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Life
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Clinical Update for Resuscitation Science
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Clinical Update for Resuscitation Science

A special issue of Life (ISSN 2075-1729). This special issue belongs to the section "Medical Research".

Deadline for manuscript submissions: 30 July 2025 | Viewed by 7599

Special Issue Editor

Dr. Mitsuaki Nishikimi

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Guest Editor
Department of Emergency and Critical Care Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 734-8551, Japan
Interests: cardiac arrest; ARDS; ECMO; trauma
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Resuscitation science has advanced over the past decade, leading to improved outcomes for critically ill patients with severe acute respiratory or circulatory failure. However, despite these advancements, their outcomes remain poor. For example, the survival rates of patients with cardiac arrest are approximately 10% (varying from 0% to 18%), and even among survivors, many patients are discharged or transferred to other hospitals in a vegetative state or coma. Therefore, there is a need to develop better strategies for the management of such critically ill patients.

The objective of this Special Issue is to discuss knowledge gaps and research priorities in the field of resuscitation science, as well as to present potential novel treatment strategies that seek to improve their outcomes. The scope of this Special Issue intentionally encompasses a wide range of topics and perspectives related to resuscitation research.

This Special Issue focuses on any and all critically ill patients who need resuscitative interventions, such as those with severe acute respiratory or circulatory failure, requiring the support of extracorporeal membrane oxygenation, or severe trauma, as well as patients experiencing cardiac arrest. Additionally, we seek to encompass studies related to training and education on resuscitative procedures. This broad scope takes in clinical and basic research, review articles, and case reports related to resuscitation science.

Dr. Mitsuaki Nishikimi
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. Life is an international peer-reviewed open access monthly 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

  • resuscitation science
  • cardiac arrest
  • acute respiratory failure
  • acute circulatory failure
  • trauma

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Published Papers (5 papers)

