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Cardiac Arrest in Intensive Care: Management and Prognosis
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Cardiac Arrest in Intensive Care: Management and Prognosis

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

Deadline for manuscript submissions: 20 October 2024 | Viewed by 1643

Special Issue Editor

Prof. Dr. Saïd Hachimi-Idrissi

E-Mail Website
Guest Editor
1. Critical Care Medicine and Pediatric at the University of Ghent and Free University Brussel, Brussel, Belgium
2. Department of Emergency Medicine, Ghent University Hospital, Corneel Heymanslaan, 10, 9000 Ghent, Belgium
3. Cerebral Resuscitation Research Group, Free University Brussel, Laarbeeklaan 103, 1070 Brussels, Belgium
4. Global Network on Emergency Medicine, Brookline, MA 02446, USA
Interests: critical care medicine; intensive care medicine; resuscitation; cardiopulmonary resuscitation; sepsis; airway management; mechanical ventilation; CPR; emergency management

Special Issue Information

Dear Colleagues,

It is estimated that there are more than 400,000 victims of out-of-hospital cardiac arrest annually in Europe, of whom less than 5% survive.

The current guidelines emphasize starting with chest compression at a pace of 120/min with a ratio of 30 chest compressions to 2 breaths in adults. These guidelines focus on restoring the heartbeat without considering the cause of cardiac arrest, the changes in lung compliance, the ventilation pattern, heart dynamics, or the lungs during CPR. These factors might not respond the same way when the standard CRP is carried out compared to long-lasting CPR or delayed CRP.

Therefore, we are recommending the analysis of all pathophysiological mechanisms involved in CPR and thus adaption of the chest compression frequency, depth, release, and ventilation with or without PEEP to improve the quality of CPR tailored to the patient’s conditions and hence improve the chance of restarting the heartbeat.

Topics of interest include, but are not limited to, the following:

  • Tailored resuscitation instead of one size fits all;
  • PEEP/ No PEEP during CRP incardiac arrest;
  • Head positioning, ideal PCO2, PO2, Pulse index, etc., during CPR;
  • eCPR;
  • Hemodynamic;
  • Monitoring in the ICU after CA;
  • TTM post-ROSC, ideal core temperature post-cardiac arrest;
  • AI;
  • Prognostications (outcome).

Prof. Dr. Saïd Hachimi-Idrissi
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

  • CPR
  • tailored CPR
  • monitoring
  • PEEP
  • TTM
  • head positioning
  • PCO2
  • PO2
  • eCPR
  • monitoring
  • prognostication

Published Papers (2 papers)

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13 pages, 2027 KiB  
Article
Amiodarone Administration during Cardiopulmonary Resuscitation Is Not Associated with Changes in Short-Term Mortality or Neurological Outcomes in Cardiac Arrest Patients with Shockable Rhythms
by Nicolas Kramser, Dragos Andrei Duse, Michael Gröne, Bernd Stücker, Fabian Voß, Ursala Tokhi, Christian Jung, Patrick Horn, Malte Kelm and Ralf Erkens
J. Clin. Med. 2024, 13(13), 3931; https://doi.org/10.3390/jcm13133931 - 4 Jul 2024
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Abstract
Background: The search for the best therapeutic approach in cardiopulmonary resuscitations (CPR) remains open to question. In this study, we evaluated if Amiodarone administration during CPR was associated with short-term mortality or neurological development. Methods: A total of 232 patients with sudden cardiac [...] Read more.
Background: The search for the best therapeutic approach in cardiopulmonary resuscitations (CPR) remains open to question. In this study, we evaluated if Amiodarone administration during CPR was associated with short-term mortality or neurological development. Methods: A total of 232 patients with sudden cardiac arrest (CA) with shockable rhythms were included in our analysis. Propensity score matching based on age, gender, type of CA, and CPR duration was used to stratify between patients with and without Amiodarone during CPR. Primary endpoints were short-term mortality (30-day) and neurological outcomes assessed by the cerebral performance category. Secondary endpoints were plasma lactate, phosphate levels at hospital admission, and the peak Neuron-specific enolase. Results: Propensity score matching was successful with a caliper size used for matching of 0.089 and a sample size of n = 82 per group. The 30-day mortality rates were similar between both groups (p = 0.24). There were no significant differences in lactate levels at hospital admission and during the following five days between the groups. Patients receiving Amiodarone showed slightly higher phosphate levels at hospital admission, while the levels decreased to a similar value during the following days. Among CA survivors to hospital discharge, no differences between the proportion of good neurological outcomes were detected between the two groups (p = 0.58), despite slightly higher peak neuron-specific enolase levels in CA patients receiving Amiodarone (p = 0.03). Conclusions: Amiodarone administration is not associated with short-term mortality or neurological outcomes in CA patients with shockable rhythms receiving CPR. Full article
(This article belongs to the Special Issue Cardiac Arrest in Intensive Care: Management and Prognosis)
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7 pages, 967 KiB  
Brief Report
Detecting Intrathoracic Airway Closure during Prehospital Cardiopulmonary Resuscitation Using Quasi-Static Pressure–Volume Curves: A Pilot Study
by Maxim Vanwulpen, Arthur Bouillon, Ruben Cornelis, Bert Dessers and Saïd Hachimi-Idrissi
J. Clin. Med. 2024, 13(14), 4274; https://doi.org/10.3390/jcm13144274 - 22 Jul 2024
Viewed by 474
Abstract
Background: Intrathoracic airway closure frequently occurs during cardiac arrest, possibly impairing ventilation. Previously, capnogram analysis was used to detect this pathophysiological process. In other populations, quasi-static pressure–volume curves obtained during constant low-flow inflations are routinely used to detect intrathoracic airway closure. This study [...] Read more.
Background: Intrathoracic airway closure frequently occurs during cardiac arrest, possibly impairing ventilation. Previously, capnogram analysis was used to detect this pathophysiological process. In other populations, quasi-static pressure–volume curves obtained during constant low-flow inflations are routinely used to detect intrathoracic airway closure. This study reports the first use of quasi-static pressure–volume curves to detect intrathoracic airway closure during prehospital cardiopulmonary resuscitation. Methods: Connecting a pressure and flow sensor to the endotracheal tube enabled the performance of low-flow inflations during cardiopulmonary resuscitation using a manual resuscitator. Users connected the device following intubation and performed a low-flow inflation during the next rhythm analysis when chest compressions were interrupted. Determining the lower inflection point on the resulting pressure–volume curves allowed for the detection and quantification of intrathoracic airway closure. Results: The research device was used during the prehospital treatment of ten cardiac arrest patients. A lower inflection point indicating intrathoracic airway closure was detected in all patients. During cardiac arrest, the median pressure at which the lower inflection point occurred was 5.56 cmH20 (IQR 4.80, 8.23 cmH20). This value varied considerably between cases and was lower in patients who achieved return of spontaneous circulation. Conclusions: In this pilot study, quasi-static pressure–volume curves were obtained during prehospital cardiopulmonary resuscitation. Intrathoracic airway closure was detected in all patients. Further research is needed to determine whether the use of ventilation strategies to counter intrathoracic airway closure could lead to improved outcomes and if the degree of airway closure could serve as a prognostic factor. Full article
(This article belongs to the Special Issue Cardiac Arrest in Intensive Care: Management and Prognosis)
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