Portable cardiopulmonary bypass: resuscitation from prolonged ice-water submersion and asystole

Accidental hypothermia associated with near-drowning and cardiac arrest has a high mortality, especially in the adult. We report the resuscitation of a 31-year-old man who suffered extended ice-water submersion, severe hypothermia (23 degrees C), and prolonged (> or = 78 minutes) cardiac asystole. A modified portable cardiopulmonary bypass system and femoral-femoral cannulation in the Emergency Department permitted the rapid institution of core rewarming, oxygenation, and controlled reperfusion, with a successful outcome. Rapid initiation of cardiopulmonary bypass outside the operating room can be an initial treatment option in this unique clinical situation.