title: Therapeutic hypothermia after exsanguination.
abstract: Therapeutic hypothermia has been shown to be effective in out-of-hospital cardiac arrest, and use of this therapy has been expanded to involve in-hospital cardiac arrest. The utility of hypothermia in cardiac arrest after hemorrhage is not known. We describe a case of successful neurological and functional outcome after in-hospital pulseless electrical activity arrest secondary to exsanguination from an internal carotid artery rupture. Therapeutic hypothermia by surface cooling was initiated after acute control of the bleeding source, restoration of circulating blood volume, and hemodynamic stabilization. We believe therapeutic hypothermia use will continue to increase for in-hospital cardiac arrests.
authors.affiliation: Department of Anesthesiology and Critical Care, Vanderbilt University School of Medicine, 526 MAB, 1211 21st Ave. South, Nashville, TN 37212, USA. stuart.mcgrane@vanderbilt.edu
authors.forename: Stuart
authors.initials: S
authors.lastname: McGrane
authors.forename: Jennifer
authors.initials: J
authors.lastname: Maziad
authors.forename: James L
authors.initials: JL
authors.lastname: Netterville
authors.forename: Nahel N
authors.initials: NN
authors.lastname: Saied
mesh_terms: D001810:Blood Volume; D020212:Carotid Artery Injuries / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D002343:Carotid Artery, Internal / Q000503:physiopathology; D058734:Exsanguination / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D006323:Heart Arrest / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D006439:Hemodynamics; D006489:Hemostatic Techniques; D006801:Humans; D007036:Hypothermia, Induced; D008297:Male; D008875:Middle Aged; D009460:Neurologic Examination; D020127:Recovery of Function; D012121:Respiration, Artificial; D013997:Time Factors; D020196:Trauma, Nervous System / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control*; D016896:Treatment Outcome; D057772:Vascular System Injuries / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*