Case Report Is It Possible to Maintain Consciousness and Spontaneous Ventilation with Chest Compression in the Early Phase of Cardiac Arrest? Menekse Oksar and Selim Turhanoglu Department of Anesthesiology and Reanimation, Mustafa Kemal University Faculty of Medicine, 31100 Hatay, Turkey Correspondence should be addressed to Menekse Oksar; menekseoksar@gmail.com Received 29 October 2015; Revised 5 January 2016; Accepted 17 January 2016 Academic Editor: Pavel Michalek Copyright © 2016 M. Oksar and S. Turhanoglu. Tis is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Chest compression is important in cardiopulmonary resuscitation. However, life support algorithms do not specify when chest compression should be initiated in patients with persistent spontaneous normal breathing in the early phase afer cardiac arrest. Here we describe the case of a 69-year-old man who underwent femoral bypass surgery and was extubated at the end of the procedure. Afer extubation, the patient’s breathing pattern and respiratory rate were normal. Te patient subsequently developed ventricular fbrillation, evident on two monitors. Because defbrillation was inefective, chest compression was initiated even though the patient had spontaneous normal breathing and defensive motor refexes, which were continued throughout resuscitation. He regained consciousness and underwent tracheal extubation without neurological sequelae on postoperative day 1. Tis case highlights the necessity of chest compression in the early phase of cardiac arrest. 1. Introduction Te 2010 American Heart Association recommendations and European Resuscitation Council guidelines for cardiopul- monary resuscitation (CPR) focus on the requirement of immediately initiating chest compression and ventilation to maintain cerebral blood fow and adequate gas exchange, respectively [1]. Maintaining cerebral perfusion prevents neu- rological damage. Some studies have shown that conscious, spontaneous breathing may continue for a short time afer cerebral perfusion stops; for example, repeated rhythmic coughs every 1–3 s maintained consciousness for up to 39 s in three patients who developed ventricular fbrillation during coronary arteriography [2]. Cardiac arrest survivors recall memories of awareness, fear, and persecution afer CPR [3]. Early diagnosis of cardiac arrest may prolong spontaneous breathing and consciousness by maintaining cerebral per- fusion through efective chest compression. We present a 69-year-old man with uninterrupted spontaneous normal breathing during CPR. 2. Case Report A 69-year-old man (American Society of Anesthesiologists class 2; weight 70 kg; height 1.72 m) with peripheral arterial disease and diabetes mellitus underwent femoral bypass surgery. Anesthesia was induced using 2 mg midazolam, 100 g fentanyl, and 2 mg/kg propofol. Endotracheal intu- bation was achieved with 40 mg rocuronium, anesthesia was maintained by 2% sevofurane with N 2 O and 50% O 2 , and diuretic and insulin infusions were administered as required. Te patient showed normal blood gas levels (pH, 7.36; PaCO 2 , 43 mmHg; PaO 2 , 92 mmHg; lactate, 3.5 mmol/L; and base excess, 1.2 mmol/L). His blood glucose level was 220 mg/dL, O 2 saturation level was 99% on 50% O 2 , heart rate (HR) was 88 beats/min, and mean arterial pressure (MAP) was 70 mmHg. Neuromuscular blockade was reversed using 200 mg sugammadex, and the patient was extubated. Tere- afer, his breathing pattern was regular, with a respiratory rate of 17 breaths/min and a tidal volume of 600 mL. Oxy- hemoglobin saturation determined using pulse oximetry Hindawi Publishing Corporation Case Reports in Anesthesiology Volume 2016, Article ID 3158015, 4 pages http://dx.doi.org/10.1155/2016/3158015