A Case Report of Therapeutic Hypothermia in the Postoperative Cardiac Arrest of a Noncardiac Surgical Patient

摘要

Therapeutic hypothermia (TH) has been used to decrease neurological morbidity in comatose patients who have suffered out-of-hospital cardiac arrest. In the modern TH era, there are no studies evaluating the use of TH in postoperative cardiac arrest patients. Generalization of the use of TH to include postoperative cardiac arrest patients has not been systematically studied or reported. This is possibly secondary to potential complications specific to this population pool. Hypothermia can induce bleeding diathesis, delay wound healing, and increase the risk of wound infections. A recent case series examining complications after the use of TH in three postcardiac surgery cardiac arrest patients revealed no significant bleeding, electrolyte disturbances, or dysrhythmias, with the benefit of good neurological outcomes. We present the first case report of TH use in the postoperative cardiac arrest of a noncardiac surgical patient in the modern TH era. This report is of a 75-year-old woman who underwent elective colorectal resection complicated by postoperative cardiac arrest. She was successfully treated with TH. To our knowledge, this is the first report of a successful application of TH in the cardiac arrest of a postoperative noncardiac surgical patient. The complications that could have been attributed to TH were hypokalemia, hypomagnesaemia, sinus bradycardia, and ventilator-acquired pneumonia. In this case, TH was not associated with postoperative bleeding, delayed wound healing, anastomotic dehiscence, or wound infection. We hope that our report sparks future studies investigating TH in postoperative patients.