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Research

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10 pages, 1580 KiB  
Article
Time Variable Models of Severe Hemorrhagic Shock in Rats
by Matthew B. Barajas, Takuro Oyama, Miriam J. K. Walter, Masakazu Shiota, Zhu Li and Matthias L. Riess
Life 2025, 15(4), 522; https://doi.org/10.3390/life15040522 - 22 Mar 2025
Viewed by 348
Abstract
Background: Classical teaching dictates that damage control resuscitation is ideally implemented within the first or ‘golden’ hour after trauma-related hemorrhage. Given the heterogeneity of trauma, varied models must be utilized to guide ongoing investigation. We sought to determine exactly what happens during the [...] Read more.
Background: Classical teaching dictates that damage control resuscitation is ideally implemented within the first or ‘golden’ hour after trauma-related hemorrhage. Given the heterogeneity of trauma, varied models must be utilized to guide ongoing investigation. We sought to determine exactly what happens during the ‘golden hour’ by varying hemorrhage and down times and mimicking venous or arterial bleeding while varying oxygen therapy, a readily available pre-hospital intervention, on survival in a small-animal rodent model. Methods: Rats were bled by 40% of their blood volume over 30 or 60 min, with varied ‘down-times’ of 30, 45, or 60 min. FiO2 was administered at 21% or 40%, mimicking nasal cannula. Multiple linear regression was performed between the independent variables and each measured outcome. Sub-group analyses were stratified by survival. Results: There was no statistically significant variation in end-organ insult (lactate), cardiac functioning (cardiac output or left ventricle fractional area of change), mean arterial pressure at end experiment, survival, or survival times among the groups. Conclusions: This study adds to the data against an all-encompassing golden hour, as even a rapid hemorrhage with long down time did not decrease survival. Furthermore, we add to the body of literature in this field by examining cardiac markers of injury with transthoracic echocardiography. Full article
(This article belongs to the Special Issue Clinical Update for Resuscitation Science)
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12 pages, 1703 KiB  
Article
Effect Size of Targeted Temperature Management in Pediatric Patients with Post-Cardiac Arrest Syndrome According to the Severity
by Takeshi Namba, Mitsuaki Nishikimi, Ryo Emoto, Kazuya Kikutani, Shinichiro Ohshimo, Shigeyuki Matsui and Nobuaki Shime
Life 2025, 15(1), 26; https://doi.org/10.3390/life15010026 - 30 Dec 2024
Viewed by 748
Abstract
Aim: Few studies have investigated the differential effects of targeted temperature management (TTM) according to the severity of the condition in pediatric patients with post-cardiac arrest syndrome (PCAS). This study was aimed at evaluating the differential effects of TTM in pediatric patients with [...] Read more.
Aim: Few studies have investigated the differential effects of targeted temperature management (TTM) according to the severity of the condition in pediatric patients with post-cardiac arrest syndrome (PCAS). This study was aimed at evaluating the differential effects of TTM in pediatric patients with PCAS according to a risk classification tool developed by us, the rCAST. Methods: We used data from a nationwide prospective registry for out-of-hospital cardiac arrest (OHCA) patients in Japan. We classified eligible pediatric PCAS patients (aged ≤ 18 years) into quintiles based on their rCAST scores and evaluated the effect of TTM on the neurological outcomes in each severity group. Then, focusing on the severity group that appeared to benefit from TTM, we also evaluated the effect of TTM by propensity score analysis. Good neurological outcome was defined as a score on the Cerebral Performance Category or Pediatric Cerebral Performance Category scale of ≤2 at 30 days. Results: Among 1526 OHCA pediatric patients enrolled in the registry, the data of 307 PCAS patients were analyzed. None of the patients in the fifth quintile (rCAST ≥ 18.5) showed a good neurological outcome, regardless of whether they received TTM or not (0% [0/20] vs. 0% [0/73]). The propensity score analysis showed that TTM was significantly associated with a good neurological outcome in patients with rCAST scores in the first to fourth quintile (odds ratio: 1.21 [1.04–1.40], p = 0.014). Conclusions: TTM was significantly associated with good neurological outcomes in pediatric PCAS patients with rCAST scores of ≤18.0. Full article
(This article belongs to the Special Issue Clinical Update for Resuscitation Science)
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10 pages, 834 KiB  
Article
Optimal Timing of the Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio as Early Predictors of Neurological Outcomes in Postcardiac Arrest Patients
by Dongju Kim, Hanna Park, Sang-Min Kim and Won Young Kim
Life 2024, 14(11), 1421; https://doi.org/10.3390/life14111421 - 4 Nov 2024
Viewed by 977
Abstract
The neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) have been recognized as predictors of various critical illnesses. Our study aimed to investigate whether the NLR and PLR measured at different timepoints could predict poor neurological outcomes at 6 months. This observational retrospective cohort [...] Read more.
The neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) have been recognized as predictors of various critical illnesses. Our study aimed to investigate whether the NLR and PLR measured at different timepoints could predict poor neurological outcomes at 6 months. This observational retrospective cohort study included adults who had experienced out-of-hospital cardiac arrest (OHCA) and received targeted temperature management between November 2015 and December 2020. Patients with an active infection, as confirmed by an initial blood culture, were excluded. Multivariate logistic regression models were used to determine the association between the NLR and PLR at 0, 24, and 48 h after return of spontaneous circulation and poor neurological outcomes, defined as a Cerebral Performance Category score of ≥3 at 6 months. The NLR at 24 h, but not the NLR or PLR at other timepoints, was significantly associated with poor neurological outcomes (odds ratio: 1.05; 95% CI: 1.01–1.09; p = 0.018). The NLR at 24 h showed moderate accuracy in predicting poor neurological outcomes, with an AUC of 0.619. A cutoff value of 9.0 achieved 72.5% sensitivity and 47.7% specificity. The NLR measured at 24 h after ROCS could be used for early neuroprognostication given its low cost and widespread availability. Full article
(This article belongs to the Special Issue Clinical Update for Resuscitation Science)
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16 pages, 5022 KiB  
Article
Multi-Modal Assessment of Cerebral Hemodynamics in Resuscitated Out-of-Hospital Cardiac Arrest Patients: A Case-Series
by Shir Lynn Lim, May Zin Myint, Kai Lee Woo, Elaine Young Heng Chee, Chiew Sie Hong, Erta Beqiri, Peter Smielewski, Marcus Eng Hock Ong and Vijay Kumar Sharma
Life 2024, 14(9), 1067; https://doi.org/10.3390/life14091067 - 26 Aug 2024
Viewed by 1433
Abstract
We assessed the feasibility of concurrent monitoring of cerebral hemodynamics in adult, comatose out-of-hospital cardiac arrest (OHCA) patients admitted to the National University Heart Centre Singapore from October 2021 to August 2023. Patients underwent continuous near-infrared spectroscopy (NIRS) monitoring in the first 72 [...] Read more.
We assessed the feasibility of concurrent monitoring of cerebral hemodynamics in adult, comatose out-of-hospital cardiac arrest (OHCA) patients admitted to the National University Heart Centre Singapore from October 2021 to August 2023. Patients underwent continuous near-infrared spectroscopy (NIRS) monitoring in the first 72 h after return of spontaneous circulation (ROSC) and 30-min transcranial Doppler ultrasound (TCD) monitoring at least once. With constant mechanical ventilatory settings and continuous electrocardiographic, pulse oximeter and end-tidal carbon dioxide monitoring, blood pressure was manipulated via vasopressors and cerebral autoregulation assessed by measuring changes in regional cerebral oxygenation (NIRS) and cerebral blood flow velocities (TCD) in response to changes in mean arterial pressure. The primary outcome was neurological recovery at hospital discharge. Amongst the first 16 patients (median age 61, 94% males), we observed four unique patterns: preserved cerebral autoregulation, loss of cerebral autoregulation, cardio-cerebral asynchrony and cerebral circulatory arrest. Patients with preserved cerebral autoregulation had lower levels of neuro-injury biomarkers (neurofilaments light and heavy) and the majority (86%) were discharged with good neurological recovery. Multi-modal assessment of cerebral hemodynamics after OHCA is feasible and derived patterns correlated with neurological outcomes. The between- and within-patient heterogeneity in cerebral hemodynamics calls for more research on individualized treatment strategies. Full article
(This article belongs to the Special Issue Clinical Update for Resuscitation Science)
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Review

