Cardiac arrest caused by accidental severe hypothermia and myocardial infarction during general anesthesia

• Published in: Journal of international medical research Vol. 49; no. 1; p. 300060520987945
• Main Authors: Park, Dong Ho, Kim, Tae Woo, Kim, Mo Se, Han, Woong, Lee, Da Eun, Kim, Gyu Seong, Jeong, Chang Young
• Format: Journal Article
• Language: English
• Published: London, England SAGE Publications 01.01.2021; Sage Publications Ltd; SAGE Publishing
• Subjects: Anesthesia, General - adverse effects; Cardiac arrest; Cardiopulmonary Resuscitation; Case Report; General anesthesia; Heart Arrest - etiology; Heart Arrest - therapy; Heart attacks; Humans; Hypothermia; Hypothermia - complications; Hypothermia - therapy; Hypothermia, Induced - adverse effects; Male; Middle Aged; Myocardial Infarction - etiology; Myocardial Infarction - therapy; Percutaneous Coronary Intervention - adverse effects; Traumatic brain injury; percutaneous coronary intervention; coronary restenosis; accidental hypothermia; myocardial infarction; traumatic brain injury; Therapeutic hypothermia; general anesthesia
• ISSN: 0300-0605; 1473-2300
• DOI: 10.1177/0300060520987945

Therapeutic hypothermia is often used for traumatic brain injury because of its neuroprotective effect and decreased secondary brain injury. However, this procedure lacks clinical evidence supporting its efficacy, and adverse outcomes have been reported during general anesthesia. A 61-year-old man with a history of percutaneous coronary intervention (PCI) was admitted with traumatic brain injury. Immediately after admission, he underwent mild therapeutic hypothermia with a target temperature of 33.0°C for neuroprotection. During general anesthesia for emergency surgery because he developed a mass effect, hypothermic cardiac arrest occurred following an additional decrease in the core body temperature. Moreover, myocardial infarction caused by restenosis of the previous PCI lesion also contributed to the cardiac arrest. Although the patient recovered spontaneous circulation after an hour-long cardiopulmonary resuscitation with rewarming, he eventually died of subsequent repetitive cardiac arrests. When anesthetizing patients undergoing therapeutic hypothermia, caution is required to prevent adverse outcomes that can be caused by unintentional severe hypothermia and exacerbation of underlying heart disease.