1999 Cardiac arrest of 30 minutes with defibrillation.
Male aged 46 had a cardiac arrest in the community. Defibrillated by paramedics after about 30 minutes. Admitted to CCU and opened his eyes after three days. He began to say single words on day 5. Transferred to general ward on day 6. Gradually declined over 5 weeks with the development of spastic paraplegia, despite daily physiotherapy. Prescribed. . His leg spasticity became so severe that it was very difficult to bend his legs to allow him to use a wheelchair. His arms were also developing mild stiffness. He had periods in which he spoke20 words clearly, but they made little sense. He recognized his family.
Hyperbaric oxygen therapy was started after 5 weeks. 54 daily, one hour, hyperbaric oxygen sessions were undertaken at 1.75 atm abs. His cognition and speech improved and there was dramatic improvement in his spasticity. He left hospital walking without assistance.
Comment
This illustrates Ischemia with mid brain edema. Giving high dosage oxygen post arrest would on present evidence- have prevented the associated the reperfusion injury and spared some of the cortical damage.
Best wishes to all
Philip James M.D.
(Permission to reprint)
Wolfson Hyperbaric Medicine Unit
University of Dundee
Printed with Permission
