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Severe accidental hypothermia: rewarming strategy using a veno-venous bypass system and a convective air warmer
A Bräuer1, H Wrigge, J Kersten
1Dept. of Anesthesiology, Emergency and Intensive Care Medicine, University of Göttingen, Germany. abraeue@gwdg.de
Objective:
To study a rewarming strategy for patients with severe accidental hypothermia using a simple veno-venous bypass in combination with a convective air warmer.
Setting:
Eighteen beds in a university hospital intensive care unit.
Patients:
Four adults admitted with a core temperature less than 30 degrees C. Hypothermia was caused by alcoholic intoxication in three patients and by drug overdose in one patient.
Measurements And Main Results:
All patients were rewarmed by a venovenous bypass and in three cases a convective air warmer was also used. At a bypass flow rate of 100-300 ml/min the mean increase in core temperature was 1.15 degrees C/h (Range: 1.1-1.2 degrees C/h). One patient died 2 days after rewarming as a consequence of a reactivated pancreatitis. The other three patients survived without neurological sequelae.
Conclusion:
This rewarming technique seems safe and effective and allowed the controlled rewarming of our patients who suffered from severe accidental hypothermia