Successful resuscitation in complicated cardiac arrest: descriptive analysis of two clinical cases

Abstract

Background. Cardiac arrest is a time-sensitive, life-threatening emergency with high mortality, where survival depends largely on the prompt and effective application of ACLS protocols. This paper presents two cases of successful resuscitation in elderly patients admitted in critical condition to the ED of the IEM. Objective(s). To assess the effectiveness of ACLS protocols in patients experiencing cardiac arrest and to evaluate the role of multidisciplinary intervention in post-resuscitation recovery. Materials and methods. This descriptive study analyzes two clinical cases recorded at the Institute of Emergency Medicine ED in 2024. Management included the ABCDE approach, infraglottic intubation, mechanical ventilation, external defibrillation, administration of adrenaline and amiodarone, and continuous monitoring, in line with international ACLS guidelines. Results. Both patients presented with ventricular fibrillation and severe hemodynamic instability at admission. Advanced interventions, including intubation, assisted ventilation, defibrillation for ventricular fibrillation, and drug therapy according to Advanced Cardiac Life Support protocols, led to restoration of sinus rhythm and initial stabilization. The postresuscitation course was complex and required prolonged intensive care. Secondary diagnoses included hypothermia, post-hypoxic encephalopathy, aspiration pneumonia, and severe metabolic imbalances. A multidisciplinary approach contributed to gradual clinical improvement. Conclusion(s). The presented cases underscore the effectiveness of standardized ACLS protocols in the management of cardiac arrest. Timely and appropriate intervention, combined with a multidisciplinary approach, plays a critical role in reducing postresuscitation mortality and morbidity.