Induced hypothermia in cardiogenic shock: a case report

Induced hypothermia is a technique that has gained popularity as an adjuvant therapy for patients with traumatic brain injuries, refractory arrhythmias, cardiac arrest and myocardial infarction. Induced hypothermia in patients with cardiogenic shock could improve the recovery of a stunned myocardium by decreasing its metabolic demands. We report a patient who presented with cardiogenic shock after surgical replacement of both aortic and mitral valves. The patient was placed in induced hypothermia for 34 hours. The clinical course was followed using measurements of arterial blood gas concentrations, serum lactate levels and transthoracic echocardiograms. During mechanical ventilation, the patient was monitored using a bedside bispectral index state of consciousness and temperature was measured using a Swan-Ganz catheter. The requirements for vasoactive drugs declined considerably during the hypothermic and rewarming periods. Echocardiography showed improvements in the left ventricle ejection fraction from 30% to 60% in the rewarming period with improvement in the mobility of both the anterior and septal walls. Induced hypothermia could be considered as part of the management strategy for patients with cardiac surgery, extracorporeal circulation and cardiogenic shock.