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Open research questions in Cardiac Arrest and Resuscitation

39 unresolved questions extracted from the limitations and future-work sections of 554 Cardiac Arrest and Resuscitation papers in our library. Each links back to the study that raised it.

What the literature leaves open

  • Objectives: While advanced airway management (AAM) is commonly performed for children with out-of-hospital cardiac arrest (OHCA), the benefit and optimal timing of AAM remains unclear.

    Early Successful Prehospital Advanced Airway Management and Outcomes in Pediatric Out-of-Hospital Cardiac Arrests · 2026 · DOI

  • Future studies are recommended to employ designs that allow individual-level matching and include practical skill assessments to more comprehensively evaluate the effect of CPR training.

    The Effect of Cardiopulmonary Resuscitation Training on Knowledge Level: A Repeated Cross-Sectional Evaluation by Sex · 2026 · DOI

  • Abstract Background Cardiac arrest (CA) occurring in the setting of hypertension (HTN) represents a critical and under-recognized intersection of acute cardiovascular catastrophe and chronic vascular disease in the United States (U.

    Temporal Trends and Forecasted Cardiac Arrest and Hypertension-Related Mortality in U.S. Adults, 2000–2035: A Nationwide CDC WONDER Multiple Cause-of-Death Study · 2026 · DOI

  • examined, values as high as 74.8%, 68% and 83% were observed in different studies (13,14). In our study, based on the ROC curve for pH value, a cutoff value of 7.13 was obtained. Although differences in HCO3 and pCO2 levels did not reach statistical significance, non-survivors exhibited higher pCO2 levels and markedly elevated lactate concentrations, supporting the presence of combined metabolic This study was performed at a single medical center, potentially restricting the applicability of its results to broader populations. The study cohort included a heterogeneous patient population, comprising individuals with a range of underlying conditions such as cardiac, cardiothoracic, neurosurgical, traumarelated, pulmonary, and post-operative diagnoses. and respiratory acid–base disturbances in the early Furthermore, the retrospective study design and post-resuscitation period. Lactate concentrations relatively small sample size introduce inherent risks were notably elevated in patients who did not survive, of selection and information bias that could not be compared to those who were discharged alive. This entirely eliminated. As a result of the retrospective finding further supports the contribution of metabolic methodology, certain clinical variables potentially acidosis due to tissue hypoperfusion in early postaffecting both short- and long-term outcomes in postresuscitation mortality. Accumulated anions due to cardiac arrest patients particularly those related to CPR acute renal failure, which is common in post-CPR quality, neurological status, and post-resuscitation patients may also cause significant changes in pH (15,16). Jamme et al. showed that pH and HCO3 had interventions were not available for analysis and may have influenced the statistical interpretations. Turk J Intensive Care 2026; Early View:1-7 Düzgün A, et al.

    Arterial pH at hospital admission and its relationship with early mortality in post-cardiac arrest patients · 2026 · DOI

  • This study had several limitations. First, to investigate the impact of OHCA recognition time, we excluded cases in which CPR was not indicated or callers did not follow dispatcher instructions, as recognition time data were unavailable for these cases. Although we added a descriptive comparison of the analyzed cohort and the Yamamoto et al. International Journal of Emergency Medicine (2026) 19:142 major excluded adult OHCA groups, selection bias may still have been present. Second, there were few survi- vors and patients with favorable neurological outcomes, which may have limited the statistical power to detect significant differences in secondary outcomes. Third, the time variables were documented by the dispatcher who handled the call after reviewing the recorded telephone conversation and therefore might have been affected by documentation errors or variations in recording prac- tices. Fourth, this study was conducted in a single region in Japan. The relatively low proportion of CPR already in progress before dispatcher-assisted CPR in our cohort may reflect setting-specific differences in community response and reliance on dispatch-assisted CPR, which should be considered when comparing these findings with those from other EMS systems. In addition, the ana- lyzed cohort represented a selected subgroup of adult OHCA cases in which dispatcher-assisted CPR was pur- sued and documented. Therefore, caution is required when generalizing the results. In addition, our study was based on the pre-COVID-19 pandemic period (2016– 2019). The COVID-19 pandemic is reportedly associ- ated with changes in OHCA characteristics, bystander behavior, and outcomes, and because dispatch protocols were modified during the pandemic period in our region (including the introduction of mouth-and-nose covering guidance), the comparability of DACPR processes across time periods may be limited [15, 29–31]. We focused on a pre-pandemic cohort to ensure greater uniformity in dispatch protocols and data comparability. Nevertheless, the generalizability of our findings to contemporary post- pandemic practice requires confirmation in more recent datasets. Furthermore, this study did not examine post- ROSC treatments in the different hospitals to which the patients were transported, and other unknown factors may have influenced the outcomes. In addition, detailed data on CPR quality and other arrival interventions were unavailable and not included in the primary mod- els because these variables may represent post-exposure processes. Therefore, unmeasured intra-arrest and post- arrival factors may still have influenced the observed association between dispatcher recognition time and ROSC. Finally, we categorized dispatcher recognition delay using 10-second intervals for analysis, which may have limited statistical power given the sample size. We acknowledge this as a limitation, and future studies with larger datasets may explore alternative categorizations or advanced modelling approaches to refine these findings.

