac arrest and post-resuscitation treatment. This research assessed the relationship between end-tidal carbon dioxide (ETCO2) and regional cerebral oxygen saturation (rSO2) during cardiopulmonary resuscitation. Methods: The research was performed from 11 January 2023 until 31 January 2024, at the University Hospital in Poland. The cohort of responders included patients who had in-hospital cardiac arrest (IHCA). The Rapid Response Team attached the rSO2 and ETCO2 monitoring devices to each patient during cardiopulmonary resuscitation (CPR). The cohort included 104 patients. Results: The correlation coefficient between ETCO2 and rSO2 values was 0.641 (95% CI: 0.636–0.646), and during the last 4 min of CPR before ROSC, it was 0.873 (95% CI: 0.824–0.910). Conclusions: The positive correlation between ETCO2 and rSO2 may suggest that concurrent monitoring of both parameters during resuscitation might serve as a valuable predictor of CPR efficacy and the likelihood of achieving recovery of spontaneous circulation in a multimodal framework. In the lack of rapid ETCO2 monitoring capabilities, rSO2 may function as a simple and effective alternative for assessment. Full article
(This article belongs to the Special Issue Cardiopulmonary Resuscitation—from Research to Clinical Implementation)
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Review

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16 pages, 272 KiB  
Review
Enhancing Safety and Quality of Cardiopulmonary Resuscitation During Coronavirus Pandemic
by Diána Pálok, Barbara Kiss, László Gergely Élő, Ágnes Dósa, László Zubek and Gábor Élő
J. Clin. Med. 2025, 14(12), 4145; https://doi.org/10.3390/jcm14124145 - 11 Jun 2025
Viewed by 518
Abstract
Background: Professional knowledge and experience of healthcare organization went through continuous change and development with the progression of COVID-19 pandemic waves. However, carefully developed guidelines for cardiopulmonary resuscitation (CPR) remained largely unchanged regardless of the epidemic situation, with the largest change being a [...] Read more.
Background: Professional knowledge and experience of healthcare organization went through continuous change and development with the progression of COVID-19 pandemic waves. However, carefully developed guidelines for cardiopulmonary resuscitation (CPR) remained largely unchanged regardless of the epidemic situation, with the largest change being a more prominent bioethical approach. It would be possible to further improve the quality of CPR by systematic data collection, the facilitation of prospective studies, and further development of the methodology based on this evidence, as well as by providing information and developing provisions on interventions with expected poor outcomes, and ultimately by refusing resuscitation. Methods: This study involved the critical collection and analysis of literary data originating from the Web of Science and PubMed databases concerning bioethical aspects and the efficacy of CPR during the COVID-19 pandemic. Results: According to the current professional recommendation of the European Resuscitation Council (ERC), CPR should be initiated immediately in case of cardiac arrest in the absence of an exclusionary circumstance. One such circumstance is explicit refusal of CPR by a well-informed patient, which in practice takes the form of a prior declaration. ERC prescribes the following conjunctive conditions for do-not-attempt CPR (DNACPR) declarations: present, real, and applicable. It is recommended to take the declaration as a part of complex end-of-life planning, with the corresponding documentation available in an electronic database. The pandemic has brought significant changes in resuscitation practice at both lay and professional levels as well. Incidence of out-of-hospital resuscitation (OHCA) did not differ compared to the previous period, while cardiac deaths in public places almost halved during the epidemic (p < 0.001) as did the use of AEDs (p = 0.037). The number of resuscitations performed by bystanders and by the emergency medical service (EMS) also showed a significant decrease (p = 0.001), and the most important interventions (defibrillation, first adrenaline time) suffered a significant delay. Secondary survival until hospital discharge thus decreased by 50% during the pandemic period. Conclusions: The COVID-19 pandemic provided a significant impetus to the revision of guidelines. While detailed methodology has changed only slightly compared to the previous procedures, the DNACPR declaration regarding self-determination is mentioned in the context of complex end-of-life planning. The issue of safe environment has come to the fore for both lay and trained resuscitators. Future Directions: Prospective evaluation of standardized methods can further improve the patient’s autonomy and quality of life. Since clinical data are controversial, further prospective controlled studies are needed to evaluate the real hazards of aerosol-generating procedures. Full article
(This article belongs to the Special Issue Cardiopulmonary Resuscitation—from Research to Clinical Implementation)
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