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Therapeutic Hypothermia After Cardiac Arrest in a Patient With Systemic Sclerosis and Raynaud PhenomenonTherapeutic Hypothermia Systemic Sclerosis

Keren Bakal, MD; Mauricio Danckers, MD; Joshua L. Denson, MD; Harald Sauthoff, MD
Author and Funding Information

From the Department of Medicine (Drs Bakal, Danckers, Denson, and Sauthoff), NYU School of Medicine; and VA NY Harbor Healthcare System (Dr Sauthoff), US Department of Veterans Affairs, New York, NY.

CORRESPONDENCE TO: Harald Sauthoff, MD, Department of Medicine, NYU School of Medicine, 423 E 23rd St, New York, NY 10010; e-mail: Harald.sauthoff@nyumc.org


Part of this article has been presented and published in abstract form at CHEST 2012, October 22, 2012, Atlanta, GA (Bakal K, Danckers-Degregori M, Felner K, Sauthoff H. Chest. 2012;142[4_MeetingAbstracts]:289A).

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.


Chest. 2015;147(2):e27-e30. doi:10.1378/chest.14-1184
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Therapeutic hypothermia favorably impacts neurologic outcomes in patients after cardiopulmonary arrest, although the appropriate target temperature is less clear. Its safety profile in patients with systemic sclerosis (SSc) and Raynaud phenomenon (RP), who may be at increased risk for ischemic complications, has not been addressed in the literature, to our knowledge. Digital lesions are commonly seen in patients with SSc, and cold-induced myocardial ischemia has also been reported. We describe a case of a man with SSc, RP, and digital ulcers who underwent therapeutic hypothermia after cardiopulmonary arrest. He regained full neurologic function, and except for digital necrosis, no hypothermia-associated adverse events were observed. Other risk factors for ischemia, such as cocaine use, may have contributed to the development of the digital necrosis. However, clinicians should be aware of the risk for ischemic complications in patients with SSc and RP when considering the appropriate target temperature after cardiopulmonary arrest.

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