Outcome of accidental hypothermia with or without circulatory arrest

Wanscher, Michael; Agersnap, Lisbeth; Ravn, Jesper; Yndgaard, Stig; Nielsen, Jørgen Feldbæk; Danielsen, E. Michael; Hassager, Christian; Romner, Bertil; Thomsen, Carsten; Barnung, S.; Lorentzen, Anne Grethe; Høgenhaven, Hans; Davis, Matthew; Møller, Jacob Eifer

doi:10.1016/j.resuscitation.2012.05.009

Cited by 134 publications

(83 citation statements)

References 18 publications

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“…41 Second, our data do not address prehospital factors such as drowning duration, time, and water temparature as well as in-hospital factors such as body core temperature and blood pH, as recommended in the Utstein reporting guidelines for drowning. In preceding studies, the effectiveness of advanced life support treatments such as cardiopulmonary bypass 42 and extra-corporeal membrane oxygenation 43 for OHCA due to drowning has been discussed, but these data were not available for this study. Third, favorable neurological outcome was based on the Cerebral Performance Scale rather than more detailed functional neurological assessments.…”

Section: Discussionmentioning

confidence: 99%

Out-of-hospital cardiac arrest due to drowning among children and adults from the Utstein Osaka Project

et al. 2013

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Background Children have better outcomes after out-of-hospital cardiac arrest (OHCA) than adults. However, little is known about the difference in outcomes between children and adults after OHCA due to drowning. Objectives The aim of this study is to assess the outcome after OHCA due to drowning between children and adults. Our hypothesis is that outcomes after OHCA due to drowning would be in better among children (<18 years old) compared with adults (≥18 years old). Method This prospective population-based, observational study included all emergency medical service-treated OHCA due to drowning in Osaka, Japan, between 1999 and 2010 (excluding 2004). Outcomes were evaluated between younger children (0–4 years old), older children (5–17 years old), and adults (≥18 years old). Major outcome measures were one-month survival and neurologically favorable one-month survival defined as cerebral performance category 1 or 2. Multivariate logistic regression analyses were used to account for potential confounders. Results During the study period, 66,716 OHCAs were documented, and resuscitation was attempted for 62,048 patients (1300 children [2%] and 60,748 adults [98%]). Among these OHCAs, 1737 (3% of OHCAs) were due to drowning (36 younger children [2%], 32 older children [2%], and 1669 adults [96%]). The odds of one-month survival were significantly higher for younger children (28% [10/36]; adjusted odds ratio [AOR], 20.20 [95% confidence interval {CI} 7.45–54.78]) and older children (9% [3/32]; AOR, 4.47 [95% CI 1.04–19.27]) when compared with adults (2% [28/1669]). However, younger children (6% [2/36]; AOR, 5.23 [95% CI 0.52–51.73]) and older children (3% [1/32]; AOR, 2.53 [95% CI 0.19–34.07]) did not have a higher odds of neurologically favorable outcome than adult s (1% [11/1669]). Conclusion In this large OHCA registry, children had better one-month survival rates after OHCA due to drowning compared with adults. Most survivors in all groups had unfavorable neurological outcomes.

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Section: Discussionmentioning

confidence: 99%

Out-of-hospital cardiac arrest due to drowning among children and adults from the Utstein Osaka Project

et al. 2013

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“…HIE is the most common cause of death of hospitalized drowning patients. A neuroprotective effect of active hypothermia has been shown after global brain ischemia, such as after cardiac arrest and neonatal asphyxia, and in case reports of good recoveries after near drowning in cold water [5111213]. In 2005, the International Liaison Committee on Resuscitation recommended induction of hypothermia (32–34 ° C) for 12–24 hours in comatose children after resuscitation from cardiac arrest [7].…”

Section: Discussionmentioning

confidence: 99%

Therapeutic hypothermia brings favorable neurologic outcomes in children with near drowning

Chen

Chu

Cheng

et al. 2016

Tzu Chi Medical Journal

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A 1-year-10-month-old boy was admitted to our pediatric intensive care unit due to near drowning with pulmonary edema. A conventional ventilator with 100% oxygen supplementation was used initially, but was shifted to high frequency oscillatory ventilation as his oxygen saturation was around 84–88%. Therapeutic hypothermia was applied due to hypoxic ischemic encephalopathy with severe acidosis. His respiratory condition improved and he was extubated successfully on the 6th hospital day. The patient had no obvious neurological defects and he was discharged in a stable condition after 17 days of hospitalization. Our case report demonstrates the advantages of therapeutic hypothermia on survival and neurological outcomes in treating pediatric near drowning patients.

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“…Cardiac arrest as a result of hypothermia alone has a good prognosis , however, in combination with drowning the outcome is less promising. Extracorporeal life support with cardiopulmonary bypass or extracorporeal membrane oxygenation is increasingly used in the rewarming and resuscitation process and has previously been proven successful in this setting . Submersion for <10 min and drowning in ice‐cold water may increase the victim's chances of survival because cerebral oxygen consumption is reduced by approximately 5% for each 1°C reduction in temperature, within the range of 20°C–37°C .…”

Section: Introductionmentioning

confidence: 99%

Successful resuscitation after drowning with severe hypernatraemia and prolonged time to return of spontaneous circulation

Klitgaard

Kjærgaard

Bisgaard

2019

Anaesthesia Reports

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We describe the successful resuscitation of a 23-year-old previously healthy man who had drowned. After prolonged submersion, hypothermia, severe hypernatraemia, a prolonged time to return of spontaneous circulation was possible using a combination of extracorporal life support and early continuous veno-venous haemofiltration. This combination of clinical circumstances is rarely associated with positive outcomes, but this case demonstrates the utility of extracorporeal life support and haemofiltration in patients drowned in saltwater.

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Outcome of accidental hypothermia with or without circulatory arrest

Cited by 134 publications

References 18 publications

Out-of-hospital cardiac arrest due to drowning among children and adults from the Utstein Osaka Project

Out-of-hospital cardiac arrest due to drowning among children and adults from the Utstein Osaka Project

Therapeutic hypothermia brings favorable neurologic outcomes in children with near drowning

Successful resuscitation after drowning with severe hypernatraemia and prolonged time to return of spontaneous circulation

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