Successful treatment of cardiac arrest following hysteroscopic surgery using extracorporeal membrane oxygenation

Rationale: Cardiac arrest caused by water intoxication syndrome following hysteroscopic surgery is a rare but life-threatening occurrence. Extracorporeal membrane oxygenation (ECMO) is rarely used to treat water intoxication syndrome in hysteroscopic surgery. Here, we successfully treated a patient with water intoxication syndrome following hysteroscopic surgery with ECMO. Patient concerns: We report a rare case of cardiac arrest during hysteroscopic surgery treated with veno-venous (VV) ECMO. Diagnosis: Water poisoning syndrome was diagnosed by electrolyte examination, the lowest value of serum sodium was 110.7 mmol/L. Interventions: VV-ECMO was prescribed as a measure after traditional cardiopulmonary resuscitation. Results: ECMO was successfully evacuated on day 5 and the patient was discharged on day 45. Conclusion: Mastering the hysteroscopic operative techniques and using a bipolar hysteroscopic generator, isotonic fluid, perfusion pressures less than 100 mm Hg, and local anesthesia may reduce the risk of hysteroscopic water intoxication syndrome. During hysteroscopic surgery, patients may experience cardiac arrest and fatal water intoxication syndrome. Even when traditional cardiopulmonary resuscitation is successful, VV ECMO may contribute to the recovery of brain function if oxygenation is not maintained.