A 57-year-old man underwent myocardial revascularization for unstable angina. Cardiocirculatory arrest complicated the procedure and the patient was rapidly treated with advanced cardiac life support. After 26-min long resuscitation attempts, 5 DC-shock and cardioactive drug administration, an extracorporeal system was positioned and activated (extracorporeal membrane oxygenation, ECMO). After ECMO positioning, sinus rhythm was achieved after another DC-shock. Therapeutic hypothermia was started with a target temperature of 33°C. ECMO was removed after 12h, and therapeutic hypothermia was continued for 27h without any complications. The patient was discharged with good neurological outcome. This report shows the feasibility of treatment of a dramatic event such as refractory cardiac arrest, using modern and advanced techniques in the intensive cardiac care unit.
[Combined treatment of refractory cardiac arrest by extracorporeal membrane oxygenation and therapeutic hypothermia].
GASPARETTO, NICOLA;TARANTINI, GIUSEPPE;PERAZZOLO MARRA, MARTINA;BIANCO, ROBERTO;ILICETO, SABINO;CACCIAVILLANI, LUISA
2013
Abstract
A 57-year-old man underwent myocardial revascularization for unstable angina. Cardiocirculatory arrest complicated the procedure and the patient was rapidly treated with advanced cardiac life support. After 26-min long resuscitation attempts, 5 DC-shock and cardioactive drug administration, an extracorporeal system was positioned and activated (extracorporeal membrane oxygenation, ECMO). After ECMO positioning, sinus rhythm was achieved after another DC-shock. Therapeutic hypothermia was started with a target temperature of 33°C. ECMO was removed after 12h, and therapeutic hypothermia was continued for 27h without any complications. The patient was discharged with good neurological outcome. This report shows the feasibility of treatment of a dramatic event such as refractory cardiac arrest, using modern and advanced techniques in the intensive cardiac care unit.Pubblicazioni consigliate
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