Improving Survival Chances After Cardiac Arrest: A Family's Journey

Pre-hospital cardiac arrest emergency care for half an hour, myocardial infarction?

Hello, my father collapsed on the first day and was sent to the hospital for emergency treatment.
After half an hour, his heartbeat was restored.
While being observed in the emergency room, he exhibited signs of seizures, and his Glasgow Coma Scale score was 3.
In the evening, he was officially admitted to the intensive care unit for observation.
The following morning at 9 AM, due to arrhythmia, he underwent 23 defibrillation shocks within two hours.
The attending physician recommended the placement of an ECMO (Extracorporeal Membrane Oxygenation) machine and a cardiac catheterization to investigate the cause, which was confirmed to be a myocardial infarction leading to his coma.
The left coronary artery was blocked, and currently, two stents have been placed to restore blood flow (there is still another blockage on the right side).
At present, my father is on ECMO, dialysis, and a ventilator.
I understand that his condition is critical and that I need to be psychologically prepared, but I still want to know if there are any ways to increase my father's chances of waking up.
I want to communicate with him again.

ai, 20~29 year old female. Ask Date: 2016/04/02

Dr. He Dongjin reply Cardiology

Hello, please pray.
From a human perspective, the hospital staff has done their utmost for your father.
Changhua Hospital is concerned about you.

Reply Date: 2016/04/02

More Info

I'm truly sorry to hear about your father's condition. It sounds like a very challenging and distressing situation for you and your family. Improving survival chances after cardiac arrest, especially in cases involving complications like myocardial infarction and subsequent coma, is a complex issue that often requires a multi-faceted approach. Here are some key considerations and strategies that may help in this difficult time.

Understanding the Situation
Your father's case involves several critical factors: he experienced cardiac arrest, was resuscitated after a significant delay, and has since been diagnosed with a myocardial infarction (heart attack) that led to his current state. The use of ECMO (extracorporeal membrane oxygenation) indicates that his heart and lungs are struggling to function adequately on their own, which is a serious condition. The presence of arrhythmias and the need for multiple defibrillation attempts further complicate his recovery.

Factors Influencing Recovery
1. Duration of Cardiac Arrest: The longer the brain is deprived of oxygen during cardiac arrest, the higher the risk of neurological damage. Since your father was resuscitated after 30 minutes, this is a critical factor in assessing his potential for recovery.

2. Neurological Status: The Glasgow Coma Scale (GCS) score of 3 indicates a deep coma, which is concerning. Recovery from such a low level of consciousness can be challenging, but not impossible. Continuous monitoring and assessment by neurologists will be crucial.

3. Underlying Cardiac Issues: The myocardial infarction and subsequent interventions (like stenting) are vital to restoring blood flow to the heart. The success of these procedures can significantly impact overall recovery.

4. Supportive Care: The use of ECMO, dialysis, and ventilatory support are essential in managing your father's current state. These interventions aim to stabilize his condition and provide time for recovery.

Strategies to Improve Chances of Recovery
1. Communication: While your father may not be responsive, studies suggest that patients can hear and process sounds even when in a coma. Speak to him regularly, share memories, and express your love and support. This can provide emotional comfort and may even aid in his recovery.

2. Engage with Healthcare Providers: Maintain open communication with the medical team. Ask questions about his condition, treatment options, and prognosis. Understanding the medical plan can help you make informed decisions and advocate for your father's needs.

3. Consider Rehabilitation: If your father stabilizes, rehabilitation will be crucial. Cardiac rehabilitation programs can help improve heart function and overall health, and neuro-rehabilitation may be necessary if there are cognitive or physical impairments.

4. Emotional and Psychological Support: This is a difficult time for you and your family. Consider seeking support from counselors or support groups for families dealing with similar situations. Taking care of your emotional well-being is essential as you navigate this journey.

5. Stay Informed: Educate yourself about cardiac arrest, myocardial infarction, and recovery processes. Knowledge can empower you to make better decisions and understand what to expect.

Conclusion
While the situation is undoubtedly serious, there are avenues to explore that may improve your father's chances of recovery. It's essential to remain hopeful and proactive while also preparing for various outcomes. Remember to take care of yourself during this challenging time, as your well-being is crucial for supporting your father and family. Please continue to engage with his healthcare team for the most accurate and personalized guidance.

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