A Successful Resuscitation of a Young Patient with Persistent Life Threatening Ventricular Fibrillation during a Minor Surgical Procedure.
Loading...
Date
2015
Journal Title
Journal ISSN
Volume Title
Publisher
Abstract
Aims: A discussion about the treatment options for cardiac arrest due to cocaine toxicity.
Presentation of Case: This is a case report of a young man who underwent general anesthesia
for a urologic procedure. He suffered a ventricular fibrillation arrest and required over an hour of
Advanced Cardiac Life Support (ACLS). Team Strategies & Tools to Enhance Performance and
Patient Safety (TeamSTEPPS) techniques were utilized. Within one hour from the initiation of the
dysrhythmia he received femoral vessel cannulation in preparation for extracorporeal membrane
oxygenation (ECMO). The hypothermia protocol was instituted early for brain protection. The
patient completely recovered with no neurological or cardiovascular sequelae from this life
threatening cardiac arrest. Upon further investigation, it was discovered that cocaine was
consumed one day prior to surgery. Discussion: The use of cocaine is associated with multiple cardiovascular complications including
ventricular fibrillation which was the probable etiology of this patient’s dysrhythmia. Recent studies
elicited that there are underlying anatomic substrate alterations and changes in the molecular
structure when cocaine is used. Cocaine stabilizes membranes in the nervous and myocardial
tissue by antagonizing sodium and potassium channels. Multiple interventions were utilized which
resulted in a successful resuscitation.
Conclusion: The implementation of ACLS, ECMO, hypothermic brain protection and team training
all aided in the complete neurologic recovery in this patient.
Description
Keywords
Cocaine abuse, arrhythmia, cardiac arrest, extracorporeal circulation
Citation
Song Jing, Rivera Josue, Joseph Vilma, Reddy Shamantha. A Successful Resuscitation of a Young Patient with Persistent Life Threatening Ventricular Fibrillation during a Minor Surgical Procedure. British Journal of Medicine and Medical Research. 2015; 7(11): 948-952.