Treatment of Accidental Hypothermia

Kugelberg, Jan; Schüller, Hans; Berg, Bertel; Kallum, Bengt

doi:10.3109/14017436709131858

Cited by 71 publications

(13 citation statements)

References 10 publications

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“…As deep hypothermic circulatory arrest became commonly employed in cardiac surgery for complex reconstructive surgery the concept of extracorporeal rewarming for hypothermic arrest was born. The first successful cases were reported in 1967 [1,2].…”

Section: Introductionmentioning

confidence: 97%

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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Section: Introductionmentioning

confidence: 97%

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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“…The first descriptions of rewarming of accidental hypothermia with extracorporeal blood warming were reported in 1967 (Davies et al, 1967;Kugelberg et al, 1967). Other methods for rewarming have been reported, such as pleural lavage (Kjaergard and Bach, 2006), peritoneal dialysis ( Jessen and Hagelsten, 1978), and intermittent hemodialysis (Sultan et al, 2009).…”

Section: Discussionmentioning

confidence: 96%

17 Degrees Celsius Body Temperature—Resuscitation Successful?

Hungerer

Ebenhoch²,

Bühren³

2010

High Altitude Medicine & Biology

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The resuscitation of patients with accidental profound hypothermia is challenging. A 17-year-old man got lost on the first of January, after a New Year's Eve party in the foothills of the Alps. After a search of four hours, he was found unconscious with fixed pupils, a Glasgow Coma Scale of three points, and a body temperature below 20° Celsius. There were no signs for traumatic injuries. Initial electrocardiogram (ECG) showed no heart activity. Basic life support was begun by the mountain rescue service and continued by the medical helicopter team. The patient was transferred under continuous cardiac massage, airway management with intubation and intravenous line via external jugular vein by helicopter to the nearest hospital for analysis of serum potassium. Body temperature was 17°C measured by urinary bladder electronic thermometer. The serum potassium was 7.55 mmol/L, therefore the patient was transferred by helicopter to the next cardiovascular center for rewarming with extracorporal circulation (ECC). Under the rewarming process with ECC, the heart activity restarted at 25°C with external defibrillation. The patient was rewarmed to 37.2°C after four hours of ECC. Cerebral CT scans after 24 h and 48 h revealed no significant hypoxia and after extubation the early rehabilitation process started. After six weeks, the patient regained the ability to walk and started to communicate on a basic level. After 54 days the patient presented signs of septic shock. After initial stabilization and CT diagnostic, a laparotomy was performed. The intraoperative finding was a total necrosis of the small bowel and colon. The patient died on the same day. Post mortem examination showed a necrotizing enterocolitis with transmural necrosis of the bowel. Survivors of uncontrolled profound hypothermia below 20°C core temperature are rare. The epicrisis is often prolonged by complications of different causes. The present case reports a necrotizing enterocolitis with a non-occlusive mesenteric ischemia (NOMI) as a medium-term complication of profound hypothermia.

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“…The problems associated with low T core were recognized later when thermometers could record lower temperatures (to 24°C) (Wunderlich and Seguin, 1871;Guly, 2011). Since 1967, when cardiopulmonary bypass revolutionized the treatment of hypothermic arrested victims (Davies et al, 1967;Kugelberg et al, 1967), pulmonary artery temperature became the gold standard for T core measurement in patients with severe accidental hypothermia . Concurrently, interest in alternative, less invasive sites for temperature measurement led to the auditory canal and tympanic temperature (Benzinger, 1959;Brinnel and Cabanac, 1989), and others investigated the effect of environmental factors (i.e., cold) on tympanic, esophageal, and rectal measurement (Marcus, 1973;Keatinge and Sloan, 1975).…”

Section: History Of Body Temperature Measurementmentioning

confidence: 98%

Pre-Hospital Core Temperature Measurement in Accidental and Therapeutic Hypothermia

Strapazzon

Procter²,

Paal³

et al. 2014

High Altitude Medicine & Biology

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Core temperature (T core) measurement is the only diagnostic tool to accurately assess the severity of hypothermia. International recommendations for management of accidental hypothermia encourage T core measurement for triage, treatment, and transport decisions, but they also recognize that lack of equipment may be a limiting factor, particularly in the field. The aim of this nonsystematic review is to highlight the importance of field measurement of T core and to provide practical guidance for clinicians on pre-hospital temperature measurement in accidental and therapeutic hypothermia. Clinicians should recognize the difference between alternative measurement locations and available thermometers, tailoring their decision to the purpose of the measurement (i.e., intermittent vs. continual measurement), and the impact on management decisions. The importance of T core measurement in therapeutic hypothermia protocols during early cooling and monitoring of target temperature is discussed.

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Treatment of Accidental Hypothermia

Cited by 71 publications

References 10 publications

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

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

17 Degrees Celsius Body Temperature—Resuscitation Successful?

Pre-Hospital Core Temperature Measurement in Accidental and Therapeutic Hypothermia

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