About this Research Topic
The management of the out-of-hospital cardiac arrest (OHCA) represents a complex challenge for emergency medical system (EMS) operators and for the numerous many specialists involved in the hospital in the subsequent care.
The present Research Topic considers controversial aspects and interesting developments in advanced life support during OHCA.
While the optimal ventilation modalities to manage OHCA remains debated, new strategies to provide adequate gas exchange, during manual and mechanical CPR have been tested recently together with the intent to reduce the occurrence the newly developed concept of cardiopulmonary associated lung edema - CRALE. The technological improvement of new ventilators, allows patients to be ventilated during chest compressions by a pressure mode which can modify the airway pressure in relation to the phases of compression, optimizing overall the cardiopulmonary interaction.
In addition, current cardiopulmonary resuscitation guidelines are based on a fixed, time-depending cardiac rhythm analysis and defibrillation delivery; new algorithms to guide for the optimal and timely interventions, i.e. chest compressions or defibrillation, are becoming now part of clinical advances. Thus, optimizing defibrillation strategy during cardiac arrest is a pressing challenge related to the development of artificial intelligence such to provide reliable diagnosis of the cardiac rhythm, without interrupting chest compression, while speeding up the delivery of effective defibrillation and reducing the number of ineffective shocks.
This Research Topic in 'Frontiers in Anesthesiology’ focuses on the new advancements in the management of Cardiac Arrest. This research topic on cardiac arrest and CPR, therefore, introduces brilliant contributions from worldwide experts in the field of resuscitation, arising and stimulating new strategies to improve outcome of OHCA. More specifically, space is provided to basic and clinical research on pathophysiology of cardiopulmonary resuscitation as well as to bioengineering developments bring together a series of manuscripts that cover novel physiologic, diagnostic, and therapeutic approaches.
Primarily, we welcome the submission of papers focusing on:
Analysis of resuscitation data such as: ECG, impedance traces, and hemodynamics contributing to a better understanding of the changes in clinical status and interplay between therapy and patient response.
Algorithms able to identify the clinical metabolic and circulatory state during CPR; to improve ACLS therapy and survival rates.
Real-time ECG analysis, using adaptive filters or new algorithms to overcome chest compression artifacts, to identify heart rhythm during CPR and reduce the hands-off time preceding a shock.
Analysis of ventricular fibrillation waveform able to identify patients with a high chance of shock success.
Comparison of different ventilatory strategies with the standard manual bag ventilation during advanced life support .
Effects of drugs, cocktail of drugs and the best timing and way of administration to improve outcome.
New experimental interventions to optimize ALS intervention and improve outcome.
The accepted manuscripts for this research topic may include original research, meta-analyses, case series, brief reports or narrative reviews addressing the problem from various medical specialties including cardiology, physiology, pulmonary medicine, critical care and anesthesiology.
In particular, experimental and observational studies using the data aimed at:
Identifying the cardiac rhythm during cardio-pulmonary resuscitation.
Identifying the factors able to optimizing defibrillation during cardiac arrest.
Identifying the factors able to optimizing airway management and ventilation during chest compressions.
In order to address any questions similar to:
What is the impact of the identification of circulation state (pulsed rhythms, true and pseudo pulseless electrical activity) during OHCA on ROSC and outcomes?
Are real-time ECG analysis and AMSA more able to speed up the delivery of early effective defibrillation or to reduce the number of ineffective shocks?
Is the improvement in ROSC using a transport ventilator during ALS related to the duration of application of the special pressure mode during chest compressions?
Could the improvement in ROSC be due to a continuous real time monitoring of the CPR parameters, obtaining a important feedback for the operators, instead to the ventilatory pressure mode?
The present Research Topic considers controversial aspects and interesting developments in advanced life support during OHCA.
While the optimal ventilation modalities to manage OHCA remains debated, new strategies to provide adequate gas exchange, during manual and mechanical CPR have been tested recently together with the intent to reduce the occurrence the newly developed concept of cardiopulmonary associated lung edema - CRALE. The technological improvement of new ventilators, allows patients to be ventilated during chest compressions by a pressure mode which can modify the airway pressure in relation to the phases of compression, optimizing overall the cardiopulmonary interaction.
In addition, current cardiopulmonary resuscitation guidelines are based on a fixed, time-depending cardiac rhythm analysis and defibrillation delivery; new algorithms to guide for the optimal and timely interventions, i.e. chest compressions or defibrillation, are becoming now part of clinical advances. Thus, optimizing defibrillation strategy during cardiac arrest is a pressing challenge related to the development of artificial intelligence such to provide reliable diagnosis of the cardiac rhythm, without interrupting chest compression, while speeding up the delivery of effective defibrillation and reducing the number of ineffective shocks.
This Research Topic in 'Frontiers in Anesthesiology’ focuses on the new advancements in the management of Cardiac Arrest. This research topic on cardiac arrest and CPR, therefore, introduces brilliant contributions from worldwide experts in the field of resuscitation, arising and stimulating new strategies to improve outcome of OHCA. More specifically, space is provided to basic and clinical research on pathophysiology of cardiopulmonary resuscitation as well as to bioengineering developments bring together a series of manuscripts that cover novel physiologic, diagnostic, and therapeutic approaches.
Primarily, we welcome the submission of papers focusing on:
Analysis of resuscitation data such as: ECG, impedance traces, and hemodynamics contributing to a better understanding of the changes in clinical status and interplay between therapy and patient response.
Algorithms able to identify the clinical metabolic and circulatory state during CPR; to improve ACLS therapy and survival rates.
Real-time ECG analysis, using adaptive filters or new algorithms to overcome chest compression artifacts, to identify heart rhythm during CPR and reduce the hands-off time preceding a shock.
Analysis of ventricular fibrillation waveform able to identify patients with a high chance of shock success.
Comparison of different ventilatory strategies with the standard manual bag ventilation during advanced life support .
Effects of drugs, cocktail of drugs and the best timing and way of administration to improve outcome.
New experimental interventions to optimize ALS intervention and improve outcome.
The accepted manuscripts for this research topic may include original research, meta-analyses, case series, brief reports or narrative reviews addressing the problem from various medical specialties including cardiology, physiology, pulmonary medicine, critical care and anesthesiology.
In particular, experimental and observational studies using the data aimed at:
Identifying the cardiac rhythm during cardio-pulmonary resuscitation.
Identifying the factors able to optimizing defibrillation during cardiac arrest.
Identifying the factors able to optimizing airway management and ventilation during chest compressions.
In order to address any questions similar to:
What is the impact of the identification of circulation state (pulsed rhythms, true and pseudo pulseless electrical activity) during OHCA on ROSC and outcomes?
Are real-time ECG analysis and AMSA more able to speed up the delivery of early effective defibrillation or to reduce the number of ineffective shocks?
Is the improvement in ROSC using a transport ventilator during ALS related to the duration of application of the special pressure mode during chest compressions?
Could the improvement in ROSC be due to a continuous real time monitoring of the CPR parameters, obtaining a important feedback for the operators, instead to the ventilatory pressure mode?
Keywords: Cardiac Arrest, Heart, OHCA, ROSC, Defibrillation
Important Note: All contributions to this Research Topic must be within the scope of the section and journal to which they are submitted, as defined in their mission statements. Frontiers reserves the right to guide an out-of-scope manuscript to a more suitable section or journal at any stage of peer review.
