A 62-year-old man suffered
out-of-hospital cardiac arrest and was treated with mechanical compression-
decompression during transport to the hospital. In the emergency department, 28 min after
cardiac arrest, spontaneous circulation returned briefly but the patient rapidly became asystolic and mechanical compression-
decompression was again applied. After further
resuscitation a spontaneous circulation returned and the patient was transferred, deeply
comatose, to the coronary intervention laboratory while
therapeutic hypothermia was induced. In the laboratory the heart arrested again and coronary angiography was performed during manual
CPR revealing a left main stem occlusion. After successful reperfusion of the heart the patient was transferred to the intensive care unit with an intra-aortic balloon pump. The patient was treated with
hypothermia for 24 h and awoke without neurological sequelae after a sustained
intensive care period of 13 days. The present case is an example of how modern
resuscitation principles implementing new clinical and experimental findings may strengthen the chain of survival during
resuscitation.