A Case of a Full Recovery from a Cardiac Standstill That Continued for 24 Minutes

DOI 2 Citations 15 References
  • Yokoe Masamichi
    Emergency and Critical Care Medical Center, Nagoya Daini Red Cross Hospital
  • Inada Shinji
    Emergency and Critical Care Medical Center, Nagoya Daini Red Cross Hospital
  • Shiroko Takashi
    Emergency and Critical Care Medical Center, Nagoya Daini Red Cross Hospital
  • Tsukagawa Toshiyuki
    Emergency and Critical Care Medical Center, Nagoya Daini Red Cross Hospital
  • Ishikawa Kiyoshi
    Emergency and Critical Care Medical Center, Nagoya Daini Red Cross Hospital

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  • Ａｓｙｓｔｏｌｅ確認から２４分経過後，蘇生行為に反応し心拍再開・社会復帰を遂げた１例

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Abstract

Generally, the number of patients who recover from cardiac standstill is very low. In addition to that, cases where patients have been discharged from the hospital after cardiac standstill are rare. Here, we report the case of an 89-year-old male's successful discharge from the hospital after a cardiac standstill. He felt chest pain first and his family called the ambulance. After the arrival of the ambulance team, the man was examined by the team. The AED monitor showed asystole and that electric shock was not required. Since his breathing was weak, the ambulance team judged that this case was a cardiac arrest and started CPR. But on the way to the hospital, the monitor showed asystole only. On arrival at the hospital, he still was not breathing normally and his electrocardiogram showed cardiac standstill. We continued CPR and gave 1mg epinephrine injections repeatedly. After the 3rd injection of epinephrine, around 24 minutes after confirmation of cardiac standstill, spontaneous circulation was restored. Since his laboratory data showed hyperkalemia and renal dysfunction, after admission, we gave the patient additional treatment of insulin and glucose in order to decrease the level of plasma potassium. As the concetration of plasma potassium decreased, his heart rate became stable over time. The next day he regained consciousness, and his breathing improved the day after that. On the 34th day, he was discharged. This case showed, even though the patients was over 80 and experienced a cardiac standstill, as long as the cause of the cardiac standstill is hyperkalemia and we treat the patient with adequate BLS & ACLS, we may be able to resuscitate and discharge the patient successfully.

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