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Post-Return of Spontaneous Circulation (Post-ROSC) Management for Out-of-Hospital Cardiac Arrest...
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Post-Return of Spontaneous Circulation (Post-ROSC) Management for Out-of-Hospital Cardiac Arrest (OHCA) Patients: What We Can Do to Improve Survival and Return to Work and Participation in Society?

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

Deadline for manuscript submissions: 25 September 2025 | Viewed by 1276

Special Issue Editor

Dr. Enrico Baldi

E-Mail Website
Guest Editor
1. Division of Cardiology, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy
2. Cardiac Arrest and Resuscitation Science Research Team (RESTART), Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy
Interests: out-of-hospital cardiac arrest; cardiopulmonary resuscitation; arrhythmias
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Survival from out-of-hospital cardiac arrest (OHCA) has increased in recent years due to community involvement initiatives and improved pre-hospital care. However, the management of the phase after the return of spontaneous circulation (post-ROSC) plays a crucial role in allowing the patient to have the best possible chance of survival. Improvements in both the pre-hospital phase of post-ROSC (e.g., post-ROSC ECG, avoid hyperoxia, etc.) and the in-hospital treatment (e.g., coronary angiography, anti-aggregation therapy, ICU treatment) can make a significant difference for the patient's outcome. Moreover, in cases where the patient survives with a good neurological outcome, there is increasing evidence that psychological distress problems may affect the patient's quality of life and return to social life, so it appears to be of paramount importance to act in order to allow the patient not only to survive, but to return to their usual quality of life before the cardiac arrest.

This Special Issue therefore aims to explore all aspects of patient treatment, from the immediate phase after ROSC to the patient's return to society.

Dr. Enrico Baldi
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

  • return of spontaneous circulation (ROSC)
  • quality of life
  • psychological distress
  • post-ROSC management
  • return to society

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Published Papers (2 papers)

