Full neurological recovery, Cerebral Performance Category (CPC) 1, after 65-minute cardiac arrest using percutaneous cardiopulmonary system and therapeutic hypothermia

摘要

A 48-year-old man with no prior medical history suddenly developed chest pain, and collapsed in an unconscious state at his office. Basic cardiopulmonary resuscitation with chest compression was only started by his coworkers at once. The emergency medical services (EMS) arrived after approximately 8min, and ventricular fibrillation (VF) was confirmed. Automated external defibrillation was attempted twice, without successful resumption of the circulation. The patient was immediately transferred to our hospital. On arrival at the emergency department, approximately 25 min after collapse, two more electric shocks with two intravenous boluses of 1 mg epinephrine were administered, but VF persisted. As a result, the decision was made to insert a PCPS with endotracheal intubation. The PCPS was initiated at 50 min after collapse. Five additional consecutive electric shocks following the intravenous infusion of 150 mg of amiodarone were administered. Subsequently, after a total of nine electric shocks, spontaneous circulation was finally restored at 65 min after collapse.