Ventricular fibrillation by hypothermia in spinal fusion surgery: A case report

A 63-year-old man was scheduled for T12-S1 posterolateral spinal fusion surgery. The patient's vital signs were stable and there were no specific laboratory findings except for high triglycerides. In addition, echocardiography showed mild left ventricular hypertrophy, but normal left ventricular function, no regional wall abnormal contractility and normal ejection fraction. During the operation, a warming blanket and fluid warmer were applied. Near the end of the operation, the blood pressure waveform from the radial artery and pulse oxymeter became flat. Cardiotonics were administered and an infusion of intraoperative salvage of blood was administered using the cell-saver. However, the hemodynamic status of the patient deteriorated to severe hypotension, with ventricular fibrillation. The patient's vital signs with temperature became stabilized after warming for 4 hours using active warming methods, including a forced air warming blanket and warming of the fluids and blood components with a rapid infusion system.