    Impact of early cardiac arrest recognition by emergency medical service dispatchers on out-of-hospital cardiac arrest: a retrospective population-based observational study · 2026 · DOI

  • A major strength of this study is its use of a large, well- curated database for model development and the inclu- sion of an independent dataset for validation, ensuring robust and generalizable findings. The incorporation of diverse clinical variables and rigorous statistical analysis further strengthens the reliability of our results. How- ever, several limitations warrant consideration. First, the retrospective nature of the study may introduce bias, as it relies on the availability and accuracy of recorded data. Second, despite efforts to address missing data through imputation, residual data quality issues may still impact the models’ performance. Finally, the relatively small sample size of the external validation cohort may limit the applicability of the findings to broader populations.

    Prediction of in-hospital mortality risk in cardiac arrest patients using machine learning models: a study based on the MIMIC-IV database with external validation from Yunnan University Affiliated Hospital · 2026 · DOI

  • Several limitations must be acknowledged. First, the sample size was modest, and the study duration was limited to 6 h, preventing assessment of longer-term outcomes such as survival, neurological recovery, or delayed organ dysfunction. Second, as in all large-animal ECMO studies, interindividual variability in surgical instrumentation and perfusion management is possible, although randomization and standardized protocols mitigate this concern. Third, mechanistic analyses such as cytokine profiling, NO-related metabolites, or endothelial biomarkers were not performed, limiting the ability to delineate specific molecular pathways. Finally, healthy young pigs do not fully replicate the comorbidities, vascular heterogeneity, and inflammatory background of human ECMO patients.

    Comparison of norepinephrine with a combined non-catecholaminergic therapy in a porcine model of refractory cardiac arrest resuscitated with VA-ECMO · 2026 · DOI

  • Effective intervention strategies to enhance public access to EMS through improved emergency number awareness have not been rigorously tested across diverse populations and healthcare contexts. Comparative effectiveness trials of educational interventions targeting specific high-risk groups (e.g., limited English proficient populations, elderly populations, pediatric caregivers) are needed.

    Public awareness of medical emergency telephone numbers: a scoping review · 2026 · DOI

  • The mechanisms by which public knowledge of emergency telephone numbers translates into actual EMS utilization behavior during acute medical events have not been systematically studied. Research is needed to distinguish between awareness of the correct number, decision-making factors that influence calling behavior, and outcomes related to call timing in conditions such as acute myocardial infarction and stroke.

    Public awareness of medical emergency telephone numbers: a scoping review · 2026 · DOI

  • Public awareness of medical emergency telephone numbers in low- and middle-income countries has not been adequately characterized in existing literature. Specific epidemiological data on EMS activation knowledge gaps, the prevalence of preventable deaths attributable to delayed emergency contact, and country-specific barriers to EMS access in these regions remain largely undocumented.

    Public awareness of medical emergency telephone numbers: a scoping review · 2026 · DOI

  • Addition- ally, there is currently a lack of evidence regarding the survival outcome of single point piston CPR devices without suction cup use in the EMS.

