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Case Reports in Emergency Medicine
Volume 2012, Article ID 381798, 4 pages
Case Report

Successful Prolonged Mechanical CPR in a Severely Poisoned Hypothermic Patient: A Case Report

1Anesthesiology-118 Service AAT Como, Italy
2Azienda Ospedaliera Sant'Anna, via Ravona, 1 22020 San Fermo della Battaglia (CO), Italy
3AAT 118 Como, 22079 Villa Guardia, Como (CO), Italy
4Emergency Nurse AAT 118 Como, 22079 Villa Guardia, Como (CO), Italy
5Intensive Care-Hems Service, 118 Como, 22079 Villa Guardia, Como (CO), Italy

Received 5 June 2012; Accepted 26 June 2012

Academic Editors: P. Del Rio, E. Kagawa, and W. Mauritz

Copyright © 2012 Alberto Piacentini et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Mechanical cardiopulmonary resuscitation (m-CPR) devices are an alternative to manual CPR, but their efficacy has been subject to debate. We present a case of a patient with full-neurologic recovery after prolonged m-CPR. The patient presented with severe hypothermia (internal temperature 24°C) and poisoning (sedatives/hypnotics). Hepatic perfusion and metabolism are considered keys to restore spontaneous circulation. During this period no problems related to the device or patient positioning were encountered. Delivery of high-quality CPR and prolonged resuscitation were achieved. We confirm that ventilations asynchronous with chest compressions can be a problem. Reduction in chest measurements can hamper lung ventilation. A synchronous mode of manual ventilation (30 : 2) seems to be the best solution. The patient had an initial period of manual CPR. No damage to any organ or structure was noted. This case is of further interest because our EMS helicopters can fly 24 hours a day and m-CPR devices could play an important role as a “bridge” in patients when active rewarming by cardiopulmonary bypass is indicated (CPB).