Survival Without Neurological Sequelae Following Massive Pulmonary Embolism and Prolonged Cardiac Arrest.

Autor: Paciorkowski F; Emergency Department, Epicura Hospital, Hornu, BEL., Nahban W; Intensive Care Department, Epicura Hospital, Hornu, BEL., Jacques JM; Emergency Department, Epicura Hospital, Hornu, BEL.
Jazyk: angličtina
Zdroj: Cureus [Cureus] 2024 Oct 19; Vol. 16 (10), pp. e71898. Date of Electronic Publication: 2024 Oct 19 (Print Publication: 2024).
DOI: 10.7759/cureus.71898
Abstrakt: We present the case of a 17-year-old female who survived cardiac arrest caused by a massive pulmonary embolism leading to obstructive shock. Despite a prolonged low-flow period of 193 minutes, she fully recovered without apparent neurological damage, thanks to immediate cardiopulmonary resuscitation (CPR) initiated by her father, timely intervention by paramedics and medical teams, and the use of veno-arterial extracorporeal membrane oxygenation (VA-ECMO). Key factors in her recovery included the absence of a no-flow period, maintenance of end-tidal CO 2 (ETCO 2 ) levels above 25-30 mmHg during resuscitation, and the vital role of VA-ECMO in supporting organ perfusion. This case highlights the importance of prompt bystander intervention, continuous ETCO 2 monitoring during CPR, and the integration of advanced circulatory support measures in post-cardiac arrest care. Additionally, it underscores the potential for favorable neurological outcomes even after extended resuscitation, provided there is adequate cerebral perfusion and timely mechanical support. The report emphasizes the need for public education on basic life support (BLS).
Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.
(Copyright © 2024, Paciorkowski et al.)
Databáze: MEDLINE
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