Neurologically intact survivor of prolonged ventricular fibrillation: A case for intermediate dose epinephrine and postresuscitation infusion

Abstract

The authors point out that our understanding of the optimal dose of epinephrine used in the resuscitation of patients in cardiac arrest continues to evolve. Doses greater than the standard 1 mg of epinephrine every 5 minutes have been studied and shown to increase the rate of return of spontaneous circulation. However, reports of neurologically intact survivors of prolonged cardiac arrest are rare. The authors report a neurologically intact survivor of prolonged ventricular fibrillation with severe mixed acidosis who responded to intermediate doses of epinephrine and epinephrine infusion, where standard amounts had failed. Further research should be directed into the relationship between postresuscitation epinephrine infusions and neurologic outcome.