Successful rescue of renal transplantation with cardiac arrest after electrical storm: A case report

Medicine (Baltimore). 2022 Nov 25;101(47):e32030. doi: 10.1097/MD.0000000000032030.

Abstract

Rationale: Most patients with end-stage chronic kidney disease are associated with complications such as renal hypertension, renal anemia, hyperkalemia, water-sodium retention, and disorders of acid-base balance after long-term renal replacement therapy, which can lead to increased cardiac burden, some degree of myocardial damage, and finally progress to arrhythmia and heart failure. These are the main reasons why patients with chronic kidney disease are prone to cardiovascular events after renal transplantation.

Patient concerns: We report a case of sudden onset of ventricular fibrillation on the postoperative second day, with repeated electrical storm accompanied by cardiac arrest during resuscitation, a very long cardiopulmonary resuscitation (CPR) process of 5 hours and 14 minutes, and >20 cycles of cardiac defibrillation.

Diagnoses: According to the patient history and resuscitation process, a diagnosis of ES with cardiac arrest after renal transplantation was formulated.

Intervention: According to the American Heart Association guidelines for CPR and cardiovascular emergencies, resuscitation measures such as CPR, tracheal intubation, electric defibrillation, symptomatic medication, etc. were performed on the patient.

Outcomes: Finally, the patient was successfully resuscitated, after which the patient had stable respiratory circulation and no neurological complications. To our knowledge, this is the only reported case in which a patient survived with good neurologic outcomes after a resuscitation that lasted as long as 5 hours and 14 minutes.

Lessons: This case of adequate resuscitation can provide experience and a basis for CPR of patients with in-hospital complications of cardiovascular events for a long time.

Publication types

  • Case Reports

MeSH terms

  • Cardiopulmonary Resuscitation*
  • Heart Arrest* / etiology
  • Heart Arrest* / therapy
  • Heart Failure*
  • Humans
  • Kidney Failure, Chronic*
  • Kidney Transplantation*
  • Renal Insufficiency, Chronic*
  • Water-Electrolyte Imbalance*