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Resuscitation of the hypothermic patient
D J Cohen1, J R Cline, S M Lepinski
1Department of Internal Medicine, University of Wisconsin School of Medicine, Madison.
The American Journal of Emergency Medicine
|September 1, 1988
Summary
This case study highlights successful resuscitation of a patient in cardiac arrest due to hypothermia. Advanced rewarming techniques, including cardiopulmonary bypass, enabled recovery despite prolonged arrest and severe acidosis.
Area of Science:
- Emergency Medicine
- Cardiology
- Environmental Health
Background:
- Hypothermia from cold-water immersion can lead to cardiac arrest.
- Rapid and effective rewarming is critical for survival in such cases.
Observation:
- A patient experiencing cardiac arrest after cold-water immersion presented with severe hypothermia (28°C rectal).
- Ventricular fibrillation persisted for 1.5 hours despite initial resuscitation efforts.
Findings:
- Successful cardioversion was achieved after 25 minutes of partial cardiopulmonary bypass rewarming when core temperature reached 30°C.
- The patient recovered uneventfully with normal neurological function despite profound metabolic acidosis (pH 6.41).
Implications:
- This case demonstrates the feasibility of advanced rewarming techniques for hypothermic cardiac arrest.
- A management protocol for hypothermic cardiac arrest is proposed, emphasizing early rewarming strategies.