Document Detail

An exceptional case of complete neurologic recovery after more than 5-h cardiac arrest.
MedLine Citation:
PMID:  11426479     Owner:  NLM     Status:  MEDLINE    
We describe a case of more than 5 h cardiac arrest in a 60-year-old patient who underwent general anesthesia for a urologic operation. Before extubation, the patient suddenly developed ventricular fibrillation, pulseless ventricular tachycardia and asystole which was immediately treated by advanced life support (ALS) measures. Thirty minutes later seizures developed and were controlled by 200 mg of thiopentone and 10 mg of diazepam. A pattern of ventricular tachycardia, coarse ventricular fibrillation and asystole lasted for nearly 120 min. Termination of resuscitation maneuvers was considered, but long-term life support was continued for 5 h. After this time, peripheral pulses, with a supraventricular tachycardia-like rhythm and regular spontaneous breathing reappeared. Seven hours later, the patient had a Glasgow Coma Scale (GCS) of 5, dilated unresponsive, absence of pupils, and a systolic arterial pressure of 100 mmHg. He was then transferred to intensive care unit (ICU). The morning after, the patient was awake, responded to simple orders, breathing spontaneously, and free from sensomotor deficit. He was, therefore, extubated. Subsequently, other episodes of transitory ST-line upper wave followed by ventricular fibrillation appeared, suggesting Prinzmetal angina. This was successfully treated by percutaneous coronary angioplasty. The first electroencephalogram recorded the day after cardiac arrest showed a mild widespread background slowing. An electroencephalogram 6 days later showed a return to alpha rhythm with only mild theta-wave abnormalities. Four weeks after the first cardiac arrest the patient was discharged. This is an exceptional experience compared with the others reported. We believe that all the efforts must not be given up when such an event occurs during anesthesia and there are optimal conditions for resuscitation maneuvers.
L P Fabbri; M Nucera; A Becucci; A Grippo; F Venneri; V Merciai; S Boncinelli
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Resuscitation     Volume:  48     ISSN:  0300-9572     ISO Abbreviation:  Resuscitation     Publication Date:  2001 Feb 
Date Detail:
Created Date:  2001-06-27     Completed Date:  2001-08-02     Revised Date:  2009-08-25    
Medline Journal Info:
Nlm Unique ID:  0332173     Medline TA:  Resuscitation     Country:  Ireland    
Other Details:
Languages:  eng     Pagination:  175-80     Citation Subset:  IM    
Department of Pathophysiology, University of Florence, Italy.
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MeSH Terms
Cardiopulmonary Resuscitation / methods*
Central Nervous System / physiology*
Heart Arrest / etiology,  therapy*
Life Support Care / methods*
Middle Aged
Recovery of Function*
Time Factors
Urologic Surgical Procedures / adverse effects

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