Open AccessTherapeutic hypothermia after cardiac arrest during living-donor liver transplant surgery
Author(s) -
Jaesik Park,
Ju Eun Kwak,
Yun Jeong Cho,
Ho Joong Choi,
Hyo-Sang Choi,
Min Suk Chae,
Chul Soo Park,
Jong Ho Choi,
Sang Hyun Hong
Publication year - 2020
Publication title -
medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.59
H-Index - 148
eISSN - 1536-5964
pISSN - 0025-7974
DOI - 10.1097/md.0000000000022513
Subject(s) - medicine , hypothermia , anesthesia , liver transplantation , cardiopulmonary resuscitation , resuscitation , cirrhosis , transplantation , bispectral index , surgery , sedation
Rationale: Therapeutic hypothermia is an effective medical treatment for neurological recovery after cardiac arrest. Here, we describe a case of successful mild therapeutic hypothermia after cardiac arrest during living-donor liver transplantation. Patient concerns: A 54-year-old woman with alcoholic liver cirrhosis was admitted for living-donor liver transplantation. Cardiac arrest occurred during the anhepatic phase. After cardiopulmonary resuscitation, spontaneous circulation returned, but the bispectral index level remained below 10 until the end of surgery. Diagnoses: Neurological injury caused by global cerebral hypoperfusion was suspected. Interventions: The patient was treated with mild therapeutic hypothermia for 24hours after resuscitation targeting a core body temperature of 34°C with surface cooling using ice bags. Outcomes: The patient recovered consciousness about 22 hours after the event. However, she showed symptoms of delirium even when discharged. At the 3-month follow-up exam, she showed no specific neurological complications. The transplanted liver showed no problems with regeneration. Lessons: Mild therapeutic hypothermia may be safely adopted in cases of cardiac arrest in liver transplant patients and is beneficial for neurological recovery.