Impact of rescue collapse on mortality rate in severe accidental hypothermia: A matched-pair analysis

Podsiadło, Paweł; Smoleń, Agata; Kosiński, Sylweriusz; Hymczak, Hubert; Waligórski, Szymon; Witt-Majchrzak, Anna; Drobiński, Dominik; Nowak, Ewelina; Barteczko-Grajek, Barbara; Toczek, Krzysztof; Skowronek, Radomir; Darocha, Tomasz

doi:10.1016/j.resuscitation.2021.04.019

Cited by 10 publications

(16 citation statements)

References 23 publications

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“…Even large centres rarely treat more than 20 patients annually. The largest studies to date have included only a few hundred patients [ 40 ]. Pooling of data is important to hasten the development of methods for diagnosis, treatment, and outcome prediction.…”

Section: Discussionmentioning

confidence: 99%

“…Only 2.4% had a core temperature higher than 28 °C. In patients with core temperatures above 30 °C there was no cardiac arrest solely attributable due to hypothermia [ 38 , 40 ]. In general, a normal level of consciousness correlates with a low risk of hypothermic cardiac arrest [ 41 ].…”

Section: Pathophysiologymentioning

confidence: 99%

“…In general, a normal level of consciousness correlates with a low risk of hypothermic cardiac arrest [ 41 ]. Overall, rescue collapse appears to double the risk of death in severely hypothermic patients [ 40 ]. Interventions, such as sudden movements of the patient or making the patient exercise, that are known to cause rescue collapse should be avoided.…”

Section: Pathophysiologymentioning

confidence: 99%

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Accidental Hypothermia: 2021 Update

Paal

Pasquier

Darocha

et al. 2022

IJERPH

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Accidental hypothermia is an unintentional drop of core temperature below 35 °C. Annually, thousands die of primary hypothermia and an unknown number die of secondary hypothermia worldwide. Hypothermia can be expected in emergency patients in the prehospital phase. Injured and intoxicated patients cool quickly even in subtropical regions. Preventive measures are important to avoid hypothermia or cooling in ill or injured patients. Diagnosis and assessment of the risk of cardiac arrest are based on clinical signs and core temperature measurement when available. Hypothermic patients with risk factors for imminent cardiac arrest (temperature < 30 °C in young and healthy patients and <32 °C in elderly persons, or patients with multiple comorbidities), ventricular dysrhythmias, or systolic blood pressure < 90 mmHg) and hypothermic patients who are already in cardiac arrest, should be transferred directly to an extracorporeal life support (ECLS) centre. If a hypothermic patient arrests, continuous cardiopulmonary resuscitation (CPR) should be performed. In hypothermic patients, the chances of survival and good neurological outcome are higher than for normothermic patients for witnessed, unwitnessed and asystolic cardiac arrest. Mechanical CPR devices should be used for prolonged rescue, if available. In severely hypothermic patients in cardiac arrest, if continuous or mechanical CPR is not possible, intermittent CPR should be used. Rewarming can be accomplished by passive and active techniques. Most often, passive and active external techniques are used. Only in patients with refractory hypothermia or cardiac arrest are internal rewarming techniques required. ECLS rewarming should be performed with extracorporeal membrane oxygenation (ECMO). A post-resuscitation care bundle should complement treatment.

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Section: Discussionmentioning

confidence: 99%

Section: Pathophysiologymentioning

confidence: 99%

Section: Pathophysiologymentioning

confidence: 99%

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Accidental Hypothermia: 2021 Update

Paal

Pasquier

Darocha

et al. 2022

IJERPH

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“…Moreover, they report risk factors for rescue collapse. 9 In a retrospective cohort study with a matched-pair analysis, they included patients from the HELP (Hypothermic Extracorporeal Life Support in Poland) registry. This Polish registry includes hypothermic patients, mostly arrested and rewarmed with ECLS.…”

mentioning

confidence: 99%

“…This Polish registry includes hypothermic patients, mostly arrested and rewarmed with ECLS. 9,10 The control group (with hypothermia stage III) included 45 patients who did not arrest during standard non-ECLS rewarming. The RC group included 45 hypothermic patients who suffered witnessed CA who were rewarmed with ECLS.…”

mentioning

confidence: 99%