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Dear Colleagues,

Despite the significant improvement of cardiogenic shock and cardiac arrest care, resuscitating these patients is still challenging. Cardiac arrest is also a complex lethal condition with a public health burden due to irreversible functional disability. Therefore, better resuscitation strategies are necessary.

Another issue of cardiogenic shock and cardiac arrest is quickly obtaining reliable information on the probability of good neurological outcome. A reliable prognostic tool would be very helpful to tailor medical therapies to the appropriate patients.

This Special Issue of the Journal of Clinical Medicine on “Cardiac Arrest and Cardiogenic Shock: Resuscitation Strategy and Prognosis” aims to collect brilliant contributions from worldwide experts in the field of resuscitation for cardiac arrest and cardiogenic shock. Invited topics include clinical management and prognosis of cardiogenic shock, resuscitation strategies, prediction of good neurologic outcome, trends in resuscitation outcomes, resuscitation modalities, and post-resuscitation care.

Prof. Dr. Won Young Kim
Guest Editor

Manuscript Submission Information

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Keywords

cardiac arrest
cardiogenic shock
post-cardiac-arrest care
neurologic outcome

Published Papers (2 papers)

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Research

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9 pages, 616 KiB

Open AccessArticle

Inodilators May Improve the In-Hospital Mortality of Patients with Cardiogenic Shock Undergoing Veno-Arterial Extracorporeal Membrane Oxygenation

by Mijoo Kim, Seok-Woo Seong, Pil Sang Song, Jin-Ok Jeong, Jeong Hoon Yang, Hyeon-Cheol Gwon, Young-Guk Ko, Cheol Woong Yu, Woo Jung Chun, Woo Jin Jang, Hyun-Joong Kim, Jang-Whan Bae, Sung Uk Kwon, Hyun-Jong Lee, Wang Soo Lee, Sang-Don Park, Sung Soo Cho and Jae-Hyeong Park

J. Clin. Med. 2022, 11(17), 4958; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm11174958 - 24 Aug 2022

Cited by 1 | Viewed by 1713

Abstract

Although inodilators (dobutamine and milrinone) are widely used empirically for cardiogenic shock (CS), the efficacy of inodilators for patients with CS undergoing veno-arterial extracorporeal membrane oxygenation (VA-ECMO) is controversial. We evaluated the effects of inodilators on clinical outcomes using the RESCUE (REtrospective and prospective observational Study to investigate Clinical oUtcomes and Efficacy of left ventricular assist device for Korean patients with cardiogenic shock; NCT02985008) registry. We selected and analyzed the clinical outcomes of 496 patients who underwent VA-ECMO and did or did not receive inodilators. Of the 496 patients, 257 (51.8%) died during hospitalization. We selected 191 matched pairs to adjust for baseline clinical characteristics after 1:1 propensity score matching (PSM). The univariate and multivariate analyses showed that the inodilator group had significantly lower in-hospital mortality than the no-inodilator group (unadjusted hazard ratio [HR], 0.768; 95% confidence interval [CI], 0.579–1.018; p = 0.066, adjusted HR, 0.702; 95% CI, 0.552–0.944; p = 0.019). For patients with CS undergoing VA-ECMO, inodilators may improve clinical outcomes. Full article

(This article belongs to the Special Issue Cardiac Arrest and Cardiogenic Shock: Resuscitation Strategy and Prognosis)

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Other

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12 pages, 1495 KiB

Open AccessSystematic Review

Blood Pressure Targets for Out-of-Hospital Cardiac Arrest: A Systematic Review and Meta-Analysis

by Shir Lynn Lim, Christopher Jer Wei Low, Ryan Ruiyang Ling, Rehena Sultana, Victoria Yang, Marcus E. H. Ong, Yew Woon Chia, Vijay Kumar Sharma and Kollengode Ramanathan

J. Clin. Med. 2023, 12(13), 4497; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm12134497 - 05 Jul 2023

Cited by 1 | Viewed by 1353

Abstract

Background: With ideal mean arterial pressure (MAP) targets in resuscitated out-of-hospital cardiac arrest (OHCA) patients unknown, we performed a meta-analysis of randomised controlled trials (RCTs) to compare the effects of higher versus lower MAP targets. Methods: We searched four databases until 1 May 2023 for RCTs reporting the effects of higher MAP targets (>70 mmHg) in resuscitated OHCA patients and conducted random-effects meta-analyses. The primary outcome was mortality while secondary outcomes were neurological evaluations, arrhythmias, acute kidney injury, and durations of mechanical ventilation and ICU stay. We conducted inverse-variance weighted strata-level meta-regression against a proportion of non-survivors to assess differences between reported MAPs. We also conducted a trial sequential analysis of RCTs. Results: Four RCTs were included. Higher MAP was not associated with reduced mortality (OR: 1.09, 95%-CI: 0.84 to 1.42, p = 0.51), or improved neurological outcomes (OR: 0.99, 95%-CI: 0.77 to 1.27, p = 0.92). Such findings were consistent despite additional sensitivity analyses. Our robust variance strata-level meta-regression revealed no significant associations between mean MAP and the proportion of non-survivors (B: 0.029, 95%-CI: −0.023 to 0.081, p = 0.162), and trial sequential analysis revealed no meaningful survival benefit for higher MAPs. Conclusions: A higher MAP target was not significantly associated with improved mortality and neurological outcomes in resuscitated OHCA patients. Full article

(This article belongs to the Special Issue Cardiac Arrest and Cardiogenic Shock: Resuscitation Strategy and Prognosis)

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