Background: Out-of-hospital cardiac arrest
(OHCA) with ongoing CPR on arrival to emergency department still a challenge to
decide how long the resuscitation should continue or when to terminate it. Case
Summary: A patient with a 1-week history of difficulty in breathing
suffered from an OHCA. The electrocardiogram upon arrival to the hospital
showed pulseless electrical activity. Cardiopulmonary resuscitation was
initiated and continued for a total of 90 minutes without any interruption
until return of spontaneous circulation
(ROSC) was achieved. Post-cardiac care was offered, and the patient was
discharged with complete neurological recovery. Discussion: In non-shockable rhythms, the powerful defibrillator machine is not used during
resuscitation. In such cases, identifying the offending cause, performing high
quality CPR and administering epinephrine are the only effective tools in
resuscitating a patient.
References
[1]
Goldberger, Z.D., Chan, P.S., Berg, R.A., et al. (2012) Duration of Resuscitation Efforts and Survival after In-Hospital Cardiac Arrest: An Observational Study. The Lancet, 380, 1473-1481. https://doi.org/10.1016/S0140-6736(12)60862-9
[2]
Torke, A.M., Bledsoe, P., Wocial, L.D., Bosslet, G.T. and Helft, P.R. (2015) Cease: A Guide for Clinicians on How to Stop Resuscitation Efforts. Annals of the American Thoracic Society, 12, 440-445. https://doi.org/10.1513/AnnalsATS.201412-552PS
[3]
Tabachnikov, V., Zissman, K., Sliman, H. and Flugelman, M.Y. (2021) Five Hours of Resuscitation with 150 Electrical Shocks and Complete Recovery. Cureus, 13, e14255. https://doi.org/10.7759/cureus.14255
[4]
He, F., Xu, P., Wei, Z.-H., Zhang, J. and Wang, J. (2015) Complete Recovery with the Chain of Survival after a Prolonged (120 Minutes) Out-of-Hospital Cardiac Arrest Due to Brugada Syndrome. Medicine, 94, e1107. https://doi.org/10.1097/MD.0000000000001107
[5]
Youness, H., Al Halabi, T., Hussein, H., Awab, A., Jones, K. and Keddissi, J. (2016) Review and Outcome of Prolonged Cardiopulmonary Resuscitation. Critical Care Research and Practice, 2016, Article ID: 7384649. https://doi.org/10.1155/2016/7384649
[6]
Andersen, L.W., Bivens, M.J., Giberson, T., et al. (2015) The Relationship between Age and Outcome in Out-of-Hospital Cardiac Arrest Patients. Resuscitation, 94, 49-54. https://doi.org/10.1016/j.resuscitation.2015.05.015
