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Successful management of a case of sudden cardiac arrest in a postoff-pump coronary artery bypass graft surgery patient on fourth postoperative day and lessons learned: A resuscitation challenge - A case report

 Department of Anesthesia and Critical Care, Army Hospital (Research and Referral), Delhi Cantt, New Delhi, India

Correspondence Address:
Kunal Sarin,
Department of Anesthesia and Critical Care (Cardiac Anaesthesia), Army Hospital (Research and Referral), Delhi Cantt, New Delhi
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/am.am_102_21

Background: Every patient who has undergone a cardiac surgery carries a risk of sudden hemodynamic instability in the postoperative period due to already compromised cardiovascular functional status which has not yet fully recovered. Recognition of dangers and their subsequent management requires accurate knowledge of resuscitation protocols which are quite different from the standard CPR guidelines. Case Presentation: We report a case of cardiac arrest in the postoperative period. The patient had been extubated satisfactorily postcardiac surgery. The hemodynamic instability leading to cardiac arrest occurred on the 4th postoperative day, while he was straining during defecation. The patient was revived and successfully extubated with full recovery. Conclusion: The patient was off any inotropic support and on course for full recovery when he had cardiac arrest, which not only makes the case unique but also teaches us to be forewarned about such incidences in future. In spite of adequate hydration and administrating stool softener into the medication regimen, there exists a real risk of hemodynamic instability and associated cardiac arrest while straining. Moreover, postcardiac surgery patients who experience cardiac arrest need specific resuscitation protocols for a successful recovery, which are different from guidelines for cardiopulmonary resuscitation in other cases and need to be highlighted.

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