Refractory ventricular fibrillation in accidental hypothermia: salvage with                 cardiopulmonary bypass

Mulpur, Anil Kumar; Mirsadraee, Saeed; Hassan, T B; McKeague, Helena; Kaul, Pankaj

doi:10.1191/0267659104pf760oa

Cited by 7 publications

(8 citation statements)

References 14 publications

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“…In accordance with these findings, hypothermia of 30°C increased the vulnerability to pacing‐induced ventricular fibrillation by facilitating wave breaks and promoting the onset of ADP alternans in Langendorff‐perfused isolated rabbit hearts . The increased incidence of ventricular fibrillation, which is frequently observed in patients suffering from accidental hypothermia, was also experimentally confirmed in vivo in a porcine model …”

Section: Discussionsupporting

confidence: 73%

Mild hypothermia (33°C) increases the inducibility of atrial fibrillation: An in vivo large animal model study

Manninger

Alogna

Zweiker

et al. 2018

Pacing Clinical Electrophis

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Section: Discussionsupporting

confidence: 73%

Mild hypothermia (33°C) increases the inducibility of atrial fibrillation: An in vivo large animal model study

Manninger

Alogna

Zweiker

et al. 2018

Pacing Clinical Electrophis

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“…Air pockets indicated that they had been breathing before HCA ( 66 , 94 , 95 , 100 ). Fifteen men and eight women suffered HCA secondary to drug or alcohol abuse ( 2 , 45 , 46 , 53 , 54 , 56 , 57 , 62 , 63 , 70 , 76 , 81 , 86 , 90 , 91 , 98 , 101 , 104 , 105 , 109 , 121 ). All underwent successful resuscitation with ECLS.…”

Section: Resultsmentioning

confidence: 99%

Rewarming From Hypothermic Cardiac Arrest Applying Extracorporeal Life Support: A Systematic Review and Meta-Analysis

et al. 2021

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Introduction: This systematic review and meta-analysis aims at comparing outcomes of rewarming after accidental hypothermic cardiac arrest (HCA) with cardiopulmonary bypass (CPB) or/and extracorporeal membrane oxygenation (ECMO).Material and Methods: Literature searches were limited to references with an abstract in English, French or German. Additionally, we searched reference lists of included papers. Primary outcome was survival to hospital discharge. We assessed neurological outcome, differences in relative risks (RR) of surviving, as related to the applied rewarming technique, sex, asphyxia, and witnessed or unwitnessed HCA. We calculated hypothermia outcome prediction probability score after extracorporeal life support (HOPE) in patients in whom we found individual data. P < 0.05 considered significant.Results: Twenty-three case observation studies comprising 464 patients were included in a meta-analysis comparing outcomes of rewarming with CPB or/and ECMO. One-hundred-and-seventy-two patients (37%) survived to hospital discharge, 76 of 245 (31%) after CPB and 96 of 219 (44 %) after ECMO; 87 and 75%, respectively, had good neurological outcomes. Overall chance of surviving was 41% higher (P = 0.005) with ECMO as compared with CPB. A man and a woman had 46% (P = 0.043) and 31% (P = 0.115) higher chance, respectively, of surviving with ECMO as compared with CPB. Avalanche victims had the lowest chance of surviving, followed by drowning and people losing consciousness in cold environments. Assessed by logistic regression, asphyxia, unwitnessed HCA, male sex, high initial body temperature, low pH and high serum potassium (s-K+) levels were associated with reduced chance of surviving. In patients displaying individual data, overall mean predictive surviving probability (HOPE score; n = 134) was 33.9 ± 33.6% with no significant difference between ECMO and CPB-treated patients. We also surveyed 80 case reports with 96 victims of HCA, who underwent resuscitation with CPB or ECMO, without including them in the meta-analysis.Conclusions: The chance of surviving was significantly higher after rewarming with ECMO, as compared to CPB, and in patients with witnessed compared to unwitnessed HCA. Avalanche victims had the lowest probability of surviving. Male sex, high initial body temperature, low pH, and high s-K+ were factors associated with low surviving chances.

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“…Fifteen case reports were also reviewed [17][18][19][20][21][22][23][24][25][26][27][28][29][30][31], yielding a total of 17 patients. Fourteen of these patients suffered an exposure-related hypothermic arrest, all 14 of these survived neurologically intact.…”

Section: Case Reportsmentioning

confidence: 99%

Extracorporeal-Assisted Rewarming in the Management of Accidental Deep Hypothermic Cardiac Arrest

Dunne

Christou

Duff

et al. 2014

Heart, Lung and Circulation

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Refractory ventricular fibrillation in accidental hypothermia: salvage with cardiopulmonary bypass

Cited by 7 publications

References 14 publications

Mild hypothermia (33°C) increases the inducibility of atrial fibrillation: An in vivo large animal model study

Mild hypothermia (33°C) increases the inducibility of atrial fibrillation: An in vivo large animal model study

Rewarming From Hypothermic Cardiac Arrest Applying Extracorporeal Life Support: A Systematic Review and Meta-Analysis

Extracorporeal-Assisted Rewarming in the Management of Accidental Deep Hypothermic Cardiac Arrest

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