Prone CPR After Cementation-Induced Vasoplegia and Bezold-Jarisch Asystole in Spine Surgery: Case Report.
Carlos Rafael Ramírez-Paesano, Juan Diego Villegas-Alzate, Yerlin Andrés Colina-Vargas et al.
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Case in brief
A 76-year-old woman with multiple comorbidities experienced severe hypotension, bradycardia, and asystole following cementation during spine surgery. Immediate prone CPR and epinephrine administration restored circulation. Transesophageal echocardiography revealed a hyperdynamic heart, and a CT angiogram ruled out major pulmonary embolism, showing only minor polymethylmethacrylate deposits. The patient survived neurologically intact due to prompt intervention.
What made this case unusual
The case highlights the use of prone CPR in a surgical setting, which is not commonly practiced, particularly in the context of cementation-induced vasoplegia and Bezold-Jarisch asystole.
Diagnostic / clinical pearl
Clinicians should be aware that cementation during spine surgery can lead to vasoplegia and asystole, necessitating rapid recognition and intervention, including prone CPR.
Why it matters
This case underscores the importance of adapting resuscitation techniques in unique surgical scenarios to improve patient outcomes.