CPR-induced consciousness in hypothermic cardiac arrest: Where is the limit of tolerance of the human brain? A case report

Abstract 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...

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Main Authors: Łukasz Migiel, Tomasz Darocha, Hubert Hymczak, Paweł Podsiadło, Konrad Mendrala, Sylweriusz Kosiński
Format: Article
Language:English
Published: BMC 2025-07-01
Series:Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
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Online Access:https://doi.org/10.1186/s13049-025-01426-y
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author Łukasz Migiel
Tomasz Darocha
Hubert Hymczak
Paweł Podsiadło
Konrad Mendrala
Sylweriusz Kosiński
author_facet Łukasz Migiel
Tomasz Darocha
Hubert Hymczak
Paweł Podsiadło
Konrad Mendrala
Sylweriusz Kosiński
author_sort Łukasz Migiel
collection DOAJ
description Abstract 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.
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issn 1757-7241
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publishDate 2025-07-01
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series Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
spelling doaj-art-eca48c75623e466f9cb86c1b99f9bcae2025-08-20T03:45:34ZengBMCScandinavian Journal of Trauma, Resuscitation and Emergency Medicine1757-72412025-07-013311410.1186/s13049-025-01426-yCPR-induced consciousness in hypothermic cardiac arrest: Where is the limit of tolerance of the human brain? A case reportŁukasz Migiel0Tomasz Darocha1Hubert Hymczak2Paweł Podsiadło3Konrad Mendrala4Sylweriusz Kosiński5Tatra Mountain Rescue ServiceDepartment of Anaesthesiology and Intensive Care, Medical University of SilesiaDepartment of Anaesthesiology and Intensive Care, Andrzej Frycz Modrzewski Krakow UniversityDepartment of Emergency Medicine, Jan Kochanowski UniversityDepartment of Anaesthesiology and Intensive Care, Medical University of SilesiaMountain Medicine Laboratory, Jagiellonian University Medical CollegeAbstract 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.https://doi.org/10.1186/s13049-025-01426-yHypothermia, accidentalCardiac arrest, suddenResuscitationConsciousness
spellingShingle Łukasz Migiel
Tomasz Darocha
Hubert Hymczak
Paweł Podsiadło
Konrad Mendrala
Sylweriusz Kosiński
CPR-induced consciousness in hypothermic cardiac arrest: Where is the limit of tolerance of the human brain? A case report
Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
Hypothermia, accidental
Cardiac arrest, sudden
Resuscitation
Consciousness
title CPR-induced consciousness in hypothermic cardiac arrest: Where is the limit of tolerance of the human brain? A case report
title_full CPR-induced consciousness in hypothermic cardiac arrest: Where is the limit of tolerance of the human brain? A case report
title_fullStr CPR-induced consciousness in hypothermic cardiac arrest: Where is the limit of tolerance of the human brain? A case report
title_full_unstemmed CPR-induced consciousness in hypothermic cardiac arrest: Where is the limit of tolerance of the human brain? A case report
title_short CPR-induced consciousness in hypothermic cardiac arrest: Where is the limit of tolerance of the human brain? A case report
title_sort cpr induced consciousness in hypothermic cardiac arrest where is the limit of tolerance of the human brain a case report
topic Hypothermia, accidental
Cardiac arrest, sudden
Resuscitation
Consciousness
url https://doi.org/10.1186/s13049-025-01426-y
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