Open AccessCardiac arrest in intensive care unit: Case report and future recommendations
Author(s) -
A Ghatei Mohammad,
Naveed Zafar,
Alan E. Feerick
Publication year - 2010
Publication title -
saudi journal of anaesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.416
H-Index - 24
eISSN - 1658-354X
pISSN - 0975-3125
DOI - 10.4103/1658-354x.62613
Subject(s) - medicine , septic shock , hemofiltration , central venous catheter , intensive care medicine , intensive care unit , critically ill , shock (circulatory) , hemodynamics , catheter , sepsis , anesthesia , surgery , hemodialysis
Initiation of hemofiltration in a patient in septic shock can cause hemodynamic compromise potentially leading to cardiac arrest. We propose that the standard '4Hs and 4Ts' approach to the differential diagnosis of a cardiac arrest should be supplemented in critically ill patients with anaphylaxis and human and technical errors involving drug administration (the 5(th) H and T). To illustrate the point, we report a case where norepinephrine infused through a central venous catheter (CVC) was being removed by the central venovenous hemofiltration (CVVH) catheter causing the hemodynamic instability. CVVH has this potential of interfering with the systemic availability of drugs infused via a closely located CVC.