The Hennepin Regional Poison Center have published a case series of asystolic cardiac arrest after treatment with intralipid. The authors readily acknowledge the difficulty of assigning causality, and caution against dramatic practice changes.
The Targeted temperature management Trial compared outcomes for therapeutic hypothermia at 33°C versus 36°C for cardiac arrest patients with persistent coma. It may very well be practice changing. Or maybe not. Before we can figure out what “truth” this research study may have uncovered, we will look at the development of therapeutic hypothermia and what the literature has already told us.
Transient vagal stimulation from the removal of the CVC and carotid massage from holding pressure to achieve hemostasis can lead to excessive vagal tone which caused blockage of the AV node leading to transient asystole cardiac arrest.