One-Year Review in Cardiac Arrest: The 2022 Randomized Controlled Trials

Penna, A La; Magliocca, Aurora; Merigo, Giulia; Stirparo, Giuseppe; Silvestri, Ivan; Fumagalli, Francesca; Ristagno, Giuseppe

doi:10.3390/jcm12062235

Cited by 5 publications

(3 citation statements)

References 68 publications

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“…Cardiac arrest stands as a formidable challenge in global health, currently ranking as the third leading cause of death worldwide [1]. The recent EuReCa TWO study reported an incidence of out-of-hospital cardiac arrest (OHCA) in Europe of 89 events per 100,000 inhabitants per year.…”

Section: Introductionmentioning

confidence: 99%

Acute Lung Injury after Cardiopulmonary Resuscitation: A Narrative Review

Marchese,

Bungaro,

Magliocca

et al. 2024

JCM

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Although cardiopulmonary resuscitation (CPR) includes lifesaving maneuvers, it might be associated with a wide spectrum of iatrogenic injuries. Among these, acute lung injury (ALI) is frequent and yields significant challenges to post-cardiac arrest recovery. Understanding the relationship between CPR and ALI is determinant for refining resuscitation techniques and improving patient outcomes. This review aims to analyze the existing literature on ALI following CPR, emphasizing prevalence, clinical implications, and contributing factors. The review seeks to elucidate the pathogenesis of ALI in the context of CPR, assess the efficacy of CPR techniques and ventilation strategies, and explore their impact on post-cardiac arrest outcomes. CPR-related injuries, ranging from skeletal fractures to severe internal organ damage, underscore the complexity of managing post-cardiac arrest patients. Chest compression, particularly when prolonged and vigorous, i.e., mechanical compression, appears to be a crucial factor contributing to ALI, with the concept of cardiopulmonary resuscitation-associated lung edema (CRALE) gaining prominence. Ventilation strategies during CPR and post-cardiac arrest syndrome also play pivotal roles in ALI development. The recognition of CPR-related lung injuries, especially CRALE and ALI, highlights the need for research on optimizing CPR techniques and tailoring ventilation strategies during and after resuscitation.

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Section: Introductionmentioning

confidence: 99%

Acute Lung Injury after Cardiopulmonary Resuscitation: A Narrative Review

Marchese,

Bungaro,

Magliocca

et al. 2024

JCM

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“…The number of trials in the field of out-of-hospital cardiac arrest (OHCA) has grown exponentially throughout the last decade, largely with a focus on increased survival as a key metric for the effectiveness of interventions [1]. In 2018, in an effort to clarify meaningful outcomes for ongoing research, the International Liaison Committee on Resuscitation published the Core Outcome Set for Cardiac Arrest (COSCA) in Adults [2].…”

Section: Introductionmentioning

confidence: 99%

Trend of Outcome Metrics in Recent Out-of-Hospital-Cardiac-Arrest Research: A Narrative Review of Clinical Trials

Htet,

Jafari,

Walker

et al. 2023

JCM

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Cardiopulmonary resuscitation (CPR) research traditionally focuses on survival. In 2018, the International Liaison Committee on Resuscitation (ILCOR) proposed more patient-centered outcomes. Our narrative review assessed clinical trials after 2018 to identify the trends of outcome metrics in the field OHCA research. We performed a search of the PubMed database from 1 January 2019 to 22 September 2023. Prospective clinical trials involving adult humans were eligible. Studies that did not report any patient-related outcomes or were not available in full-text or English language were excluded. The articles were assessed for demographic information and primary and secondary outcomes. We included 89 studies for analysis. For the primary outcome, 31 (35%) studies assessed neurocognitive functions, and 27 (30%) used survival. For secondary outcomes, neurocognitive function was present in 20 (22%) studies, and survival was present in 10 (11%) studies. Twenty-six (29%) studies used both survival and neurocognitive function. Since the publication of the COSCA guidelines in 2018, there has been an increased focus on neurologic outcomes. Although survival outcomes are used frequently, we observed a trend toward fewer studies with ROSC as a primary outcome. There were no quality-of-life assessments, suggesting a need for more studies with patient-centered outcomes that can inform the guidelines for cardiac-arrest management.

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“…Postcardiac arrest syndrome (PCAS) results in high morbidity and mortality due to a series of life-threatening complications such as multiorgan failure and neurological damage [1][2][3]. PCAS is a type of global ischemic reperfusion injury that occurs after the return of spontaneous circulation (ROSC) by a mechanism similar to one in systemic inflammatory response syndrome (SIRS) or sepsis [4,5].…”

Section: Introductionmentioning

confidence: 99%

Comparison of Prognostic Performance between Procalcitonin and Procalcitonin-to-Albumin Ratio in Post Cardiac Arrest Syndrome

Yoon

Choi

Lim

et al. 2023

JCM

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(1) Background: Post-cardiac arrest syndrome (PCAS) is a type of global ischemic reperfusion injury that occurs after the return of spontaneous circulation (ROSC). The procalcitonin to albumin ratio (PAR) has been studied as an independent prognostic factor of various diseases. There are no previous studies of PAR in patients with PCAS. We assessed if PAR is more effective than procalcitonin (PCT) in predicting prognosis for patients with PCAS. (2) Methods: This retrospective cohort study included a total of 187 patients with PCAS after non-traumatic out-of-hospital cardiac arrest (OHCA) between January 2016 and December 2020. Multivariate logistic regression analysis was conducted to assess the association between PAR and PCAS prognosis. The predictive performance of PAR was compared with PCT via the receiver-operating characteristic (ROC) analysis and DeLong test.; (3) Results: PAR at 24 and 48 h after hospital admission were independently associated with one-month neurological outcome (OR: 1.167, 95% CI: 1.023–1.330; OR: 1.077, 95% CI: 1.012–1.146, p < 0.05). By ROC analysis, PAR showed better performance over PCT at 48 h after admission in predicting one-month CPC (0.763 vs. 0.772, p = 0.010). (4) Conclusions: Our findings suggest that PAR at 48 h after admission is more effective in predicting a one-month neurological outcome than PCT at 48 h after admission in patients with PCAS after OHCA.

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One-Year Review in Cardiac Arrest: The 2022 Randomized Controlled Trials

Cited by 5 publications

References 68 publications

Acute Lung Injury after Cardiopulmonary Resuscitation: A Narrative Review

Acute Lung Injury after Cardiopulmonary Resuscitation: A Narrative Review

Trend of Outcome Metrics in Recent Out-of-Hospital-Cardiac-Arrest Research: A Narrative Review of Clinical Trials

Comparison of Prognostic Performance between Procalcitonin and Procalcitonin-to-Albumin Ratio in Post Cardiac Arrest Syndrome

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