Profound Accidental Hypothermia Research Articles

Profound Accidental Hypothermia: Systematic Approach to Active Recognition and Treatment.

We sought to organize a functional system of recognition and advanced treatment of hypothermic patients with extracorporeal rewarming as a treatment option. All patients with suspected hypothermia are consulted with the hypothermia coordinator (HC), whose role is to provide expertise on hypothermia recognition and treatment to all rescue and medical services. Patients with Swiss staging system of hypothermia class III and IV are subjected to extracorporeal rewarming. Patients with class I and II are managed in local hospitals, after the HC provides instructions. From program initiation (July 29, 2013) to November 1, 2015, HC consulted 104 hypothermic patients; 21 in hypothermia class III and IV were subjected to extracorporeal rewarming in the John Paul II Hospital in Cracow, Poland. The remaining people were rewarmed in the referring hospitals. Cardiac arrest upon referral was present in 10 cases (resuscitation times from arrest to extracorporeal membrane oxygenation implantation ranged 107–345 minutes). Seven patients died, and the remaining 14 have been rewarmed with the restoration of hemodynamic stability. Systematic approach to active recognition and treatment of profound accidental hypothermia patients, on the basis of HC cooperation with emergency medical services, enables advanced management with good outcomes, especially in patients with cardiac arrest.

Rapid non-invasive rewarming in a cooled large animal model

Purpose: Rewarming of individuals with profound accidental hypothermia can be difficult and may result in treatment options such as ECMO that are difficult to manage. The current study investigates how new techniques available for rapid cooling can also be applied to reverse these effects. Two techniques of rewarming: a conventional cooling blanket (Medi-Therm III) vs. a circulating skin-water contact approach are compared.

Neurologic Recovery From Profound Accidental Hypothermia After 5 Hours of Cardiopulmonary Resuscitation

To describe the successful neurologic recovery from profound accidental hypothermia with cardiac arrest despite the longest reported duration of cardiopulmonary resuscitation. Case report. Mountain. A 57-year-old woman experienced profound accidental hypothermia (16.9°C) in a mountainous region of Grenoble. She was unconscious and had extreme bradycardia (6 beats/min) at presentation. A cardiac arrest occurred at the mobilization that was not responsive to electrical shocks or epinephrine. Cardiopulmonary resuscitation was continued for 307 minutes after rescue until venoarterial extracorporeal membrane oxygenation blood flow had been established at the emergency department. At a 3-month follow-up, the patient showed good physical and mental recovery. With no evidence of trauma or asphyxia, profound accidental hypothermia with cardiac arrest represents a specific condition for which successful neurologic recovery is feasible despite prolonged cardiopulmonary resuscitation.

Therapeutic hypothermia after profound accidental hypothermia and cardiac arrest

Therapeutic hypothermia after profound accidental hypothermia and cardiac arrest

Part 8: Advanced Challenges in Resuscitation

Part 8: Advanced Challenges in Resuscitation

Profound accidental hypothermia and freeze injury of the extremities in a child

Profound accidental hypothermia and freeze injury of the extremities in a child

Initial treatment of profound accidental hypothermia: Harnett RM, O'Brian EM, Sial FR, et al Aviat Space Environmental Med July 1980:680–687

Initial treatment of profound accidental hypothermia: Harnett RM, O'Brian EM, Sial FR, et al Aviat Space Environmental Med July 1980:680–687

Management of Profound Accidental Hypothermia with Cardiorespiratory Arrest

Complete recovery following rapid is described in three tourists who were admitted in a state of profound hypothermia with total cardiorespiratory arrest (rectal temperature ranging from 19 to 24 C). In all three patients, respiration and circulation had ceased during the rescue operation. Rapid core was achieved by thoracotomy and continuous irrigation of the pericardial cavity with warm fluids in one patient, whereas in the other two patients was accomplished with extracorporeal circulation using femoro-femoral bypass. In the first patient, the heart could not be defibrillated earlier than 90 minutes following thoracotomy; in the other patients was attained very rapidly, and within half an hour after institution of bypass, resuscitation of the heart was successful. The patients fully recovered their intellectual and physical abilities, despite the prolonged periods of circulatory arrest lasting from 2 1/2 to 4 hours. We conclude that rapid core is the adequate therapy for profound accidental hypothermia with circulatory arrest or low cardiac output. If feasible extracorporeal circulation represents the method of choice because it combines the advantage of immediate central with the benefit of efficient circulatory support, the heart is rewarmed before the shell, thus preventing the rewarming shock due to peripheral vasodilatation. Resuscitative efforts should be promptly initiated and vigorously pursued, even in the state of clinical death; in profound hypothermia neurologic examination is inconclusive regarding prognosis.

Venoarterial Bypass in Hypothermia

To the Editor.— Referring to the article Recovery After Prolonged Asystolic Cardiac Arrest in Profound Hypothermia: A Case Report and Literature Review by Southwick and Dalglish (1980;243:1250), their discussion of treatment did not include cardiopulmonary bypass as an aid in resuscitation and rewarming. Cardiopulmonary bypass has been advocated for core rewarming after accidental profound hypothermia. 1,2 I recently resuscitated a 60-year-old man who was asystolic for 120 minutes because of profound accidental hypothermia (initial rectal temperature 26 °C). After 90 minutes of external cardiac compression and attempts to rewarm using warm blankets, water-heated mattresses, intravenous infusions of warm saline solution, and gastric and bladder lavages, the patient was given a venoarterial bypass using the right femoral artery and vein. Partial cardiopulmonary bypass with flow rates of 800 to 1,000 mL/min was used to gradually rewarm and help maintain the circulation during the remainder of the asystolic period. Venoarterial bypass at

Intractable ventricular fibrillation associated with profound accidental hypothermia--successful treatment with partial cardiopulmonary bypass.

IN the following case of profound accidental hypothermia intractable ventricular fibrillation was reversed after two hours by rapid rewarming with the use of partial cardiopulmonary bypass followed by electroversion.Case ReportA 58-year-old alcoholic man was admitted to the hospital comatose with a rectal temperature of 25°C and a blood pressure of 80/? mm Hg. There were no localizing neurologic signs; the pupils were equal and reacted normally to light. An electrocardiogram showed an idioventricular rhythm of 35 per minute and prominent "Osborne" or "J" waves. An atrial electrogram showed an irregular atrial rate of 230 per minute. The hematocrit . . .

The Characteristic Electrocardiogram of Accidental Hypothermia

There are few electrocardiographic patterns which are distinctive enough to be considered characteristic of a particular metabolic abnormality. The electrocardiogram of profound accidental hypothermia is, however, frequently diagnostic of that condition. Although the pattern has been previously reported, 1-5 it is apparently not well enough known to be immediately recognized. We have recently had experience with an elderly patient who became hypothermic as a result of a cerebrovascular accident and neglect. Her initial ECG was diagnostic of hypothermia, but the abnormalities were not immediately recognized by either the house staff or her attending physicians until a literature search was carried out. Since prompt recognition of this condition and its cardiac effects is essential for the institution of optimal therapy, we present the case history and ECG of our patient to emphasize the diagnostic value of the ECG in this condition. Patient Summary A 90-year-old woman was seen in the emergency