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Related Experiment Videos

Hypothermia in trauma patients

M J Segers1, J C Diephuis, R G van Kesteren

  • 1Department of Surgery, University Hospital Vrije Universiteit, Amsterdam, The Netherlands.

Der Unfallchirurg
|December 16, 1998
PubMed
Summary

Accidental hypothermia (AH) management improved with a hemodynamic algorithm. Continuous arteriovenous rewarming (CAVR) showed promise, though complications require careful monitoring.

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Area of Science:

  • Emergency Medicine
  • Critical Care Medicine
  • Cardiovascular Medicine

Background:

  • Accidental hypothermia (AH) is an unintentional core temperature drop below 35°C.
  • AH severity and co-morbidities like trauma significantly impact patient prognosis.
  • Hypothermia is a critical factor in trauma victim survival rates.

Purpose of the Study:

  • To evaluate an algorithm-based management strategy for adult accidental hypothermia patients.
  • To assess the efficacy and complications of continuous arteriovenous rewarming (CAVR) and cardiopulmonary bypass (CPB).
  • To analyze outcomes in trauma patients with accidental hypothermia.

Main Methods:

  • Implementation of a hemodynamic-based algorithm for AH patient management.
  • Treatment stratification: CAVR for patients with perfusing rhythms and systolic BP > 80 mmHg.
  • CPB for arrested and hemodynamically unstable patients.

Main Results:

  • Twenty-two AH patients admitted over 3 years; 14 with trauma.
  • Eighteen patients treated with CAVR, 2 with CPB, according to the algorithm.
  • Mortality was 28% in the CAVR group and 32% overall; CAVR complications related to vascular access.

Conclusions:

  • The algorithm effectively stratified AH patients for rewarming therapy.
  • CAVR offers good patient access for simultaneous diagnosis and treatment of injuries.
  • Careful monitoring is needed for CAVR-related complications, especially in trauma patients with coagulopathy.

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