A 26-year-old man, who was training in bad weather for a mountain ultramarathon, became hypothermic after running for 4 h. He deteriorated and was unable to continue. His running partner went for help. The man suffered an unwitnessed hypothermic cardiac arrest. The on-site management and evacuation are described and included the use of intermittent cardiopulmonary resuscitation and a mechanical device during transport. The patient was successfully resuscitated and rewarmed by Extracorporeal Membrane Oxygenation (ECMO) after more than 2 h of cardiopulmonary resuscitation. After 14 h of ECMO support and five days of ventilation, the patient subsequently made a good neurological recovery. At hospital discharge, he had normal cerebral function, and an improving peripheral polyneuropathy affecting distal limbs, with paraesthesia in both feet and reduced coordination and fine motor skills in both hands.
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Hypothermic cardiac arrest: prognostic factors for successful resuscitation before rewarming.
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Department of Anaesthesiology and Intensive Care, Medical University of Silesia, Katowice, Poland.
Objective: To indicate factors predicting return of spontaneous circulation in patients with hypothermic cardiac arrest in the pre-rewarming period.
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Department of Emergency Medicine, Jan Kochanowski University, Kielce, Poland.
Aim Of The Study: Predictive factors for poor outcomes in hypothermic cardiac arrest (HCA) differ from those in normothermic out-of-hospital cardiac arrest (OHCA). This study aimed to evaluate the outcomes of extracorporeal life support (ECLS) in HCA patients who may not be considered eligible based on the guidelines set by the Extracorporeal Life Support Organization (ELSO).
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Department of Emergency Medicine, Hokkaido University Hospital, N14W5 Kita-Ku, Sapporo, 060-8648, Japan.
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Université de Paris, Inserm UMR-S 942 MASCOT, Paris, France.
Article Synopsis
- - Ventilator-associated pneumonia (VAP) is common in cardiac arrest patients, but diagnosing it post-arrest is difficult, leading to debate over the effectiveness of biomarkers like C-reactive protein (CRP) and procalcitonin (PCT) for this purpose.
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The Beginning of an ECLS Center: First Successful ECPR in an Emergency Department in Romania-Case-Based Review.
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Department of Emergency Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iasi, Romania.
According to the latest international resuscitation guidelines, extracorporeal cardiopulmonary resuscitation (ECPR) involves the utilization of extracorporeal membrane oxygenation (ECMO) in specific patients experiencing cardiac arrest, and it can be considered in situations where standard cardiopulmonary resuscitation efforts fail if they have a potentially reversible underlying cause, among which we can also find hypothermia. In cases of cardiac arrest, both witnessed and unwitnessed, hypothermic patients have higher chances of survival and favorable neurological outcomes compared to normothermic patients. ECPR is a multifaceted procedure that requires a proficient team, specialized equipment, and comprehensive multidisciplinary support within a healthcare system.
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