Accidental hypothermia

Wickstrom, Per H.; Ruiz, Ernest; Lilja, G.; Hinterkopf, J. Peter; Haglin, John J.

doi:10.1016/0002-9610(76)90029-5

Cited by 66 publications

(2 citation statements)

References 25 publications

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“…Patients were rewarmed at a rate of 0.3°C/min and 0.35°C/min and both patients died (27). Recently, mortality decreased after the introduction of core rewarming as a viable method of treating accidental hypothermia cases (9)(10)(11)(12)(13)(14)(15)(16)18). The collective wisdom for clinical use of the hypothermia technique was to warm the patients using a rate of 0.5°C/min or less which is perceived by the majority to be slow.…”

Section: Table 3a-bmentioning

confidence: 99%

“…Knowledge that proper cardiovascular function was critical in recovery from severe hypothermia had no effect upon early patient experience (2). Subsequent publications described a lower mortality rate with some form of internal or core rewarming such as gastric or rectal lavage, hemo-or peritoneal dialysis, central venous warm crystalloid infusion, respiration with humidified air, or partial cardiopulmonary bypass (9)(10)(11)(12)(13)(14)(15). The effect of these rewarming methods on the different body functions has been studied and reported repeatedly (16)(17)(18)(19).…”

Section: Introductionmentioning

confidence: 99%

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Rewarming, Ultraprofound Hypothermia and Cardiopulmonary Bypass

Elrifai,

Bailes,

Shih

et al. 1992

J Extra Corpor Technol

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Rewarming, a key event in resuscitation from accidental, experimental and clinical hypothermia, is sometimes followed by neurologic, cardiac, and respiratory sequelae and may lead to death. The rate of rewarming has been implicated but not quantified as etiologic in these sequelae. Under anesthesia fifteen dogs were cannulated and connected to an extracorporeal circuit for oxygenation, core cooling and rewarming. They were subjected to ultra-profound hypothermia with a core (esophageal) temperature as low as 1.3°C, cardiac arrest, blood substitution, and continuous low flow perfusion. After 2-3 hours of cardiac arrest, rewarming began. Mechanical activity of the heart was seen between 10° and 28°C and respiration resumed at 29°C. The rewarming rates of the 15 dogs were retrospectively studied. They were placed into three categories (G) based on the outcome. G-I (N = 2): no neurological complications, G-II (N=8): transient neurological problems, and G-III (N=5): death, mainly from cardiovascular and respiratory complications confirmed at death by autopsy. Heat gain by each animal was recorded as a function of time for all experiments. The time it took each dog to reach 35°C was determined and a mean was calculated (rewarming rate). Normal body temperature for a dog is 37.8°C. Statistical analysis (ANOV A) was performed ex post facto to determine the relationship between rewarming rate and outcome. Our data contradicts the notion that slow core rewarming from nadir to normal temperature offers better outcome. During rewarming metabolic needs change at different temperatures and our laboratory observations appear to provide an explanation for complications that may occur upon rewarming from profound hypothermia.

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