Clinical Update for Resuscitation Science

A special issue of Life (ISSN 2075-1729). This special issue belongs to the section "Medical Research".

Deadline for manuscript submissions: 28 November 2024 | Viewed by 3700

Special Issue Editor


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Guest Editor
Department of Emergency and Critical Care Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 734-8551, Japan
Interests: cardiac arrest; ARDS; ECMO; trauma
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Special Issue Information

Dear Colleagues,

Resuscitation science has advanced over the past decade, leading to improved outcomes for critically ill patients with severe acute respiratory or circulatory failure. However, despite these advancements, their outcomes remain poor. For example, the survival rates of patients with cardiac arrest are approximately 10% (varying from 0% to 18%), and even among survivors, many patients are discharged or transferred to other hospitals in a vegetative state or coma. Therefore, there is a need to develop better strategies for the management of such critically ill patients.

The objective of this Special Issue is to discuss knowledge gaps and research priorities in the field of resuscitation science, as well as to present potential novel treatment strategies that seek to improve their outcomes. The scope of this Special Issue intentionally encompasses a wide range of topics and perspectives related to resuscitation research.

This Special Issue focuses on any and all critically ill patients who need resuscitative interventions, such as those with severe acute respiratory or circulatory failure, requiring the support of extracorporeal membrane oxygenation, or severe trauma, as well as patients experiencing cardiac arrest. Additionally, we seek to encompass studies related to training and education on resuscitative procedures. This broad scope takes in clinical and basic research, review articles, and case reports related to resuscitation science.

Dr. Mitsuaki Nishikimi
Guest Editor

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Keywords

  • resuscitation science
  • cardiac arrest
  • acute respiratory failure
  • acute circulatory failure
  • trauma

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Published Papers (3 papers)

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Research

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10 pages, 834 KiB  
Article
Optimal Timing of the Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio as Early Predictors of Neurological Outcomes in Postcardiac Arrest Patients
by Dongju Kim, Hanna Park, Sang-Min Kim and Won Young Kim
Life 2024, 14(11), 1421; https://doi.org/10.3390/life14111421 - 4 Nov 2024
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Abstract
The neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) have been recognized as predictors of various critical illnesses. Our study aimed to investigate whether the NLR and PLR measured at different timepoints could predict poor neurological outcomes at 6 months. This observational retrospective cohort [...] Read more.
The neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) have been recognized as predictors of various critical illnesses. Our study aimed to investigate whether the NLR and PLR measured at different timepoints could predict poor neurological outcomes at 6 months. This observational retrospective cohort study included adults who had experienced out-of-hospital cardiac arrest (OHCA) and received targeted temperature management between November 2015 and December 2020. Patients with an active infection, as confirmed by an initial blood culture, were excluded. Multivariate logistic regression models were used to determine the association between the NLR and PLR at 0, 24, and 48 h after return of spontaneous circulation and poor neurological outcomes, defined as a Cerebral Performance Category score of ≥3 at 6 months. The NLR at 24 h, but not the NLR or PLR at other timepoints, was significantly associated with poor neurological outcomes (odds ratio: 1.05; 95% CI: 1.01–1.09; p = 0.018). The NLR at 24 h showed moderate accuracy in predicting poor neurological outcomes, with an AUC of 0.619. A cutoff value of 9.0 achieved 72.5% sensitivity and 47.7% specificity. The NLR measured at 24 h after ROCS could be used for early neuroprognostication given its low cost and widespread availability. Full article
(This article belongs to the Special Issue Clinical Update for Resuscitation Science)
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16 pages, 5022 KiB  
Article
Multi-Modal Assessment of Cerebral Hemodynamics in Resuscitated Out-of-Hospital Cardiac Arrest Patients: A Case-Series
by Shir Lynn Lim, May Zin Myint, Kai Lee Woo, Elaine Young Heng Chee, Chiew Sie Hong, Erta Beqiri, Peter Smielewski, Marcus Eng Hock Ong and Vijay Kumar Sharma
Life 2024, 14(9), 1067; https://doi.org/10.3390/life14091067 - 26 Aug 2024
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Abstract
We assessed the feasibility of concurrent monitoring of cerebral hemodynamics in adult, comatose out-of-hospital cardiac arrest (OHCA) patients admitted to the National University Heart Centre Singapore from October 2021 to August 2023. Patients underwent continuous near-infrared spectroscopy (NIRS) monitoring in the first 72 [...] Read more.
We assessed the feasibility of concurrent monitoring of cerebral hemodynamics in adult, comatose out-of-hospital cardiac arrest (OHCA) patients admitted to the National University Heart Centre Singapore from October 2021 to August 2023. Patients underwent continuous near-infrared spectroscopy (NIRS) monitoring in the first 72 h after return of spontaneous circulation (ROSC) and 30-min transcranial Doppler ultrasound (TCD) monitoring at least once. With constant mechanical ventilatory settings and continuous electrocardiographic, pulse oximeter and end-tidal carbon dioxide monitoring, blood pressure was manipulated via vasopressors and cerebral autoregulation assessed by measuring changes in regional cerebral oxygenation (NIRS) and cerebral blood flow velocities (TCD) in response to changes in mean arterial pressure. The primary outcome was neurological recovery at hospital discharge. Amongst the first 16 patients (median age 61, 94% males), we observed four unique patterns: preserved cerebral autoregulation, loss of cerebral autoregulation, cardio-cerebral asynchrony and cerebral circulatory arrest. Patients with preserved cerebral autoregulation had lower levels of neuro-injury biomarkers (neurofilaments light and heavy) and the majority (86%) were discharged with good neurological recovery. Multi-modal assessment of cerebral hemodynamics after OHCA is feasible and derived patterns correlated with neurological outcomes. The between- and within-patient heterogeneity in cerebral hemodynamics calls for more research on individualized treatment strategies. Full article
(This article belongs to the Special Issue Clinical Update for Resuscitation Science)
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Review

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12 pages, 556 KiB  
Review
Advancements in Trauma-Induced Acute Kidney Injury: Diagnostic and Therapeutic Innovations
by Sergio Lassola, Francesco Cundari, Giuseppe Marini, Francesco Corradi and Silvia De Rosa
Life 2024, 14(8), 1005; https://doi.org/10.3390/life14081005 - 13 Aug 2024
Cited by 1 | Viewed by 1943
Abstract
Acute kidney injury following trauma impacts patient recovery critically, necessitating an integrated approach to emergency care and nephrology. This review aims to provide a comprehensive understanding of trauma-induced nephropathy, highlighting recent advancements in pathophysiological insights, diagnostic techniques, and strategic interventions. Our key findings [...] Read more.
Acute kidney injury following trauma impacts patient recovery critically, necessitating an integrated approach to emergency care and nephrology. This review aims to provide a comprehensive understanding of trauma-induced nephropathy, highlighting recent advancements in pathophysiological insights, diagnostic techniques, and strategic interventions. Our key findings emphasize the role of biomarkers, like Neutrophil Gelatinase-Associated Lipocalin and Liver Fatty Acid-Binding Protein, and imaging techniques, such as contrast-enhanced ultrasound, in early AKI detection. Preventive strategies, including aggressive fluid resuscitation, avoidance of nephrotoxic agents, and hemodynamic optimization, are essential for mitigating AKI progression. Integrating these approaches into trauma care frameworks aims to enhance patient outcomes and set a foundation for future research and clinical improvements. Full article
(This article belongs to the Special Issue Clinical Update for Resuscitation Science)
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