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Cardiogenic Shock and Cardiac Arrest: Updates, Challenges and Opportunities
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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 471

Special Issue Editor

Dr. Torben K. Becker

E-Mail Website
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

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

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

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Published Papers (1 paper)

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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 321
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
(This article belongs to the Special Issue Cardiogenic Shock and Cardiac Arrest: Updates, Challenges and Opportunities)
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