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12 pages, 556 KiB  
Review
Advancements in Trauma-Induced Acute Kidney Injury: Diagnostic and Therapeutic Innovations
by Sergio Lassola, Francesco Cundari, Giuseppe Marini, Francesco Corradi and Silvia De Rosa
Life 2024, 14(8), 1005; https://doi.org/10.3390/life14081005 - 13 Aug 2024
Cited by 3 | Viewed by 3464
Abstract
Acute kidney injury following trauma impacts patient recovery critically, necessitating an integrated approach to emergency care and nephrology. This review aims to provide a comprehensive understanding of trauma-induced nephropathy, highlighting recent advancements in pathophysiological insights, diagnostic techniques, and strategic interventions. Our key findings [...] Read more.
Acute kidney injury following trauma impacts patient recovery critically, necessitating an integrated approach to emergency care and nephrology. This review aims to provide a comprehensive understanding of trauma-induced nephropathy, highlighting recent advancements in pathophysiological insights, diagnostic techniques, and strategic interventions. Our key findings emphasize the role of biomarkers, like Neutrophil Gelatinase-Associated Lipocalin and Liver Fatty Acid-Binding Protein, and imaging techniques, such as contrast-enhanced ultrasound, in early AKI detection. Preventive strategies, including aggressive fluid resuscitation, avoidance of nephrotoxic agents, and hemodynamic optimization, are essential for mitigating AKI progression. Integrating these approaches into trauma care frameworks aims to enhance patient outcomes and set a foundation for future research and clinical improvements. Full article
(This article belongs to the Special Issue Clinical Update for Resuscitation Science)
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