Postarrest targeted temperature management immediately following craniotomy-a case report.
Therapeutic hypothermia or targeted temperature management (TTM) has been shown to improve survival and neurological outcome after cardiac arrest. TTM is not frequently utilized in the postoperative setting because of the concern for exacerbation of bleeding. We present the case of a 65-year-old man who had a cardiac arrest during craniotomy for a brain tumor resection. He was successfully resuscitated from pulseless electrical activity and remained unresponsive. After assessment for postoperative brain hemorrhage, the neurocritical care team initiated TTM. Repeat imaging revealed no additional bleeding. The patient was discharged with a cerebral performance category of 1 to an acute rehabilitation center 11 days following his cardiac arrest. This case highlights the need for further consideration of TTM in the postoperative cardiac arrest population.
1 Center for Resuscitation Science, University of Pennsylvania , Philadelphia, Pennsylvania.
Gail
G
Delfin
Marion
M
Leary
Sarah M
SM
Perman
Donald M
DM
O'Rourke
Joshua M
JM
Levine
Benjamin S
BS
Abella