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Cardiac Arrest

In this thematic series for Critical Care, the focus is on important recent developments and state-of-the art practice in the field of cardiac arrest.

Cardiac arrest is a major public health problem. Many thousands of people have a cardiac arrest each year worldwide, many of whom will be admitted to the ICU, where urgent and appropriate treatment is essential to their survival. Mortality rates remain high, however, and keeping up-to-date with the very latest clinical practice evidence is crucial for the ICU physician to ensure optimum patient management.

In this themed series we will feature four invited articles on cardiac arrest, One review presents the current evidence related to vasopressor use, notably epinephrine and vasopressin, in cardiac arrest resuscitation. The role of mechanical ventilation and optimal ventilatory settings are covered in another of our reviews, which highlights the importance of a personalized approach. The potential benefits of temperature control on cardiac arrest outcomes have been much studied over the last 20 years and this remains an area of hot debate. The current understanding of the role of temperature management in cardiac arrest is discussed in detail in another article, with results from recent randomized controlled studies. Finally, although the majority of the cardiac arrest literature has focused on out-of-hospital events, large cardiac arrest registries are now providing valuable epidemiological and outcome data for in-hospital cardiac arrest and the impact of various therapeutic approaches in these patients. Some of the results are summarized in one of the invited articles in this series.

Unsolicited submissions are welcome.

  1. The “Blood Pressure and Oxygenation Targets in Post Resuscitation Care” (BOX) trial investigated whether a low versus high blood pressure target, a restrictive versus liberal oxygenation target, and a shorter ...

    Authors: Martin A. S. Meyer, Christian Hassager, Simon Mølstrøm, Britt Borregaard, Johannes Grand, Benjamin Nyholm, Laust E. R. Obling, Rasmus P. Beske, Anna Sina P. Meyer, Ditte Bekker‑Jensen, Matilde Winther-Jensen, Vibeke L. Jørgensen, Henrik Schmidt, Jacob E. Møller and Jesper Kjaergaard
    Citation: Critical Care 2024 28:20
  2. Epinephrine increases the chances of return of spontaneous circulation (ROSC) in out-of-hospital cardiac arrest (OHCA), especially when the initial rhythm is non-shockable. However, this drug could also worsen...

    Authors: François Javaudin, Wulfran Bougouin, Lucie Fanet, Jean-Luc Diehl, Daniel Jost, Frankie Beganton, Jean-Philippe Empana, Xavier Jouven, Frédéric Adnet, Lionel Lamhaut, Jean-Baptiste Lascarrou, Alain Cariou and Florence Dumas
    Citation: Critical Care 2023 27:496
  3. Brain injury is a leading cause of morbidity and mortality in patients resuscitated from cardiac arrest. Mitochondrial dysfunction contributes to brain injury following cardiac arrest; therefore, therapies tha...

    Authors: Joseph M. Wider, Erin Gruley, Paul T. Morse, Junmei Wan, Icksoo Lee, Anthony R. Anzell, Garrett M. Fogo, Jennifer Mathieu, Gerald Hish, Brian O’Neil, Robert W. Neumar, Karin Przyklenk, Maik Hüttemann and Thomas H. Sanderson
    Citation: Critical Care 2023 27:491
  4. Previous research indicated outcomes among refractory out-of-hospital cardiac arrest (OHCA) patients with initial shockable rhythm were different in Singapore and Osaka, Japan, possibly due to the differences ...

    Authors: Yohei Okada, Nur Shahidah, Yih Yng Ng, Michael Y. C. Chia, Han Nee Gan, Benjamin S. H. Leong, Desmond R. Mao, Wei Ming Ng, Nausheen Edwin, Takeyuki Kiguchi, Norihiro Nishioka, Tetsuhisa Kitamura, Taku Iwami and Marcus Eng Hock Ong
    Citation: Critical Care 2023 27:479
  5. To evaluate the potential association between early dysnatremia and 6-month functional outcome after cardiac arrest.

    Authors: Jean Baptiste Lascarrou, Cyrielle Ermel, Alain Cariou, Timo Laitio, Hans Kirkegaard, Eldar Søreide, Anders M. Grejs, Matti Reinikainen, Gwenhael Colin, Fabio Silvio Taccone, Amélie Le Gouge and Markus B. Skrifvars
    Citation: Critical Care 2023 27:472
  6. Extracorporeal cardiopulmonary resuscitation (ECPR) has been proposed as a rescue therapy for patients with refractory cardiac arrest. This study aimed to evaluate the association between ECPR and clinical out...