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10 pages, 413 KiB  
Protocol
V-CARE (Virtual Care After REsuscitation): Protocol for a Randomized Feasibility Study of a Virtual Psychoeducational Intervention After Cardiac Arrest—A STEPCARE Sub-Study
by Marco Mion, Gisela Lilja, Mattias Bohm, Erik Blennow Nordström, Dorit Töniste, Katarina Heimburg, Paul Swindell, Josef Dankiewicz, Markus B. Skrifvars, Niklas Nielsen, Janus C. Jakobsen, Judith White, Matt P. Wise, Nikos Gorgoraptis, Meadbh Keenan, Philip Hopkins, Nilesh Pareek, Maria Maccaroni and Thomas R. Keeble
J. Clin. Med. 2025, 14(13), 4429; https://doi.org/10.3390/jcm14134429 - 22 Jun 2025
Viewed by 440
Abstract
Background: Out-of-hospital cardiac arrest (OHCA) survivors and their relatives may face challenges following hospital discharge, relating to mood, cognition, and returning to normal day-to-day activities. Identified research gaps include a lack of knowledge around what type of intervention is needed to best navigate [...] Read more.
Background: Out-of-hospital cardiac arrest (OHCA) survivors and their relatives may face challenges following hospital discharge, relating to mood, cognition, and returning to normal day-to-day activities. Identified research gaps include a lack of knowledge around what type of intervention is needed to best navigate recovery. In this study, we investigate the feasibility and patient acceptability of a new virtual psychoeducational group intervention for OHCA survivors and their relatives and compare it to a control group receiving a digital information booklet. Methods: V-CARE is a comparative, single-blind randomized pilot trial including participants at selected sites of the STEPCARE trial, in the United Kingdom and Sweden. Inclusion criteria are a modified Rankin Scale (mRS) ≤ 3 at 30-day follow-up; no diagnosis of dementia; and not experiencing an acute psychiatric episode. One caregiver per patient is invited to participate optionally. The intervention group in V-CARE receives four semi-structured, one-hour-long, psychoeducational sessions delivered remotely via video call by a trained clinician once a week, 2–3 months after hospital discharge. The sessions cover understanding cardiac arrest; coping with fatigue and memory problems; managing low mood and anxiety; and returning to daily life. The control group receives an information booklet focused on fatigue, memory/cognitive problems, mental health, and practical coping strategies. Results: Primary: feasibility (number of patients consented) and acceptability (retention rate); secondary: satisfaction with care (Client Satisfaction Questionnaire 8 item), self-management skills (Self-Management Assessment Scale) and, where available, health-related outcomes assessed in the STEPCARE Extended Follow-up sub-study including cognition, fatigue, mood, quality of life, and return to work. Conclusions: If preliminary insights from the V-CARE trial suggest the intervention to be feasible and acceptable, the results will be used to design a larger trial aimed at informing future interventions to support OHCA recovery. Full article
(This article belongs to the Special Issue Post-Return of Spontaneous Circulation (Post-ROSC) Management for Out-of-Hospital Cardiac Arrest (OHCA) Patients: What We Can Do to Improve Survival and Return to Work and Participation in Society?)
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12 pages, 870 KiB  
Study Protocol
The REVIVE Project: From Survival to Holistic Recovery—A Prospective Multicentric Evaluation of Cognitive, Emotional, and Quality-of-Life Outcomes in Out-of-Hospital Cardiac Arrest Survivors
by Alice Mandrini, Marco Mion, Roberto Primi, Sara Bendotti, Alessia Currao, Leila Ulmanova, Carlo Arnò, Filippo Dossi, Cristian Fava, Daniele Ghiraldin, Davide Pegorin, Paola Genoni, Diego Maffeo, Cinzia Dossena, Silvia Affinito, Giovanni Bertazzoli, Francesco Cipullo, Cecilia Fantoni, Matteo Della Torre, Silvia Frattini, Gioele Papi, Angelica Praderio, Luca Tarantino, Simone Savastano, Enrico Baldi and all the LombardiaCARe Researchersadd Show full author list remove Hide full author list
J. Clin. Med. 2025, 14(11), 3631; https://doi.org/10.3390/jcm14113631 - 22 May 2025
Viewed by 576
Abstract
Background/Objectives: Most survivors of out-of-hospital cardiac arrest (OHCA) may suffer from cognitive, mental difficulties, and fatigue, which negatively impact their quality of life, despite a good physical recovery. However, no definitive data are available on this topic, so this study aims to [...] Read more.
Background/Objectives: Most survivors of out-of-hospital cardiac arrest (OHCA) may suffer from cognitive, mental difficulties, and fatigue, which negatively impact their quality of life, despite a good physical recovery. However, no definitive data are available on this topic, so this study aims to assess the feasibility and acceptability of a centralized, sub-regional screening system for OHCA survivors in Italy and the prevalence of these disorders. Methods: OHCA survivors discharged with good neurological outcomes (Cerebral Performance Category (CPC) ≤ 2 and modified Ranking Scale (mRS) ≤ 3) from hospitals in the “Lombardia CARe” registry will be evaluated by a clinical psychologist using the Montreal Cognitive Assessment (MoCA), Hospital Anxiety and Depression Scale (HADS), EQ-5D-5L for quality of life, and the Impact of Event Scale-Revised (IES-R) at pre-discharge or within 15 days and then at 1, 3, 6, and 12 months. Patients with clinical issues will be referred for psychological support or to a community rehabilitation program. Feasibility will be defined as a recruitment rate ≥ 80% and acceptability as a retention rate ≥ 50% over 12 months. Results: Based on historical data from the Lombardia CARe, an estimated 350 eligible survivors are expected, which will allow estimation of a prevalence ranging between 20% and 30% with 5% precision and 95% confidence. Conclusions: This study will be the first in Italy to evaluate the feasibility and acceptability of a centralized, sub-regional system for pre-/post-discharge evaluation of cognitive impairment, mental health, and quality of life in a large cohort of OHCA survivors, documenting the prevalence of these disorders. Full article
(This article belongs to the Special Issue Post-Return of Spontaneous Circulation (Post-ROSC) Management for Out-of-Hospital Cardiac Arrest (OHCA) Patients: What We Can Do to Improve Survival and Return to Work and Participation in Society?)
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