Profound hypothermia: value of prolonged cardiopulmonary resuscitation

A patient with severe hypothermia (core temperature of 22.2 C) and ventricular fibrillation had manual cardiopulmonary resuscitation for 3 1/2 hours while various rewarming technics raised her temperature to a level permitting successful electrical cardioversion. Laboratory testing revealed disseminated intravascular coagulation and several endocrinologic abnormalities. The need for prolonged, aggressive resuscitative measures and the possible role of corticosteroids in the management of profound hypothermia are discussed.