    Authors: Yohei Okada, Sho Komukai, Taro Irisawa, Tomoki Yamada, Kazuhisa Yoshiya, Changhwi Park, Tetsuro Nishimura, Takuya Ishibe, Hitoshi Kobata, Takeyuki Kiguchi, Masafumi Kishimoto, Sung-Ho Kim, Yusuke Ito, Taku Sogabe, Takaya Morooka, Haruko Sakamoto…
    Citation: Critical Care 2023 27:442
  7. To assess the association with outcomes of cardiac index (CI) and mixed venous oxygen saturation (SvO2) in comatose patients resuscitated from out-of-hospital cardiac arrest (OHCA).

    Authors: Johannes Grand, Christian Hassager, Henrik Schmidt, Simon Mølstrøm, Benjamin Nyholm, Henrik Frederiksen Høigaard, Jordi S. Dahl, Martin Meyer, Rasmus P. Beske, Laust Obling, Jesper Kjaergaard and Jacob E. Møller
    Citation: Critical Care 2023 27:410

    The Matters Arising to this article has been published in Critical Care 2023 27:492

    The Matters Arising to this article has been published in Critical Care 2023 27:451

  8. This study aimed to quantitatively analyse ultra-early brain diffusion-weighted magnetic resonance imaging (DW-MRI) findings to determine the apparent diffusion coefficient (ADC) threshold associated with neur...

    Authors: Jung A. Yoon, Changshin Kang, Jung Soo Park, Yeonho You, Jin Hong Min, Yong Nam In, Wonjoon Jeong, Hong Joon Ahn, In Ho Lee, Hye Seon Jeong, Byung Kook Lee and Jae Kwang Lee
    Citation: Critical Care 2023 27:407
  9. Supplemental oxygen is commonly administered to patients after out-of-hospital cardiac arrest. However, the findings from studies on oxygen targeting for out-of-hospital cardiac arrest are inconclusive. Thus, ...

    Authors: Xin Cheng, Yu Zhang, Haidong Deng, Yuning Feng, Weelic Chong, Yang Hai, Pengfei Hao, Jialing He, Tiangui Li, Liyuan Peng, Peng Wang, Yangchun Xiao and Fang Fang
    Citation: Critical Care 2023 27:401

    The Matters Arising to this article has been published in Critical Care 2023 27:471

  10. Though early hypotension after pediatric in-hospital cardiac arrest (IHCA) is associated with inferior outcomes, ideal post-arrest blood pressure (BP) targets have not been established. We aimed to leverage pr...

    Authors: Monique M. Gardner, David A. Hehir, Ron W. Reeder, Tageldin Ahmed, Michael J. Bell, Robert A. Berg, Robert Bishop, Matthew Bochkoris, Candice Burns, Joseph A. Carcillo, Todd C. Carpenter, J. Michael Dean, J. Wesley Diddle, Myke Federman, Richard Fernandez, Ericka L. Fink…
    Citation: Critical Care 2023 27:388
  11. Singapore and Osaka in Japan have comparable population sizes and prehospital management; however, the frequency of ECPR differs greatly for out-of-hospital cardiac arrest (OHCA) patients with initial shockabl...

    Authors: Yohei Okada, Nur Shahidah, Yih Yng Ng, Michael Y. C. Chia, Han Nee Gan, Benjamin S. H. Leong, Desmond R. Mao, Wei Ming Ng, Taro Irisawa, Tomoki Yamada, Tetsuro Nishimura, Takeyuki Kiguchi, Masafumi Kishimoto, Tasuku Matsuyama, Norihiro Nishioka, Kosuke Kiyohara…
    Citation: Critical Care 2023 27:351
  12. This work provides an epidemiological overview of out-of-hospital cardiac arrest (OHCA) in children in Germany between 2007 and 2021. We wanted to identify modifiable factors associated with survival.

    Authors: Stephan Katzenschlager, Inga K. Kelpanides, Patrick Ristau, Matthias Huck, Stephan Seewald, Sebastian Brenner, Florian Hoffmann, Jan Wnent, Jo Kramer-Johansen, Ingvild B. M. Tjelmeland, Markus A. Weigand, Jan-Thorsten Gräsner and Erik Popp
    Citation: Critical Care 2023 27:349
  13. Serum neuron-specific enolase (NSE) is the only recommended biomarker for multimodal prognostication in postcardiac arrest patients, but low sensitivity of absolute NSE threshold limits its utility. This study...

