Full neurological recovery following a hypothermic, near-drowning cardiac arrest with a 34 minute submersion time: A case repor

Hypothermia increases the ischemic tolerance of the brain and can lead to a remarkable recovery in prolonged cardiac arrest. Neurological outcomes can be very favorable, particularly if cardiac arrest precedes hypothermia or if the onset of hypothermia following cardiac arrest is rapid. Case reports of good neurological recovery following up to 7 h submersion and core temperatures as low as 13.7°C can be found. Our case involved a 43-year-old male who presented following a collapse and out of hospital cardiac arrest. A 34 min period of face-down submersion in a canal on a cold February evening was followed by a brief period of cardiopulmonary resuscitation on extrication. He was transferred to our emergency department with a core temperature of 26°C. He went onto make a full neurological recovery. The UK’s temperate climate means that case reports of prolonged hypothermic cardiac arrest are rare. While this gentleman had many favorable circumstances to his predicament, including age, cardiovascular fitness and rapid cooling, prompt and effective resuscitation, and a controlled warming regime would also have contributed. Keywords: Hypothermia cardiac arrest, neurological recovery.