Neurologically intact survival following prolonged cardiac arrest monitored with continuous capnography and subsequent treatment with therapeutic hypothermia

摘要

Previously, we reported complete neurologic recovery following a prolonged cardiac arrest in which the resuscitation was guided by continuous capnography. Herein we report a similar incident in a man with a long period of pulselessness and eventual recovery in which both continuous capnography and subsequent therapeutic hypothermia were used. A 61-year-old man told his wife that he was "not feeling well," proceeded to the bathroom in their residence, and collapsed. His wife confirmed that he was unresponsive and called 911 emergency services. With coaching from the dispatcher, she attempted cardiopulmonary resuscitation (CPR), but chest compressions were frequently interrupted by competing attempts to arouse her husband or communicate with the dispatcher. A sheriff's deputy arrived 9.2 minutes after receipt of the 911 call and attached an automated external de-fibrillator (AED) (HeartStart FR2+, Philips Medical Systems, Seattle, WA). The AED algorithm determined that ventricular fibrillation (VF) was present but not of sufficient amplitude, frequency, and conduction properties to warrant a shock, and therefore the rescuer was directed to perform 2 minutes of CPR before the first shock (Figure).