New Insights and Prospects of Cardiac Arrest

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 2024 | Viewed by 3523

Special Issue Editor


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Guest Editor
Department of Cardiology, University Heart and Vascular Center Hamburg, Martinistraße 42, 20246 Hamburg, Germany
Interests: cardiology; clinical science; heart failure treatment; treatment of adults with congenital heart disease; cardiovascular imaging; device therapy with CRT; magnetic resonance imaging of the heart and its applications; cardiovascular imaging of heart rhythm disorders

Special Issue Information

Dear Colleagues,

In recent years, many exciting advancements have been made in the management of cardiac arrest.

Out-of-hospital cardiac arrest is still a leading cause of death (OHCA) despite the use of advanced emergency devices. Most adults could be saved from cardiac arrest with the early recognition of cardiac arrest, prompt effective shocks via defibrillation and a functional post-resuscitation care program. 

The treatment of cardiac arrest is a real challenge for cardiologists, intensivists, and emergency physicians. Much progress has been made during the last years both in understanding the underlying mechanisms and in developing new treatments, but work must still be conducted. The more we study this topic, the more we improve patients’ chances of survival.

This Special Issue aims to highlight the current knowledge regarding cardiac arrest and underline possible current practices and future perspectives on cardiac arrest.

In this Special Issue, original articles and reviews are welcome. We look forward to receiving your contributions.

Dr. Christoph Sinning
Guest Editor

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Keywords

  • cardiac arrest
  • cardiology
  • clinical science
  • heart disease
  • cardiovascular imaging

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Published Papers (3 papers)

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Research

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17 pages, 668 KiB  
Article
Cardiac Arrest Mortality and Disposition Patterns in United States Emergency Departments
by Kenneth M. Zabel, Mohammed A. Quazi, Katarina Leyba, Alexandra C. Millhuff, Mikel Madi, Wilfredo Henriquez Madrid, Aman Goyal, Muhammad Ibraiz Bilal, Amir H. Sohail, Shazib Sagheer and Abu Baker Sheikh
J. Clin. Med. 2024, 13(18), 5585; https://doi.org/10.3390/jcm13185585 - 20 Sep 2024
Viewed by 924
Abstract
Background: Despite resuscitative efforts, cardiac arrest (CA) continues to result in high mortality and poor prognosis. However, a gap remains in understanding the comparative outcomes of efforts in emergency departments (ED) over recent years. This study evaluated patients with CA during ED [...] Read more.
Background: Despite resuscitative efforts, cardiac arrest (CA) continues to result in high mortality and poor prognosis. However, a gap remains in understanding the comparative outcomes of efforts in emergency departments (ED) over recent years. This study evaluated patients with CA during ED visits, with a particular focus on outcomes of mortality and transition of care. Methods: We conducted a retrospective cohort analysis using the National Emergency Department Sample (NEDS) database. The study population included patients aged 18 years or older who visited the ED between January 2016 and December 2020. Statistical analysis of patients and hospital characteristics included chi-squared tests for independence and multivariable logistic regression models to report the associations of factors with mortality in the ED and disposition from the ED. The primary outcome measured was mortality in the ED, and the secondary outcome included transition of care. Results: A total of 699,822,424 ED visits occurred between 2016 and 2020, with 1,414,060 (0.20%) CAs. The survival rate from CA ranged from 24.6% to 28.1%. In 2020, the rate of ED CA increased to 0.27%, with an inpatient mortality rate of 58.8%. There was no significant difference in mortality between sexes (p = 0.690). There was a trend for higher mortality in the ED among patients who were self-paid. Notably, the odds of transfer from the ED to other hospitals were significantly lower in minority groups. Conclusions: Our results showed significant disparities in ED mortality and patient disposition following cardiac arrest, highlighting the need for equitable healthcare resources and policies. Full article
(This article belongs to the Special Issue New Insights and Prospects of Cardiac Arrest)
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9 pages, 377 KiB  
Article
Frequency, Prognosis, and Clinical Features of Unexpected versus Expected Cardiac Arrest in the Emergency Department: A Retrospective Analysis
by Karolina Szaruta-Raflesz, Tomasz Łopaciński and Mariusz Siemiński
J. Clin. Med. 2024, 13(9), 2509; https://doi.org/10.3390/jcm13092509 - 24 Apr 2024
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Abstract
Background: Though out-of-hospital CA (OHCA) is widely reported, data on in-hospital CA (IHCA) and especially cardiac arrest (CA) in the emergency department (CAED) are scarce. This study aimed to determine the frequency, prevalence, and clinical features of unexpected CAED and compare the [...] Read more.
Background: Though out-of-hospital CA (OHCA) is widely reported, data on in-hospital CA (IHCA) and especially cardiac arrest (CA) in the emergency department (CAED) are scarce. This study aimed to determine the frequency, prevalence, and clinical features of unexpected CAED and compare the data with those of expected CAED. Methods: We defined unexpected CAED as CA occurring in patients in non-critical ED-care areas; classified as not requiring strict monitoring. This classification was the modified Japanese Triage and Acuity Scale and physician assessment. A retrospective analysis of cases from 2016 to 2018 was performed, in comparison to other patients experiencing CAED. Results: The 38 cases of unexpected CA in this study constituted 34.5% of CA diagnosed in the ED and 8.4% of all CA treated in the ED. This population did not differ significantly from other CAED regarding demographics, comorbidities, and survival rates. The commonest symptoms were dyspnoea, disorders of consciousness, generalised weakness, and chest pain. The commonest causes of death were acute myocardial infarction, malignant neoplasms with metastases, septic shock, pulmonary embolism, and heart failure. Conclusions: Unexpected CAED represents a group of potentially avoidable CA and deaths. These patients should be analysed, and ED management should include measures aimed at reducing their incidence. Full article
(This article belongs to the Special Issue New Insights and Prospects of Cardiac Arrest)
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Review

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14 pages, 285 KiB  
Review
Emerging Evidence in Out-of-Hospital Cardiac Arrest—A Critical Appraisal of the Cardiac Arrest Center
by Felix Memenga and Christoph Sinning
J. Clin. Med. 2024, 13(13), 3973; https://doi.org/10.3390/jcm13133973 - 7 Jul 2024
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Abstract
The morbidity and mortality of out-of-hospital cardiac arrest (OHCA) due to presumed cardiac causes have remained unwaveringly high over the last few decades. Less than 10% of patients survive until hospital discharge. Treatment of OHCA patients has traditionally relied on expert opinions. However, [...] Read more.
The morbidity and mortality of out-of-hospital cardiac arrest (OHCA) due to presumed cardiac causes have remained unwaveringly high over the last few decades. Less than 10% of patients survive until hospital discharge. Treatment of OHCA patients has traditionally relied on expert opinions. However, there is growing evidence on managing OHCA patients favorably during the prehospital phase, coronary and intensive care, and even beyond hospital discharge. To improve outcomes in OHCA, experts have proposed the establishment of cardiac arrest centers (CACs) as pivotal elements. CACs are expert facilities that pool resources and staff, provide infrastructure, treatment pathways, and networks to deliver comprehensive and guideline-recommended post-cardiac arrest care, as well as promote research. This review aims to address knowledge gaps in the 2020 consensus on CACs of major European medical associations, considering novel evidence on critical issues in both pre- and in-hospital OHCA management, such as the timing of coronary angiography and the use of extracorporeal cardiopulmonary resuscitation (eCPR). The goal is to harmonize new evidence with the concept of CACs. Full article
(This article belongs to the Special Issue New Insights and Prospects of Cardiac Arrest)
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