Accidental Deep Hypothermia With Cardiac Arrest. Prompt Complete Recovery After Rewarming by Extracorporeal Circulation. Case Report

Šimek, Martin; Hájek, Roman; Bruk, Vilém; Fabikova, Karolina; Němec, Petr; Raimr, Jakub; Husár, Roman; Hubáček, Petr

doi:10.5507/bp.2007.017

Cited by 5 publications

(10 citation statements)

References 15 publications

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Section: Discussionmentioning

confidence: 99%

“…Accidental hypothermia with circulatory arrest and especially in drowning and near-drowning has high mortality due to pulmonary, renal, and neurological complications (1,(7)(8)(9)(10)(11)(12)(13). The lack of reliable information about duration of submersion and the time between the accident and the initiation of cardiopulmonary resuscitation are main problems in prediction of outcome.…”

Section: Discussionmentioning

confidence: 99%

“…Although prediction of outcome cannot be based on laboratory parameters (21), elevated serum potassium level >10 mM, pH < 6.5, and low arterial oxygen level have been reported to be prognostic factors for poor outcomes (1,3,15,17). Wollenek et al (4) established a prognosis score with five indicators: age younger than 3 years, submersion time of more than 5 min, resuscitation delayed for more than 10 min, coma at hospital admission, and an initial pH of less than 7.10.…”

Section: Discussionmentioning

confidence: 99%

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Extracorporeal Circulation for Rewarming in Drowning and Near‐Drowning Pediatric Patients

et al. 2010

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Drowning and near-drowning is often associated with severe hypothermia requiring active core rewarming.We performed rewarming by cardiopulmonary bypass(CPB). Between 1987 and 2007, 13 children (9 boys and 4 girls) with accidental hypothermia were rewarmed by extracorporeal circulation (ECC) in our institution. The average age of the patients was 3.2 years. Resuscitation was started immediately upon the arrival of the rescue team and was continuously performed during the transportation.All patients were intubated and ventilated. Core temperature at admission ranged from 20 to 29°C (mean 25.3°C). Connection to the CPB was performed by thoracic (9 patients) or femoral/iliac means (4 patients). Restoration of circulation was achieved in 11 patients (84.6%). After CPB termination two patients needed an extracorporeal membrane oxygenation system due to severe pulmonary edema.Five patients were discharged from hospital after prolonged hospital stay. During follow-up, two patients died(10 and 15 months, respectively) of pulmonary complications and one patient was lost to follow-up. The two remaining survivors were without neurological deficit.Modes of rewarming, age, sex, rectal temperature, and serum electrolytes did not influence mortality. In conclusion,drowning and near-drowning with severe hypothermia remains a challenging emergency. Rewarming by ECC provides efficient rewarming and full circulatory support.Although nearly half of the children may survive after rewarming by ECC, long-term outcome is limited by pulmonary and neurological complications.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Extracorporeal Circulation for Rewarming in Drowning and Near‐Drowning Pediatric Patients

et al. 2010

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“…Deep accidental hypothermia (DAH) is an unusual emergency clinical emergency with a possible high mortality. The exposure to the cold environment could be caused from an intoxication of alcohol or drugs or from other diseases by elder people [ [1] , [2] , [3] , [4] ]. The use of extracorporeal circulation (ECC) can provide a fast and safe body rewarming with good results [ 2 , 4 ].…”

Section: Introductionmentioning

confidence: 99%

Deep accidental hypothermia accompanied with cardiac arrest after alcohol and drug poisoning treated with extracorporeal life support

Grapatsas¹,

Leivaditis²,

Panagiotopoulos³

et al. 2018

Respiratory Medicine Case Reports

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Deep accidental hypothermia is an unusual clinical entity in developed countries. We report a case of a 30 year old male Caucasian patient with accidental severe hypothermia who was transferred to the emergency department of our hospital after prolonged exposure in the urban city's night environment cold as a result of alcohol and drugs abuse. The patient was found unconscious in the first early hours from onlookers. The time that the patient remained unconscious is unknown. During the transfer to the hospital because of cardiac arrest cardiopulmonary resuscitation began. In the emergency department an extracorporeal life support system (ECLS) was implanted under cardiopulmonary resuscitation in order to achieve hemodynamic stabilization and rapid and safe rewarming. The patient's rewarming lasted 6 hours. The patient was extubated the next day.

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“…La mayor parte de las publicaciones son de experimentación con animales, casos clínicos, series de casos y revisiones realizadas por expertos. Se sabe que los métodos cruentos de recalentamiento activo interno consiguen su objetivo a mayor velocidad [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20] , pero nunca se ha demostrado que los enfermos tratados de ese modo tengan mayor supervivencia 2 .…”

Section: Introductionunclassified

Parada cardíaca por hipotermia accidental y resucitación cardiopulmonar prolongada

Kot

Botella

2010

Medicina Intensiva

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In cardiac arrest produced by accidental hypothermia, cardiopulmonary resuscitation must be prolonged until normal body temperature is achieved. There are different rewarming methods. In theory, the more invasive ones are elective in patients with cardiac arrest because of their higher rewarming speed. However, it has not been proven that these methods are better than the non-invasive ones. We present a case report of a patient with cardiac arrest due to accidental hypothermia who was treated without interruption for three hours with heart massage. This is the longest successful cardiopulmonary resuscitation known up-to-date in Spain. In order to rewarm the body, a combination of non-invasive methods was used: active external rewarming with convective warm air, gastric and bladder lavage with warm saline solution and intravenous warm saline infusion. This case shows that it is possible to treat hypothermic cardiac arrest successfully through these rewarming methods, which are both easy to apply and feasible in any hospital.

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Accidental Deep Hypothermia With Cardiac Arrest. Prompt Complete Recovery After Rewarming by Extracorporeal Circulation. Case Report

Cited by 5 publications

References 15 publications

Extracorporeal Circulation for Rewarming in Drowning and Near‐Drowning Pediatric Patients

Extracorporeal Circulation for Rewarming in Drowning and Near‐Drowning Pediatric Patients

Deep accidental hypothermia accompanied with cardiac arrest after alcohol and drug poisoning treated with extracorporeal life support

Parada cardíaca por hipotermia accidental y resucitación cardiopulmonar prolongada

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