J Korean Med Sci.  2013 Aug;28(8):1257-1259. 10.3346/jkms.2013.28.8.1257.

Therapeutic Hypothermia Following Emergent Coronary Artery Bypass Grafting After Failed Percutaneous Coronary Intervention in a Comatose Post-Cardiac Arrest Patient

• Choi SP
• Wee JH
• Park JH
• Park KN
• Hong SJ
• Lee SH

• KMID: 1793036
• DOI: http://doi.org/10.3346/jkms.2013.28.8.1257

Abstract

We report the case of 60-yr-old female in which therapeutic hypothermia (TH) was successfully induced maintaining the target temperature of 34degrees C for 12 hr despite a risk of hypothermia-induced coagulation abnormalities following an emergent coronary artery bypass grafting (CABG) due to failed percutaneous coronary intervention, who suffered a cardiac arrest. Emergent CABG may be a relative contraindication for TH in post-cardiac arrest patients because hypothermia may increase the risk of infection and bleeding. However, the possibility of an improved neurologic outcome outweighs the risk of bleeding, although major surgery may be a relative contraindication for TH.

Keyword

Hypothermia; Cardiac Arrest; Coronary Artery Bypass Grafting

MeSH Terms

Body Temperature
Coma/complications
*Coronary Artery Bypass
Electrocardiography
Female
Heart Arrest/complications/*diagnosis/therapy
Humans
*Hypothermia, Induced
Intensive Care Units
Middle Aged
Percutaneous Coronary Intervention
Treatment Outcome

Figure

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  Fig. 1 The electrocardiogram showed atrial fibrillation with ST-segment elevation in leads V5-6, II, III, and aVF and ST-segment depression in leads V1-3.

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  Fig. 2 Tympanic (diamond) and rectal (triangle) temperatures of the patient during percutaneous coronary intervention (PCI), coronary artery bypass grafting (CABG), and therapeutic hypothermia (TH). CPB, cardiopulmonary bypass; ROSC, return of spontaneous circulation; ICU, intensive care unit.

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