Resuscitation after three hours of cardiac arrest with severe hypothermia following a toxic coma

We report the case of a 37-year-old woman who survived from severe hypothermia (rectal temperature: 22 degrees C) and prolonged cardiac arrest with asystole after benzodiazepine and tricyclic antidepressant poisoning. Basic-cardiopulmonary resuscitation and mechanical ventilation was started by a Fr...

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Bibliographic Details
Published in:Annales françaises d'anesthésie et de réanimation 2008-06, Vol.27 (6), p.510
Main Authors: Gillart, T, Loiseau, S, Azarnoush, K, Gonzalez, D, Guelon, D
Format: Article
Language:fre
Subjects:
Adult
Antidepressive Agents, Tricyclic - toxicity
Benzodiazepines - toxicity
Coma - chemically induced
Extracorporeal Membrane Oxygenation
Female
Heart Arrest - chemically induced
Humans
Hypothermia - chemically induced
Resuscitation
Treatment Outcome
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Summary:We report the case of a 37-year-old woman who survived from severe hypothermia (rectal temperature: 22 degrees C) and prolonged cardiac arrest with asystole after benzodiazepine and tricyclic antidepressant poisoning. Basic-cardiopulmonary resuscitation and mechanical ventilation was started by a French Mobile Intensive-Care unit. Spontaneous circulation was restored at 25 degrees C under epinephrin after three hours of chest compression from home to the intensive-care unit and rewarming with extracorporeal circulation. The patient was discharged at day 13 without any neurological deficit. The discussion focuses on the benefit of extracorporeal-membrane oxygenation (ECMO) as extracorporeal circulation device through femoral access, the differential diagnosis between death and recoverable cardiac arrest and neuroprotection.
ISSN:1769-6623
DOI:10.1016/j.annfar.2008.04.018