Abstract
A 51-year-old male remained immersed in sea water (6°C) for 40 min. Brought ashore, the ECG showed asystole. Advanced life support was immediately commenced. On arrival in hospital his rectal temperature was 27°C, but continued to fall to 24°C. The ECG remained isoelectric. Cardiopulmonary resuscitation was continued until extracorporeal circulation was established 190 min after rescue. Upon rewarming ventricular fibrillation occurred which was converted to sinus rhythm with a bolus of lignocaine followed by D.C. conversion at 31.5°C. When rewarming was complete after 60 min, signs of severe heart failure became evident. Sternotomy and pericardiotomy were performed to exclude cardiac tamponade. After 60 min of re-perfusion the patient was be weaned from bypass supported by a high-dose vasopressor infusion and nitroglycerine. He was discharged after 13 days with no evidence of any permanent organ damage. Given the advantage of providing circulatory support, extracorporeal circulation may be useful when rewarming hypothermic victims with cardiac arrest.
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References
Zell SC, Kurtz KJ (1985) Severe exposure hypothermia: a resuscitation protocol. Ann Emerg Med 14:339–345
Althaus U, Äberhard P, Schüpbach P, Nachbur BH, Mühlemann W (1982) Management of profound accidental hypothermia with cardiorespiratory arrest. Ann Surg 195:492–495
Feiss P, Mora C, Devalois B, Gebeaux R, Christides C (1987) Hypothermie profonde accidentelle et arrêt circulatoire. Traitement par circulation extracorporelle. Ann Fr Anesth Reanim 6:217–218
Maningas P, Guzman L, Hollenbach S (1986) Regional blood flow during hypothermic arrest. Ann Emerg Med 15:390–396
Gillon J, Vogel M, Holterman R (1986) Ventricular fibrillat ion during orotracheal intubation of hypothermic dogs. Ann Emerg Med 15:412–415
Criley J, Niemann J, Rossborough J (1981) The heart is a conduit in CPR. Crit Care Med 9:373–374
Moss J (1986) Accidental severe hypothermia (Review). Surg Gynecol Obstet 162:501–513
Lønning PE, Skulberg A, Åbyholm F (1986) Accidental hypothermia — review of the literature. Acta Anaesthesiol Scand 30:601–613
Villalobos TJ (1985) A cause of the thrombocytopenia and leukopenia that occurs in dogs during deep hypothermia. J Clin Invest 37:1
Hauty MG, Esrig BC, Hill JG, Long WB (1987) Prognostic factors in severe accidental hypothermia: experience from the Mt Hood tragedy. J Trauma 27:1107–1112
White DC, Nowell NW (1965) The effect of alcohol on the cardiac arrest temperature in hypothermic rats. Clin Sci 28:395–399
Webb WR, Harrison N, Dodds R et al (1968) Protective effect of ethyl alcohol in profound hypothermia. Cryobiology 4:290–294
Kugelberg J, Schüller H, Berg B, Kallum B (1967) Treatment of accidental hypothermia. Scand J Thorac Cardiovasc Surg 1:142–146
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Husby, P., Andersen, K.S., Owen-Falkenberg, A. et al. Accidental hypothermia with cardiac arrest: Complete recovery after prolonged resuscitation and rewarming by extracorporeal circulation. Intensive Care Med 16, 69–72 (1990). https://doi.org/10.1007/BF01706328
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DOI: https://doi.org/10.1007/BF01706328