Abstract
The prognosis of traumatic cardiac arrest (TCA) is poor, and survival without significant neurological deficit is rare. We report a survival case of TCA in a 5 year-old boy injured by collapsing material. The patient was in shock en route to the hospital, and went into cardiopulmonary arrest (CPA) just before arrival. Cardiopulmonary resuscitation (CPR) was begun immediately, which resulted in a return of spontaneous circulation (ROSC). Type IIIb liver injury was identified on abdominal CT, and damage control surgery was performed. In the OR the patient had two episodes of CPA, for a total arrest duration of 31 minutes. Right hepatic lobectomy was performed 27 hours after the accident once the patient was hemodynamically stable, and he was transferred to another hospital without neurological deficit on post-operative day 44. The survival rate of TCA in children is 4.8-8.0%. In our case, CPA occurred just prior to arrival at the hospital, the duration of cardiac arrest was brief, and there was no craniocervical injury, which may have contributed to the patient's favorable outcome. Our case suggests that neurologically intact survival in a child with TCA is possible with continuous CPR and damage control surgery performed immediately following ROSC.