    Association Between use of a Single-Piston CPR Device in the Resuscitation Process and the Short-Term Survival of OHCA Patients · 2024 · DOI

  • This study has some limitations. First, this was a retrospective single centered study, so the study could only reach as far as the pre-existing data provided, and there was a portion of the population whose first arrest rhythm was not recorded. Additionally, data on the time during which the mechanical chest compression device was applied either at the scene or in the EMS was not available. A few additional factors, e.g., the limited number of available mechanical CPR devices at the study hospital’s ED, could have led to unequal distribution of the use of the device among cases and thus could have resulted in selection bias. The MCPR devices in this study were not significantly different from models which have been thoroughly evaluated in many previous studies. There was also limited data regarding EMS actions which may have affected the outcomes. Also, the small number of cases receiving mechanical CPR in this study could have resulted in an overestimated adjusted odds ratio in the multivariable analysis of the association with ROSC. Lastly, in this study, the number of mechanical CPR devices used was rather small which may have affected the power of the statistical analysis.

    Association Between use of a Single-Piston CPR Device in the Resuscitation Process and the Short-Term Survival of OHCA Patients · 2024 · DOI

  • Objectives: Dual dispatch early defibrillation in out-of-hospital cardiac arrest (OHCA) victims provided by firefighters in addition to Emergency medical services (EMS) has proven to increase rate of return of spontaneous circulation (ROSC) and thus survival in the metropolitan or suburban areas whereas the data in rural areas are scarce.

    Impact of dual dispatch system implementation on response times and survival outcomes in out-of-hospital cardiac arrest in rural areas · 2022 · DOI

  • Our results indicate that healthcare providers need to be prepared that ND experiencers may report clinically significant NDE features during both unconsciousness itself and that more research into this topic is warranted.

    Near-Death Experience features during various phases related to unconsciousness: An exploratory study of Norwegian hospital patients. · 2018 · DOI

  • The following issues were insufficiently known among the nurses: an estimation of the child's weight (52–76%), a second dose of Amiodaron given during the child's resuscitation (47–86%), volume of fluids during the performance of the fluid resuscitation (48–86%).

    Wiedza personelu ratownictwa medycznego z zakresu zaawansowanych zabiegów resuscytacyjnych u dzieci · 2012 · DOI

  • A combination of vasopressin and epinephrine may be more effective than epinephrine alone in cardiopulmonary resuscitation (CPR), but evidence is lacking to make clinical recommendations.

    Vasopressin and epinephrine versus epinephrine in management of patients with cardiac arrest: a meta-analysis · 2010 · DOI

  • 14,15iven the proven survival benefit of high-quality CPR and the lack of data on actual performance, we sought to de-termine whether well-trained hospital staff perform CPR compressions and ventilations according to guideline recommendations.

    Quality of Cardiopulmonary Resuscitation During In-Hospital Cardiac Arrest · 2005 · DOI

  • Second, while we adjusted for major comorbidities, we lacked data on the “quality of CPR” (e.

    Low-flow time and neurological outcomes in out-of-hospital cardiac arrest: implications for prehospital care quality and health outcomes · 2026 · DOI

  • Conclusion: Despite moderate awareness, CPR training coverage and confidence remain insufficient.

    PUBLIC AWARENESS OF SUDDEN CARDIAC DEATH AND CARDIOPULMONARY RESUSCITATION IN TURKIYE: A SURVEY STUDY · 2026 · DOI

  • Abstract Background Equivocal data exist on whether noradrenaline during resuscitation from circulatory shock affects tissue mitochondrial respiration.

    Impact of noradrenaline, adrenergic receptors, and radical formation on cardiac mitochondria in resuscitated swine · 2026 · DOI

  • Discussion and Conclusion: The study suggests mCPR may improve immediate outcomes, particularly in cases of arrhythmias and cardiogenic shock, though long-term effects remain unclear.

    Clinical Profile and Outcomes of Cardiac Arrest Patients Resuscitated Using a Mechanical Chest Compression Device (LUCAS) Admitted in Asian Hospital and Medical Center: A Descriptive Study · 2026 · DOI

  • Future research should concentrate on gaps in evidence-based practice, especially measurements to demonstrate the effectiveness of first aid training, in order to advance the case for mandatory first aid education in schools.

    Skills for life: First aid and cardiopulmonary resuscitation in schools · 2017 · DOI

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39 open questions have been extracted from the limitations and future-work passages of 554 Cardiac Arrest and Resuscitation papers in our library. Each one below links back to the study that raised it, so you can read the original claim in context.

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