[Post-cardiac arrest syndrome after general anesthesia: role of therapeutic hypothermia and remifentanil]. / Síndrome de postparada cardiaca tras anestesia general. papel de la hipotermia terapéutica y remifentanilo.

Moderate therapeutic hypothermia is often used in aneurysm surgery and is therefore a technique anesthesiologists are familiar with. We report the case of a patient who had entered into a coma after cardiac arrest in the postanesthetic recovery unit during central venous catheterization; the patient required 35 minutes of advanced cardiopulmonary resuscitation before heart rhythm and tissue perfusion were restored. The protocol for treating post-cardiac arrest syndrome included therapeutic hypothermia, which was maintained for 12 hours. The patient was extubated after 2 days, with no neurologic deficit. Post-cardiac arrest syndrome is associated with multiple biochemical reactions which are attenuated by hypothermia. Currently available evidence does not allow definitive recommendations regarding the different techniques for inducing therapeutic hypothermia, the ideal temperature to maintain, the duration, or the rewarming process. Further studies are required.

Síndrome de postparada cardiaca tras anestesia general. Papel de la hipotermia terapéutica y remifentanilo / Post-cardiac arrest syndrome after general anesthesia: role of therapeutic hypothermia and remifentanil

La hipotermia terapéutica moderada se ha empleado frecuentemente en la cirugía aneurismática. Por tanto, es una técnica conocida para los anestesiólogos. Describimos el caso de un paciente en coma tras una parada cardiaca intrahospitalaria en la unidad de reanimación durante la cateterización de una vía central, que requirió 35 minutos de reanimación cardiopulmonar avanzada antes de la restauración del ritmo cardiaco y perfusión tisular. El protocolo para tratar el síndrome postparada cardiaca incluyó hipotermia terapéutica que fue mantenida durante 12 horas. El paciente fue extubado al 2º día sin déficit neurológico. El síndrome postparada cardiaca se asocia a reacciones bioquímicas múltiples, que son suprimidas con hipotermia. Actualmente, la evidencia médica disponible es insuficiente para hacer recomendaciones definitivas entre las diferentes técnicas para inducir la hipotermia terapéutica, la temperatura óptima de mantenimiento, duración y el proceso de recalentamiento. Son necesarios estudios adicionales en este campo(AU)

Moderate therapeutic hypothermia is often used in aneurysm surgery and is therefore a technique anesthesiologists are familiar with. We report the case of a patient who had entered into a coma after cardiac arrest in the postanesthetic recovery unit during central venous catheterization; the patient required 35 minutes of advanced cardiopulmonary resuscitation before heart rhythm and tissue perfusion were restored. The protocol for treating post-cardiac arrest syndrome included therapeutic hypothermia, which was maintained for 12 hours. The patient was extubated after 2 days, with no neurologic deficit. Post-cardiac arrest syndrome is associated with multiple biochemical reactions which are attenuated by hypothermia. Currently available evidence does not allow definitive recommendations regarding the different techniques for inducing therapeutic hypothermia, the ideal temperature to maintain, the duration, or the rewarming process. Further studies are required(AU)