title: A case of survival after cardiac arrest and 3½ hours of resuscitation.
abstract: Although survival rates after cardiac arrest remain low, new techniques are improving patients' outcomes. We present the case of a 40-year-old man who survived a cardiac arrest that lasted approximately 3½ hours. Resuscitation was performed with strict adherence to American Heart Association/American College of Cardiology Advanced Cardiac Life Support guidelines until bedside extracorporeal membrane oxygenation could be placed. A hypothermia protocol was initiated immediately afterwards. The patient had a full neurologic recovery and was bridged from dual ventricular assist devices to a total artificial heart. On hospital day 160, he underwent orthotopic heart and cadaveric kidney transplantation. On day 179, he was discharged from the hospital in ambulatory condition. To our knowledge, this is the only reported case in which a patient survived with good neurologic outcomes after a resuscitation that lasted as long as 3½ hours. Documented cases of resuscitation with good recovery after prolonged arrest give hope for improved overall outcomes in the future.
authors.affiliation: Departments of Cardiology (Drs. Bassett, Kar, and Nusbaum) and Cardiovascular Surgery (Dr. Gregoric), Texas Heart Institute, Houston, Texas 77030.
authors.forename: Derek M
authors.initials: DM
authors.lastname: Nusbaum
authors.affiliation: Departments of Cardiology (Drs. Bassett, Kar, and Nusbaum) and Cardiovascular Surgery (Dr. Gregoric), Texas Heart Institute, Houston, Texas 77030.
authors.forename: Scott T
authors.initials: ST
authors.lastname: Bassett
authors.affiliation: Departments of Cardiology (Drs. Bassett, Kar, and Nusbaum) and Cardiovascular Surgery (Dr. Gregoric), Texas Heart Institute, Houston, Texas 77030.
authors.forename: Igor D
authors.initials: ID
authors.lastname: Gregoric
authors.affiliation: Departments of Cardiology (Drs. Bassett, Kar, and Nusbaum) and Cardiovascular Surgery (Dr. Gregoric), Texas Heart Institute, Houston, Texas 77030.
authors.forename: Biswajit
authors.initials: B
authors.lastname: Kar
mesh_terms: D000328:Adult; D016887:Cardiopulmonary Resuscitation / Q000379:methods*; D015199:Extracorporeal Membrane Oxygenation / Q000379:methods*; D006323:Heart Arrest / Q000150:complications / Q000503:physiopathology / Q000628:therapy*; D016027:Heart Transplantation / Q000379:methods; D006353:Heart-Assist Devices; D006801:Humans; D007036:Hypothermia, Induced / Q000379:methods*; D016030:Kidney Transplantation / Q000379:methods; D007902:Length of Stay; D008297:Male; D051437:Renal Insufficiency / Q000209:etiology / Q000601:surgery; D017741:Survivors; D013997:Time Factors; D016896:Treatment Outcome
keywords: Advanced cardiac life support/methods; cardiopulmonary resuscitation/methods/standards; delivery of health care; heart arrest/complications/therapy; heart transplantation; heart-assist devices; myocardial infarction/complications/therapy; outcome and process assessment (health care); time factors; treatment outcome