The first reported case of a comatose patient with cocaine-induced cardiac arrest successfully treated with therapeutic hypothermia is reported in the Annals of Emergency Medicine (“Therapeutic Hypothermia in Cocaine-Induced Cardiac Arrest”).

The case involves a 28-year-old woman brought to the Brackenridge emergency department after a suspected cocaine-induced cardiac arrest. She was treated with chest compressions, electric shocks, and infused medications but remained in a coma before physicians decided to induce hypothermia.

The woman was cooled to between 32° and 33° Celsius (or about 91° Fahrenheit) for 24 hours and then gradually warmed over a period of six hours. The patient walked out of the hospital with near-complete neurologic recovery six days later.

Truman J. Milling Jr, MD, of Brackenridge Hospital in Austin, Tex, one of the authors, noted hypothermia has been used to treat patients whose hearts had to be restarted with electric shocks—usually due to heart attacks—but this marks the first time it has been used in a drug overdose. The success suggests hypothermia could be an important therapy for patients who overdose on heart-stopping street drugs, he added.

Therapeutic hypothermia is relatively new for treatment of comatose cardiac arrest patients. It has drawn interest because it appears to protect the brain from damage after the heart has briefly stopped supplying it with blood. Females younger than 50 and patients with drug overdose had been excluded in the landmark studies that led to the broad use of hypothermia.

The Annals of Emergency Medicine is the peer-reviewed scientific journal for the American College of Emergency Physicians, a national medical society with more than 25,000 members. more information visit