Persistent Ventricular Fibrillation During Therapeutic Hypothermia and Prolonged High-Dose Vasopressor Therapy: Case Report |
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Authors: | Joshua C Poles Tyler F Vadeboncoeur Bentley J Bobrow |
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Institution: | ∗ Kansas City University of Medicine and Biosciences, Kansas City, Missouri;† Department of Emergency Medicine, Mayo Clinic Florida, Jacksonville, Florida;‡ Department of Emergency Medicine, Maricopa Medical Center, Phoenix, Arizona |
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Abstract: | Background: Recent emphasis on high quality prehospital cardiopulmonary resuscitation has resulted in more out-of-hospital cardiac arrest victims surviving to the emergency department. As such, standardized in-hospital post-cardiac arrest care is necessary to assure optimal neurological recovery. Although therapeutic hypothermia has arisen as a key component in the post-cardiac arrest care paradigm, its interaction with other therapies remains poorly defined. Objective: The purpose of this communication is to demonstrate a potential interaction between therapeutic hypothermia and routinely administered resuscitation medications. Case Report: We present a case of idiopathic ventricular fibrillation in a previously healthy 36-year-old man who developed persistent ventricular fibrillation in the setting of mild therapeutic hypothermia and high doses of routine resuscitation medications. Conclusion: This case illustrates the importance of understanding the potential interaction between therapeutic hypothermia and resuscitation medications along with the need for a systematic and standardized, multi-disciplinary approach to post-cardiac arrest care. |
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Keywords: | therapeutic hypothermia ventricular fibrillation dopamine dobutamine drug metabolism |
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