Persistent ventricular fibrillation during therapeutic hypothermia and prolonged high-dose vasopressor therapy: case report.
BACKGROUND
Recent emphasis on high quality prehospital cardiopulmonary resuscitation has resulted in more out-of-hospital cardiac arrest victims surviving to the emergency department. As such, standardized in-hospital post-cardiac arrest care is necessary to assure optimal neurological recovery. Although therapeutic hypothermia has arisen as a key component in the post-cardiac arrest care paradigm, its interaction with other therapies remains poorly defined.


OBJECTIVE
The purpose of this communication is to demonstrate a potential interaction between therapeutic hypothermia and routinely administered resuscitation medications.


METHODS
We present a case of idiopathic ventricular fibrillation in a previously healthy 36-year-old man who developed persistent ventricular fibrillation in the setting of mild therapeutic hypothermia and high doses of routine resuscitation medications.


CONCLUSIONS
This case illustrates the importance of understanding the potential interaction between therapeutic hypothermia and resuscitation medications along with the need for a systematic and standardized, multi-disciplinary approach to post-cardiac arrest care.
Poles
Joshua C
JC
Kansas City University of Medicine and Biosciences, Kansas City, Missouri, USA. jpoles@kcumbl.edu
Vadeboncoeur
Tyler F
TF
Bobrow
Bentley J
BJ
D000328:Adult; D002316:Cardiotonic Agents / Q000008:administration & dosage* / Q000009:adverse effects; D004280:Dobutamine / Q000008:administration & dosage / Q000009:adverse effects; D004298:Dopamine / Q000008:administration & dosage / Q000009:adverse effects; D006323:Heart Arrest / Q000628:therapy; D006801:Humans; D007036:Hypothermia, Induced / Q000009:adverse effects*; D008297:Male; D014693:Ventricular Fibrillation / Q000209:etiology*
D002316:Cardiotonic Agents; D004280:Dobutamine; D004298:Dopamine