低温心脏骤停时心肺复苏诱导的意识：人类大脑的耐受极限在哪里？一例病例报告。
CPR-induced consciousness in hypothermic cardiac arrest: Where is the limit of tolerance of the human brain? A case report.
作者信息
Migiel Łukasz, Darocha Tomasz, Hymczak Hubert, Podsiadło Paweł, Mendrala Konrad, Kosiński Sylweriusz
机构信息
Tatra Mountain Rescue Service, Zakopane, Poland.
Department of Anaesthesiology and Intensive Care, Medical University of Silesia, Katowice, Poland.
出版信息
Scand J Trauma Resusc Emerg Med. 2025 Jul 1;33(1):111. doi: 10.1186/s13049-025-01426-y.
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.
SUPPLEMENTARY INFORMATION
The online version contains supplementary material available at 10.1186/s13049-025-01426-y.
背景
心肺复苏诱导的意识（CPRIC）定义为在心肺复苏期间出现的意识，范围从睁眼到好斗行为和发声，尽管没有自主循环。此前尚未有低温心脏骤停时出现CPRIC的报道。
患者情况
一名从冷水中救出的中年男子在心肺复苏期间似乎有意识，尽管已确认心脏骤停且存在严重意外低温。另一个可能影响受害者行为的因素是严重低血糖。患者通过静脉-动脉体外膜肺氧合（V-A ECMO）复温，出院时无任何神经功能缺损。
结论
在低温心脏骤停中，意识的反常保留可能是心肺复苏期间脑灌注充足以及低温的神经保护作用的结果，尽管存在其他脑损伤危险因素。
补充信息
在线版本包含可在10.1186/s13049-025-01426-y获取的补充材料。
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