Article Text
Abstract
A 38-year-old man was found unconscious, alone in the driver's seat of his car. The emergency medical team identified his condition as pulseless ventricular tachycardia. Defibrillation was attempted but failed. Extracorporeal membrane oxygenation (ECMO) was started in the emergency room 52 min after the estimated arrest following the extracorporeal cardiopulmonary resuscitation (ECPR) protocol in our center. The initial prognosis under the standard protocol was <25% chance of survival. A novel adjunctive to our ECPR protocol, cerebral selective deep (<30°C) hypothermia (CSDH), was applied. CSDH adds a second independent femoral access extracorporeal circuit, perfusing cold blood into the patient's common carotid artery. The ECMO and CSDH circuits demonstrated independent control of cerebral and core temperatures. Nasal temperature was lowered to below 30°C for 12 hours while core was maintained at normothermia. The patient was discharged without significant neurological deficit 32 days after the initial arrest.
- Brain
- Catheter
- Device
- Intervention
- Technique
This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Statistics from Altmetric.com
Footnotes
Republished with permission from BMJ Case Reports Published 20 January 2017; doi:10.1136/bcr-2016-012806
Contributors C-HW: writing and designing the system. Y-TL and H-WC: patient care. Y-CW and J-JH: catheter intervention. JRG: design. YSC: writing, design of the system, and intervention.
Competing interests Chih-Hsien Wang, Yu-Ting Lin, Mao Ting, Heng-Wen Chou, Yi-Chih Wang, Juey-Jen Hwang, Yih-Sharng Chen: none. John R. Gilbert is both the CTO and a shareholder of APMTD, which is the master distributor for the TwinFlo® Device in Taiwan.
Patient consent Obtained.
Ethics approval The institutional review board approved the study (series No 2016-03049 BIPA).
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement The authors agree to share unpublished data if requested.