Work

CPR-induced consciousness in hypothermic cardiac arrest: Where is the limit of tolerance of the human brain? A case report

Year: 2025

Type: article

Abstract: BACKGROUND: 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. PATIENT PRESENTATION: 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. CONCLUSIONS: 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.

Source: Scandinavian Journal of Trauma Resuscitation and Emergency Medicine

DOI: 10.1186/s13049-025-01426-y

Authors: Łukasz Migiel, Tomasz Darocha, Hubert Hymczak, Paweł Podsiadło, Konrad Mendrala, Sylweriusz Kosiński

Institutions: Medical University of Silesia, Andrzej Frycz Modrzewski Krakow University, Jan Kochanowski University, Jagiellonian University

Language: English

Topic: Cardiac Arrest and Resuscitation

Subfield: Emergency Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $2,590