    Authors: Youn-Jung Kim, Yong Hwan Kim, Chun Song Youn, In Soo Cho, Su Jin Kim, Jung Hee Wee, Yoo Seok Park, Joo Suk Oh, Byung Kook Lee and Won Young Kim
    Citation: Critical Care 2023 27:313
  14. Extracorporeal cardiopulmonary resuscitation (ECPR) is rapidly becoming a common treatment strategy for patients with refractory cardiac arrest. Despite its benefits, ECPR raises a variety of ethical concerns ...

    Authors: Hiromichi Naito, Masaaki Sakuraya, Takashi Hongo, Hiroaki Takada, Tetsuya Yumoto, Takashi Yorifuji, Toru Hifumi, Akihiko Inoue, Tetsuya Sakamoto, Yasuhiro Kuroda and Atsunori Nakao
    Citation: Critical Care 2023 27:252
  15. Prognosis after resuscitation from cardiac arrest (CA) remains poor, with high morbidity and mortality as a result of extensive cardiac and brain injury and lack of effective treatments. Hypertonic sodium lact...

    Authors: Filippo Annoni, Fuhong Su, Lorenzo Peluso, Ilaria Lisi, Enrico Caruso, Francesca Pischiutta, Elisa Gouvea Bogossian, Bruno Garcia, Hassane Njimi, Jean-Louis Vincent, Nicolas Gaspard, Lorenzo Ferlini, Jacques Creteur, Elisa R. Zanier and Fabio Silvio Taccone
    Citation: Critical Care 2023 27:161
  16. To determine the clinical feasibility of novel serum biomarkers in out-of-hospital cardiac arrest (OHCA) patients treated with target temperature management (TTM).

    Authors: Hwan Song, Hyo Jin Bang, Yeonho You, Jung Soo Park, Changshin Kang, Hyo Joon Kim, Kyu Nam Park, Sang Hoon Oh and Chun Song Youn
    Citation: Critical Care 2023 27:113

    The Correspondence to this article has been published in Critical Care 2023 27:187

  17. There is inconclusive evidence regarding the effectiveness of extracorporeal cardiopulmonary resuscitation (ECPR) for out-of-hospital cardiac arrest (OHCA) patients. We aimed to evaluate the association betwee...

    Authors: Yeongho Choi, Jeong Ho Park, Joo Jeong, Yu Jin Kim, Kyoung Jun Song and Sang Do Shin
    Citation: Critical Care 2023 27:87
  18. The Chain of Survival highlights the effectiveness of early recognition of cardiac arrest and call for help, early cardiopulmonary resuscitation and early defibrillation. Most patients, however, remain in card...

    Authors: Gavin D. Perkins and Keith Couper
    Citation: Critical Care 2023 27:81
  19. This study aimed to assess the effect of different blood pressure levels on global cerebral metabolism in comatose patients resuscitated from out-of-hospital cardiac arrest (OHCA).

    Authors: Simon Mølstrøm, Troels Halfeld Nielsen, Carl-Henrik Nordstrøm, Axel Forsse, Søren Møller, Søren Venø, Dmitry Mamaev, Tomas Tencer, Ásta Theódórsdóttir, Thomas Krøigård, Jacob Møller, Christian Hassager, Jesper Kjærgaard, Henrik Schmidt and Palle Toft
    Citation: Critical Care 2023 27:73
  20. This study aimed to investigate the association between ultra-early (within 6 h after return of spontaneous circulation [ROSC]) brain diffusion-weighted magnetic resonance imaging (DW-MRI) and neurological out...

    Authors: Changshin Kang, Jin Hong Min, Jung Soo Park, Yeonho You, Wonjoon Jeong, Hong Joon Ahn, Yong Nam In, In Ho Lee, Hye Seon Jeong, Byung Kook Lee and Jinwoo Jeong
    Citation: Critical Care 2023 27:16
  21. In-hospital cardiac arrest (IHCA) is associated with a high risk of death, but mortality rates are decreasing. The latest epidemiological and outcome data from several cardiac arrest registries are helping to ...

    Authors: James Penketh and Jerry P. Nolan
    Citation: Critical Care 2022 26:376

    The Correspondence to this article has been published in Critical Care 2023 27:22

    The Correspondence to this article has been published in Critical Care 2023 27:17

  22. Most of the patients who die after cardiac arrest do so because of hypoxic-ischemic brain injury (HIBI). Experimental evidence shows that temperature control targeted at hypothermia mitigates HIBI. In 2002, on...

    Authors: Claudio Sandroni, Daniele Natalini and Jerry P. Nolan
    Citation: Critical Care 2022 26:361