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Clinical Advances in Cardiac Arrest and Cardiopulmonary Resuscitation
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Clinical Advances in Cardiac Arrest and Cardiopulmonary Resuscitation

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

Deadline for manuscript submissions: 25 November 2024 | Viewed by 5959

Special Issue Editor

Dr. Eugene Yuriditsky

E-Mail Website
Guest Editor
Division of Cardiology, Department of Medicine, New York University School of Medicine, New York, NY, USA
Interests: cardiac critical care; pulmonary embolism; cardiopulmonary resuscitation; shock

Special Issue Information

Dear Colleagues,

In recent years, the field of cardiopulmonary resuscitation has experienced rather incredible developments pertaining to post-arrest temperature management, novel approaches to defibrillation, and the use of extracorporeal cardiopulmonary resuscitation. Advancements including physiologic feedback and the use of point-of-care ultrasound have added an element of personalization to the historically algorithmical approaches.

In this Special Issue of the Journal of Clinical Medicine on ‘Clinical Advances in Cardiac Arrest and Cardiopulmonary Resuscitation’, we aim to highlight measures that can be undertaken to optimize arrest recognition, EMS activation, and defibrillator access and use; underscore the technologies that can aid in intra-arrest care, augment perfusion, and increase survival; emphasize the ways to improve neurologic outcomes following return of spontaneous circulation; and present discussions on the future of neuroprotection.

We cordially invite contributions from worldwide experts in the field of cardiopulmonary resuscitation exploring the aforementioned issues at the forefront of the field.

Dr. Eugene Yuriditsky
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 arrest
  • extracorporeal cardiopulmonary resuscitation
  • therapeutic hypothermia
  • targeted temperature management
  • defibrillation
  • automated external defibrillator
  • neuroprognostication

Published Papers (2 papers)

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Research

10 pages, 1001 KiB  
Article
Improved Extracorporeal Cardiopulmonary Resuscitation (ECPR) Outcomes are Associated with a Restrictive Patient Selection Algorithm
by Benjamin Assouline, Nathalie Mentha, Hannah Wozniak, Viviane Donner, Carole Looyens, Laurent Suppan, Robert Larribau, Carlo Banfi, Karim Bendjelid and Raphaël Giraud
J. Clin. Med. 2024, 13(2), 497; https://doi.org/10.3390/jcm13020497 - 16 Jan 2024
Viewed by 1046
Abstract
Introduction: Out-of-hospital cardiac arrest (OHCA) is a leading cause of mortality. Despite decades of intensive research and several technological advancements, survival rates remain low. The integration of extracorporeal cardiopulmonary resuscitation (ECPR) has been recognized as a promising approach in refractory OHCA. However, evidence [...] Read more.
Introduction: Out-of-hospital cardiac arrest (OHCA) is a leading cause of mortality. Despite decades of intensive research and several technological advancements, survival rates remain low. The integration of extracorporeal cardiopulmonary resuscitation (ECPR) has been recognized as a promising approach in refractory OHCA. However, evidence from recent randomized controlled trials yielded contradictory results, and the criteria for selecting eligible patients are still a subject of debate. Methods: This study is a retrospective analysis of refractory OHCA patients treated with ECPR. All adult patients who received ECPR, according to the hospital algorithm, from 2013 to 2021 were included. Two different algorithms were used during this period. A “permissive” algorithm was used from 2013 to mid-2016. Subsequently, a revised algorithm, more “restrictive”, based on international guidelines, was implemented from mid-2016 to 2021. Key differences between the two algorithms included reducing the no-flow time from less than three minutes to zero minutes (implying that the cardiac arrests must occur in the presence of a witness with immediate CPR initiation), reducing low-flow duration from 100 to 60 min, and lowering the age limit from 65 to 55 years. The aim of this study is to compare these two algorithms (permissive (1) and restrictive (2)) to determine if the use of a restrictive algorithm was associated with higher survival rates. Results: A total of 48 patients were included in this study, with 23 treated under Algorithm 1 and 25 under Algorithm 2. A significant difference in survival rate was observed in favor of the restrictive algorithm (9% vs. 68%, p < 0.05). Moreover, significant differences emerged between algorithms regarding the no-flow time (0 (0–5) vs. 0 (0–0) minutes, p < 0.05). Survivors had a significantly shorter no-flow and low-flow time (0 (0–0) vs. 0 (0–3) minutes, p < 0.01 and 40 (31–53) vs. 60 (45–80) minutes, p < 0.05), respectively. Conclusion: The present study emphasizes that a stricter selection of OHCA patients improves survival rates in ECPR. Full article
(This article belongs to the Special Issue Clinical Advances in Cardiac Arrest and Cardiopulmonary Resuscitation)
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20 pages, 1121 KiB  
Article
Treatment of Refractory Cardiac Arrest by Controlled Reperfusion of the Whole Body: A Multicenter, Prospective Observational Study
by Georg Trummer, Christoph Benk, Jan-Steffen Pooth, Tobias Wengenmayer, Alexander Supady, Dawid L. Staudacher, Domagoj Damjanovic, Dirk Lunz, Clemens Wiest, Hug Aubin, Artur Lichtenberg, Martin W. Dünser, Johannes Szasz, Dinis Dos Reis Miranda, Robert J. van Thiel, Jan Gummert, Thomas Kirschning, Eike Tigges, Stephan Willems, Friedhelm Beyersdorf and on behalf of the Extracorporeal Multi-Organ Repair Study Groupadd Show full author list remove Hide full author list
J. Clin. Med. 2024, 13(1), 56; https://doi.org/10.3390/jcm13010056 - 21 Dec 2023
Cited by 2 | Viewed by 4507
Abstract
Background: Survival following cardiac arrest (CA) remains poor after conventional cardiopulmonary resuscitation (CCPR) (6–26%), and the outcomes after extracorporeal cardiopulmonary resuscitation (ECPR) are often inconsistent. Poor survival is a consequence of CA, low-flow states during CCPR, multi-organ injury, insufficient monitoring, and delayed treatment [...] Read more.
Background: Survival following cardiac arrest (CA) remains poor after conventional cardiopulmonary resuscitation (CCPR) (6–26%), and the outcomes after extracorporeal cardiopulmonary resuscitation (ECPR) are often inconsistent. Poor survival is a consequence of CA, low-flow states during CCPR, multi-organ injury, insufficient monitoring, and delayed treatment of the causative condition. We developed a new strategy to address these issues. Methods: This all-comers, multicenter, prospective observational study (69 patients with in- and out-of-hospital CA (IHCA and OHCA) after prolonged refractory CCPR) focused on extracorporeal cardiopulmonary support, comprehensive monitoring, multi-organ repair, and the potential for out-of-hospital cannulation and treatment. Result: The overall survival rate at hospital discharge was 42.0%, and a favorable neurological outcome (CPC 1+2) at 90 days was achieved for 79.3% of survivors (CPC 1+2 survival 33%). IHCA survival was very favorable (51.7%), as was CPC 1+2 survival at 90 days (41%). Survival of OHCA patients was 35% and CPC 1+2 survival at 90 days was 28%. The subgroup of OHCA patients with pre-hospital cannulation showed a superior survival rate of 57.1%. Conclusions: This new strategy focusing on repairing damage to multiple organs appears to improve outcomes after CA, and these findings should provide a sound basis for further research in this area. Full article
(This article belongs to the Special Issue Clinical Advances in Cardiac Arrest and Cardiopulmonary Resuscitation)
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