Critical Care and Shock

Therapeutic hypothermia in cardiogenic shock post cardiac arrest supported with left ventricular assist device (Impella 5.0 LP)

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We report a 48-year-old male suffering from cardiac arrest secondary to ventricular fibrillation. After the return of spontaneous circulation, the therapeutic hypothermia protocol was initiated (33 oC). However, given the persistent cardiogenic shock, the hypothermia protocol was interrupted. A decision was made to insert an Impella 5.0 LP for hemodynamic support via the left femoral artery. After stabilization, cooling was resumed (Arctic sun) for 24 hours, which was well tolerated hemodynamically. After 5 days of support, patient was weaned off all vasopressors. The Impella was removed, after which the patient was awoken and extubated with complete neurological recovery.