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Postarrest targeted temperature management immediately following craniotomy-a case report.
Gail Delfin1, Marion Leary, Sarah M Perman
11 Center for Resuscitation Science, University of Pennsylvania , Philadelphia, Pennsylvania.
Therapeutic Hypothermia and Temperature Management
|May 20, 2014
Summary
Therapeutic hypothermia (TTM) can improve outcomes after cardiac arrest. This case study shows TTM is safe and effective in a postoperative patient, suggesting wider use is warranted.
Area of Science:
- Neurosurgery
- Critical Care Medicine
- Cardiology
Background:
- Therapeutic hypothermia (TH) or targeted temperature management (TTM) improves survival and neurological outcomes post-cardiac arrest.
- TTM is underutilized in postoperative settings due to bleeding concerns.
Purpose of the Study:
- To assess the safety and efficacy of TTM in a patient experiencing cardiac arrest during craniotomy.
- To highlight the potential benefits of TTM in the postoperative cardiac arrest population.
Main Methods:
- Case report of a 65-year-old male undergoing craniotomy for brain tumor resection.
- Patient experienced pulseless electrical activity cardiac arrest, was resuscitated, and remained unresponsive.
- Neurocritical care team initiated TTM after ruling out postoperative brain hemorrhage.
Main Results:
- Repeat imaging confirmed no additional bleeding after TTM initiation.
- The patient was discharged with a Cerebral Performance Category of 1.
- Patient transferred to acute rehabilitation 11 days post-cardiac arrest.
Conclusions:
- TTM can be safely implemented in postoperative cardiac arrest patients.
- This case supports further investigation and consideration of TTM in this patient group.
- TTM may offer significant neurological and survival benefits for postoperative cardiac arrest survivors.
