[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 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.
Département d'anesthésie-réanimation, hôpital Gabriel-Montpied, CHU de Clermont-Ferrand, B.P. 69, 63003 Clermont-Ferrand, France. tgillart@chu-clermont-ferrand.fr
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T
Gillart
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S
Loiseau
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K
Azarnoush
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D
Gonzalez
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D
Guelon
D000328:Adult; D000929:Antidepressive Agents, Tricyclic / Q000633:toxicity*; D001569:Benzodiazepines / Q000633:toxicity*; D003128:Coma / Q000139:chemically induced*; D015199:Extracorporeal Membrane Oxygenation; D005260:Female; D006323:Heart Arrest / Q000139:chemically induced*; D006801:Humans; D007035:Hypothermia / Q000139:chemically induced; D012151:Resuscitation; D016896:Treatment Outcome
D000929:Antidepressive Agents, Tricyclic; D001569:Benzodiazepines