A case of hypothermic cardiac arrest treated with an external chest compression device (LUCAS) during transport to re-warming

Abstract

The recommended treatment for severe hypothermia with circulatory collapse is re-warming using cardiopulmonary by-pass. This may require transporting a patient to hospital with on-going cardiopulmonary resuscitation (CPR). Manual CPR during patient transport may result in sub-optimal chest compressions and can be a hazard for the ambulance crew. We report a case of a patient with a core temperature of 22.2 °C and crew-witnessed cardiac arrest due to hypothermia. After unsuccessful initial resuscitation he was transported to hospital for re-warming with cardiopulmonary by-pass. CPR was continued during transport using a mechanical active compression–decompression device (the LUCAS-device). During cardiopulmonary by-pass ROSC was achieved after 90 min of cardiac arrest. The patient recovered with a cerebral performance category of 3. Using a mechanical device for chest compressions during transport of a hypothermic patient with on-going CPR is feasible, effective and safe.