Neurologic Recovery From Profound Accidental Hypothermia After 5 Hours of Cardiopulmonary Resuscitation

Abstract

OBJECTIVE: To describe the successful neurologic recovery from profound accidental hypothermia with cardiac arrest despite the longest reported duration of cardiopulmonary resuscitation. DESIGN: Case report. SETTING: Mountain. PATIENT: A 57-year-old woman experienced profound accidental hypothermia (16.9°C) in a mountainous region of Grenoble. She was unconscious and had extreme bradycardia (6 beats/min) at presentation. A cardiac arrest occurred at the mobilization that was not responsive to electrical shocks or epinephrine. INTERVENTION: Cardiopulmonary resuscitation was continued for 307 minutes after rescue until venoarterial extracorporeal membrane oxygenation blood flow had been established at the emergency department. MEASUREMENTS AND MAIN RESULTS: At a 3-month follow-up, the patient showed good physical and mental recovery. CONCLUSION: With no evidence of trauma or asphyxia, profound accidental hypothermia with cardiac arrest represents a specific condition for which successful neurologic recovery is feasible despite prolonged cardiopulmonary resuscitation.