Key result
V-A ECMO rewarming enables neurologically intact survival after hypothermic cardiac arrest with CPR-induced consciousness.
Why the study?
CPR-induced consciousness had not previously been reported in hypothermic cardiac arrest.
Case Report (n=1)
This case demonstrates that CPR-induced consciousness can occur during hypothermic cardiac arrest with severe hypoglycemia, and patients can survive with intact neurological function following V-A ECMO rewarming.
Raises awareness of CPR-induced consciousness in hypothermic arrest with hypoglycemia; case report leaves open ECMO's role in neurologically intact survival.
CPR-induced consciousness (CPRIC) is defined as consciousness during CPR, ranging from eye opening to combative behaviour and vocalisation, despite the absence of spontaneous circulation. CPRIC has not previously been reported in hypothermic cardiac arrest. A middle-aged man who was pulled from cold water appeared conscious during CPR, despite confirmed cardiac arrest and severe accidental hypothermia. An additional factor that could have influenced the victim’s behaviour was severe hypoglycaemia. The patient was rewarmed with veno-arterial extracorporeal membrane oxygenation (V-A ECMO) and discharged from the hospital without any neurological deficits. In hypothermic cardiac arrest, the paradoxical preservation of consciousness may be a consequence of adequate cerebral perfusion during cardiopulmonary resuscitation and the neuroprotective effect of hypothermia, despite other risk factors for brain injury.
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Migiel et al. (2025) conducted a case report in Hypothermic cardiac arrest (n=1). Cardiopulmonary resuscitation and V-A ECMO was evaluated on Neurological outcome and survival. A 57-year-old man with hypothermic cardiac arrest and severe hypoglycemia exhibited CPR-induced consciousness and survived without neurological deficits after rewarming with V-A ECMO.
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