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2009 MGH Case 15-2009 — A 25-Year-Old Man with Coma after Cardiac Arrest

NEJM, Volume 360:2118-2125 May 14, 2009 Number 20
Camille N. Kotton, M.D., Nahel Elias, M.D., Francis L. Delmonico, M.D., and Richard L. Kradin, M.D.

Presentation of Case

Dr. Mathias Lichterfeld (Infectious Disease): A 25-year-old man was admitted to this hospital because of coma after cardiac arrest.

He had been well until 4 hours before admission, when he was seen to have had seizurelike movements and to have collapsed, without pulse or respirations. Emergency medical services was called and arrived approximately 7 minutes later. Examination disclosed ventricular fibrillation. Cardiopulmonary resuscitation, including the administration of epinephrine and atropine and electrical defibrillation followed by the administration of lidocaine, was performed; a junctional cardiac rhythm was established after 4 minutes. The patient remained hypotensive and unconscious. He was transported to this . . .

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