title: Therapeutic hypothermia after cardiac arrest in a patient with systemic sclerosis and Raynaud phenomenon.
abstract: Therapeutic hypothermia favorably impacts neurologic outcomes in patients after cardiopulmonary arrest, although the appropriate target temperature is less clear. Its safety profile in patients with systemic sclerosis (SSc) and Raynaud phenomenon (RP), who may be at increased risk for ischemic complications, has not been addressed in the literature, to our knowledge. Digital lesions are commonly seen in patients with SSc, and cold-induced myocardial ischemia has also been reported. We describe a case of a man with SSc, RP, and digital ulcers who underwent therapeutic hypothermia after cardiopulmonary arrest. He regained full neurologic function, and except for digital necrosis, no hypothermia-associated adverse events were observed. Other risk factors for ischemia, such as cocaine use, may have contributed to the development of the digital necrosis. However, clinicians should be aware of the risk for ischemic complications in patients with SSc and RP when considering the appropriate target temperature after cardiopulmonary arrest.
authors: Department of Medicine, NYU School of Medicine, US Department of Veterans Affairs.
authors: Keren
authors: K
authors: Bakal
authors: Department of Medicine, NYU School of Medicine, US Department of Veterans Affairs.
authors: Mauricio
authors: M
authors: Danckers
authors: Department of Medicine, NYU School of Medicine, US Department of Veterans Affairs.
authors: Joshua L
authors: JL
authors: Denson
authors: VA NY Harbor Healthcare System, US Department of Veterans Affairs, New York, NY; Department of Medicine, NYU School of Medicine, US Department of Veterans Affairs. Electronic address: Harald.sauthoff@nyumc.org.
authors: Harald
authors: H
authors: Sauthoff
mesh_terms: D015897:Comorbidity; D005385:Fingers / Q000473:pathology; D006323:Heart Arrest / Q000453:epidemiology*; D006801:Humans; D007036:Hypothermia, Induced; D008297:Male; D008875:Middle Aged; D009336:Necrosis; D011928:Raynaud Disease / Q000453:epidemiology* / Q000628:therapy*; D012595:Scleroderma, Systemic / Q000453:epidemiology* / Q000628:therapy*; D012883:Skin Ulcer / Q000628:therapy