Case Report Full Recovery Case After 82 Minutes Out-of-Hospital Cardiac Arrest:

A middle age man underwent immediate cardiopulmonary resuscitation (CPR) for ventricular fibrillation (VF) occurred in an ambulance. After arrival in a regional hospital, return of spontaneous circulation (ROSC) was achieved 82 minutes after the collapse. He was in coma even three hours after ROSC. So, he was transferred to our university hospital to receive therapeutic hypothermia (TH). An initial bispectral index (BIS) value sug-gested a favorable outcome. Thus we decided to aggressive therapies including TH of 34C for 48 hours, followed by a very slow rewarming at the rate of 1C per day. Eventually he was discharged from the hospital with good neurological state. This case shows us two points: 1) the importance of the chain of survival: CPR done immediately after the collapse, persistent CPR for refractory VF, followed by coronary interventions after ROSC, continuing care to the university hospital, 2) decision making for TH using BIS monitoring. Case Report A61-year-old man complained of sudden back pain andcollapsed in an ambulance on the way to a secondary care hospital. In the ambulance, emergency medical technicians performed cardiopulmonary resuscitation (CPR) with shocks for ventricular fibrillation (VF). After arrival, the medical staff continued CPR for sustained VF. Return of spontaneous cir