Refractory ventricular fibrillation secondary to hyperkalemia resuscitated with extracorporeal membrane oxygenation: A case report

TL;DR

A patient with severe hyperkalemia and unresponsive ventricular fibrillation was successfully resuscitated using extracorporeal membrane oxygenation.

Contribution

This case report highlights ECPR's effectiveness in treating refractory ventricular fibrillation due to hyperkalemia.

Findings

ECPR successfully restored spontaneous circulation after 54 minutes of cardiac arrest.

The patient regained clear consciousness and was discharged without neurological disability.

ECPR proved effective when conventional CPR failed in a hyperkalemia-induced cardiac arrest.

Abstract

The routine use of extracorporeal cardiopulmonary resuscitation (ECPR) is not recommended for patients with cardiac arrest. However, ECPR is considered for selected patients with cardiac arrest of reversible cause. Extracorporeal membrane oxygenation (ECMO) provides temporary cardiopulmonary support and adequate perfusion to the end organs, thereby shortening ischemic organ time and minimizing complications. One indication for ECPR therapy is prolonged ventricular fibrillation despite optimal conventional CPR.

Here, we report a successful recovery case from ECPR, in which the patient suffered from refractory ventricular fibrillation and was predisposed to severe hyperkalemia. Ventricular fibrillation failed to respond despite prolonged conventional CPR and defibrillation management for 32 min. After successfully initiating ECPR 54 min after cardiac arrest, spontaneous circulation returned sooner. He demonstrated clear consciousness after treatment and was discharged without any neurological disability on day 11.

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