Successful extended cerebrocardiopulmonary resuscitation of a sudden death patient: A case report

  • Javier García Reyes Physician, Universidad Nacional de Colombia, Anesthesiologist Colegio Mayor de Nuestra Señora del Rosario, Coordinatos of the Department of Anesthesia, LaFont, Clinic, Hospital Engativa ESE, Bogotá, Colombia
Keywords: Sudden death, Resuscitation, Cardiac arrest, Pacemaker, Coronary disease, Valve disease, Hypoxic ischemic encephalopathy


This is the case of a 63-year-old patient, who is a plastic surgeon and has a history of aortic valve replacement, hypertension, pacemaker and anticoagulation, who experienced cardiac sudden death in the OR. Basic and advanced life support maneuvers were initiated; there was evidence of ventricular fibrillation and the patient was defibrillated 4 times unsuccessfully. Epinephrine, bicarbonate, amiodarone and lidocaine were administered. The patient alternated between ventricular fibrillation, pulseless electrical activity and asystole. Resuscitation was maintained throughout the process which lasted one hour and 45 min, including transfer to a third level clinic where the patient was considered to be asystolic. Following an additional discharge and amiodarone, the patient recovered spontaneous circulation; the vital signs were normalized and the patient remained in the ICU under hemodynamically stable conditions. After 18 h, the patient woke up with no evident neurological damage and remained in the ICU for one month for treatment of the ischemicreperfusion syndrome. After 20 more days of physical therapy in his hospital room, the patient was discharged with no neurological deficit and a recommendation for home-based rehabilitation. Three months later, the patient is doing perfectly well and leading an active family, social and labor life.

This narrative discussion considers some interesting aspects reported by other authors on the topic, based on a bibliography search in Medline, Lilacs, SciELO, and Ovid.


1. Lopshire JC, Zipes DP. Sudden cardiac death: Better understanding of risks, mechanisms, and treatment. Circulation. 2006;114:1134-6.

2. Zipes DP, Camm AJ, Borggrefe M. ACC/AHA/ESC 2006 guidelines for management of patients with ventricular arrhythmias and the prevention of sudden. cardiac death: A report of the American College of Cardiology/American Heart Association Task Force and the European Society of Cardiology Committee for Practice Guidelines (writing committee to develop guidelines for management of patients with ventricular arrhythmias and the prevention of sudden cardiac death): Developed in collaboration with the European Heart Rhythm Association and the Heart Rhythm Society. Circulation. 2006;114:e385-484.

3. Fishman GI, Chugh S. Sudden cardiac death prediction and prevention report from a National Heart, Lung, and Blood Institute and Heart Rhythm Society workshop. Circulation. 2010;122:2335-48.

4. Huikiri HV, Castellanos A, Myerburg RJ. Sudden death due cardiac arrhythmias. N Engl J Med. 2001;345:1473-82.

5. Kong MH, Fonarow GC, Peterson ED, Curtis AB, Hernandez AF, Sanders GD, et al. Systematic review of the incidence of sudden cardiac death in the United States. J Am Coll Cardiol. 2011;57:794-801.

6. Nichol G, Thomas E, Callaway CW, Hedges J, Powell JL, Aufderheide TP, et al., Resuscitation Outcomes Consortium Investigators. Regional variation in out-of-hospital cardiac arrest incidence and outcome. JAMA. 2008;300:1423-31.

7. Villalba JC. Cambios en el segmento ST del electrocardiograma durante la anestesia, en qué pensar. Rev Colomb Anestesiol. 2012;40:175-6.

8. Deo R, Albert CM. Epidemiology and genetics of sudden cardiac death. Circulation. 2012;125:620-37.

9. Tapia BA, Mier MPS. Muerte súbita cardiaca. Rev Electrónica Autops. 2005;1:21-34.

10. Lerman Jorge, presidente de la Fundación Cardiológica Argentina (FCA). Primeros tres minutos, vitales para revertir un evento de muerte súbita [editorial]. 1 de Septiembre de 2013 [Internet]. [consultado Sep 2013]. Disponible en:úbita.

11. Zheng ZJ, Croft JB, Giles WH, Mensah GA. Sudden cardiac death in the United States, 1989 to 1998. Circulation. 2001;104:2158-63.

12. Cobb LA, Fahrenbruch CE, Olsufka M, Copass MK. Changing incidence of out-of-hospital ventricular fibrillation, 1980-2000. JAMA. 2002;288:3008-13.

13. Bayés de Luna A, Elosua R. Muerte súbita. Rev Esp Cardiol. 2012;65:1039-52.

14. Ravakhah K, Motallebi M. Silent aortic regurgitation in systemic hypertension. J Heart Valve Dis. 2013;22:64-70.

15. Chandra S, Lang RM, Nicolarsen J, Gayat E, Spencer KT, Mor-Avi V, et al. Bicuspid aortic valve: Inter-racial difference in frequency and aortic dimensions. JACC Cardiovasc Imaging. 2012;5:981-9.

16. Varadarajan P, Patel R, Turk R, Kamath AR, Sampath U, Khandhar S, et al. Etiology impacts survival in patients with severe aortic regurgitation: Results from a cohort of 756 patients. J Heart Valve Dis. 2013;22:42-9.

