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Scholars Journal of Medical Case Reports | Volume-6 | Issue-04
A Patient with Cardiac Arrest Induced By Accidental Deep Hypothermia Who Required Percutaneous Cardiopulmonary Support
Kouhei Ishikawa , Kei Fujiwara , Hiroki Nagasawa, Ikuto Takeuchi , Kei Jitsuiki , Akihiko Kondo , Hiromichi Ohsaka , Kazuhiko Omori , Youichi Yanagawa
Published: April 30, 2018 | 129 142
DOI: 10.36347/sjmcr.2018.v06i04.004
Pages: 230-232
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Abstract
A 63-year-old man with alcoholism and liver dysfunction was found unconscious at home by his wife. The lowest temperature had been 0 °C on that day. On arrival, his radial artery showed no pulse, but his carotid artery did. His heart rate was 30 beats per minute. After tracheal intubation and securing a venous route, cardiac arrest occurred. The initial rhythm was ventricular fibrillation. He received basic life support, including one electrical shock, without return of circulation. He underwent percutaneous cardiopulmonary support (PCPS) for support of circulation, respiration and rewarming over the course of 40 minutes. The cause of the patient’s accidental deep hypothermia was considered to be both difficulty moving due to alcoholic hypokalemia and the low cold temperature. On the second hospital day, rewarming was completed, and he was taken off of PCPS on the third hospital day. When arterial cannulation was removed, massive transfusion was required because massive hemorrhaging had occurred. Consequently, he became complicated with acute respiratory distress syndrome. He was extubated once on the seventh hospital day, but he was re-intubated due to complications of hypoxia induced by difficulty excreting sputum. Post-tracheostomy on the 10th hospital day was eventful. He retained his normal degree of intelligence and was transported to another medical facility for rehabilitation. We herein report a patient with cardiac arrest induced by accidental deep hypothermia who obtained a favorable outcome by PCPS for cardiac arrest and rewarming. PCPS was useful for treating accidental deep hypothermia with cardiac arrest.