Introduction: According to the guidelines of the European Council for Resuscitation from 2010, hypothermia is recommended in adult comatose patients after cardiopulmonary arrest. The use of invasive and non-invasive methods of systemic hypothermia is prescribed, and during hypothermia other therapeutic procedures such as percutaneous coronary intervention can be approached in order to maximize the optimal therapeutic effect for the patient. (1,2) According to the guidelines of the European Council for Resuscitation from 2015, targeted temperature control is still recommended, now striving to reach 36°C, as opposed to the previously recommended 32–34°C. (3) Recent research from 2021 has shown that therapeutic hypothermia does not reduce mortality, and there is no significant difference between hypothermia and normothermy. (4)
Case report: 40-year-old patient lost consciousness and was arrested at work. Lay resuscitation was started, and the Emergency Medical Service was called. The initial rhythm in the ECG was ventricular fibrillation, and he was defibrillated on one occasion, followed by pulseless electrical activity. The resuscitation procedure was continued with the use of three ampoules of adrenaline, to which return of spontaneous circulation was achieved. Upon arrival at the Coronary Care Unit, the patient was intubated, mechanically ventilated, sedated, and muscle relaxed. Hemodynamically and rhythmically stable. Therapeutic hypothermia was performed, after which he recovered consciousness and was successfully extubated and separated from mechanical ventilation. The patient was indicated for the installation of an implantable cardioverter defibrillator for the purpose of secondary prevention of sudden cardiac death.
Conclusion: Timely and successful resuscitation after cardiopulmonary arrest is a prerequisite for the patient’s recovery and his return to independent living. Given the frequency of cardiopulmonary arrests, they most often occur in outpatient settings, so the outcome of further treatment and recovery depends on timely finding the victim, recognizing the condition, proper performance of lay resuscitation, use of publicly available automated external defibrillators and pace of hospitalization (2).