17. Girdauskas E, Disha K, Secknus M, Borger M, Kuntze T. Increased risk of late aortic events after isolated aortic valve replacement in patients with bicuspid aortic valve insufficiency versus stenosis. J Cardiovasc Surg (Torino). 2013;54:653-9.

18. Peberdy MA, Callaway CW, Neumar RW, Geocadin RG, Zimmerman JL, Donnino M, et al. American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2010;122:S768-86.

19. Matiz Camacho H. Reanimación Cardiopulmonar. Nuevas Guías 2010-2015. Distribuna; 2012.

20. Brown R, Jones E, Glucksman E. Decision making in resuscitation from out of hospital cardiac arrest. J Accid Emerg Med. 1996;13:98-100.

21. Medina LA, Sánchez R, Gómez MT, Cabrales JM, Echeverri D. Reanimación cerebrocardiopulmonar prolongada exitosa: reporte de un caso. Rev Colomb Cardiol. 2010;17:28-32.

22. Eisenberg MS, Mengert TJ. An excellent review of the entire history of resuscitation, although very condensed on the topic of termination. Cardiac resuscitation. N Engl J Med. 2001;344:1304-13.

23. Bailey ED, Wydro GC, Cone DC. Termination of resuscitation in the prehospital setting for adult patients suffering nontraumatic cardiac arrest. National Association of EMS Physicians Standards and Clinical Practice Committee. Prehosp Emerg Care. 2000;4:190-5.

24. Ebell MH, Jang W, Shen Y, Geocadin RG. Development and validation of the Good Outcome Following Attempted Resuscitation (GO-FAR) score to predict neurologically intact survival after in-hospital cardiopulmonary resuscitation. JAMA Intern Med. 2013;173:1872-8.

25. De Lorgeril M, Salen P, Martin JL, Monjaud I, Delaye J, Mamelle N. Mediterranean diet, traditional risk factors, and the rate of cardiovascular complications after myocardial infarction: final report of the Lyon Diet Heart Study. Circulation. 1999;99:779-85.

26. Masiá R, Pena A, Marrugat J, Sala J, Vila J, Pavesi M, et al. High prevalence of cardiovascular risk factors in Gerona, Spain, a province with low myocardial infarction incidence. REGICOR Investigators. J Epidemiol Community Health. 1998;52:707-15.

27. Keys A, Keys M. How to Eat Well and Stay Well. The Mediterranean Way. Doubleday: Garden City, N.Y.; 1975.

28. Sans S, Puigdefábregas A, Paluzie G, Monterde D, Balaguer-Vintró I. Increasing trends of acute myocardial infarction in Spain: the MONICA-Catalonia Study. Eur Heart J. 2005;26:505-15.

29. Banizi PF, Vidal L, Montenegro JL, Banina Aguerre D, Vanerio G, Antunes S, et al. Interferencias electromagnéticas en pacientes con marcapasos y cardiodesfibriladores implantados. Rev Med Urug. 2004;20:150-60.

30. Nägele H, Hashagen S, Azizi M, Behrens S, Castel MA. Analysis of terminal arrhythmias stored in the memory of pacemakers from patients dying suddenly. Europace. 2007;9:380-4.

31. Bonvini RF, Camenzind E. Pacemaker spikes misleading the diagnosis of ventricular fibrillation. Resuscitation. 2005;66:241-3.

32. Alsheikh-Ali AA, Link MS, Semsarian C, Shen W-K, Estes 3rd NAM, Maron MS, et al. Ventricular tachycardia/fibrillation early after defibrillator implantation in patients with hypertrophic cardiomyopathy is explained by a high-risk subgroup of patients. Heart Rhythm. 2013;10:214-8.

33. Daubert C, Cazeau S, Ritter P, Leclercq C. Past, present and future of cardiac resynchronization. Arch Cardiovasc Dis. 2012;105:291-9.

34. Tung P, Albert CM. Causes and prevention of sudden cardiac death in the elderly. Nat Rev Cardiol. 2013;10:135-42.

35. Lampert R. Quality of life and end-of-life issues for older patients with implanted cardiac rhythm devices. Clin Geriatr Med. 2012;28:693-702.

36. Valles AG, Khawaja FJ, Gersh BJ, Enriquez-Sarano M, Friedman PA, Park SJ, et al. Implantable cardioverter defibrillators in patients with valvular cardiomyopathy. J Cardiovasc Electrophysiol. 2012;23:1326-32.

37. Gaziano TA, Gaziano JM. Epidemiology of Cardiovascular Disease. En: Kasper D, Fauci A, Longo D. Harrison's Principles of Internal Medicine. 18th ed. 2 vols. [Internet]. 2011 [consultado 6 Dic 2013]. Disponible en:
How to Cite
García Reyes J. Successful extended cerebrocardiopulmonary resuscitation of a sudden death patient: A case report. Colomb. J. Anesthesiol. [Internet]. 2014 Jul. 1 [cited 2024 Apr. 20];42(3):229-33. Available from:


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How to Cite
García Reyes J. Successful extended cerebrocardiopulmonary resuscitation of a sudden death patient: A case report. Colomb. J. Anesthesiol. [Internet]. 2014 Jul. 1 [cited 2024 Apr. 20];42(3):229-33. Available from:
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