Active Intravascular Rewarming for Hypothermia Associated with Traumatic Injury: Early Experience with a New Technique

Taylor, Edward E.; Carroll, James P.; Lovitt, Matthew A.; Petrey, Laura B.; Gray, Paul; Mastropieri, Cyndi J.; Foreman, Michael L.

doi:10.1080/08998280.2007.11928259

Cited by 11 publications

(20 citation statements)

References 19 publications

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“…Given the increased risk of complications, such as hemorrhage or thrombosis, with invasive rewarming methods (e.g., bodycavity lavage, endovascular devices, and extracorporeal heating systems), as well as the absence of evidence that these methods improve the outcome, the best approach may be the use of active external and minimally invasive rewarming. 37 When selecting the rewarming method and rate (Table 3), clinicians should consider accessibility to an appropriate facility, local expertise, resources, and characteristics of the patient. When central venous access is required, it is important to keep the tip of the catheter (and guide wire) far from the heart in order to minimize the risk of arrhythmia.…”

Section: R E Scue C Ol L a Pse A Nd A F Ter Dropmentioning

confidence: 99%

Accidental Hypothermia

et al. 2012

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A ccidental hypothermia (i.e., an involuntary drop in core body temperature to <35°C [95°F]) is a condition associated with significant morbidity and mortality. 1-4 Each year, approximately 1500 patients in the United States have hypothermia noted on their death certificate; however, the incidence of primary and secondary hypothermia and the associated morbidity and mortality remain unknown. 5 In a single tertiary care center, 14 different rewarming methods were used to treat 84 cases of accidental hypothermia, 3 which reflects the uncertainties about treatment and the potential for complications. 3 Certain treatment approaches are available only in specialized centers, and clarification is needed regarding the choice between transporting a patient to a specialized center and providing treatment locally. Existing recommendations do not include recent developments in rewarming methods nor do they assist with decisions regarding transportation. 6-8 PR E SEN TAT IONWith cold exposure, the initial response of the body is to maintain a normal core temperature (approximately 37°C [99°F]) by means of active movement and involuntary shivering. Primary hypothermia occurs when heat production in an otherwise healthy person is overcome by the stress of excessive cold, especially when the energy stores of the body are depleted. Secondary hypothermia can occur in ill persons with a wide variety of medical conditions (Table 1), even in a warm environment. Death in patients with secondary hypothermia is often caused by the underlying condition rather than by hypothermia. In all types of hypothermia, consciousness, breathing, and circulation are initially intact but are impaired as the body cools. 10

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Section: R E Scue C Ol L a Pse A Nd A F Ter Dropmentioning

confidence: 99%

Accidental Hypothermia

et al. 2012

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“…The countercurrent heat exchange catheter requires some degree of circulation, in this case provided by CPR, to warm blood as it flows past the catheter. While the IVTTMs may appear to have less warming than cooling power since the selectable target temperature ranges from 31°C to 38°C, the initial temperature differential in our severely hypothermic patient was a substantial 15°C (38-23°C) (Laniewicz et al, 2008;Lasater, 2008;Taylor et al, 2008).…”

Section: Accidental Hypothermia and Hypothermic Cardiac Arrestmentioning

confidence: 83%

“…Taylor et al (2008) found a mean rewarming rate of 1.5°C -1°C/h in a series of critically ill trauma surgery patients. In addition, IVTTM was used in an 89-year-old with hypotension, bradycardia, and a temperature of 28.8°C (83.8°F) with rewarming of about 1°C/h (Chua and Lundbye, 2012).…”

Section: Accidental Hypothermia and Hypothermic Cardiac Arrestmentioning

confidence: 91%

Use of an Intravascular Heat Exchange Catheter and Intravenous Lipid Emulsion for Hypothermic Cardiac Arrest After Cyclobenzaprine Overdose

Westrol

Awad

Bridgeman

et al. 2015

Therapeutic Hypothermia and Temperature Management

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In this case report, a 22-year-old male developed severe hypothermia after an accidental overdose of cyclobenzaprine. During transport, the patient developed cardiac arrest. He received active rewarming measures, including pleural lavage, gastric lavage, an intravascular heat exchange catheter, and cardiopulmonary bypass. Intravenous lipid emulsion (ILE) was also administered. A discussion of cyclobenzaprine toxicity, hypothermia, ILE, and accidental hypothermic cardiac arrest follows.

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“…Un cas de thrombose veineuse liée au cathéter a été rapporté. Leur expérience a montré la facilité d'utilisation en pratique clinique courante permettant de traiter immédia-tement et en continu l'hypothermie lors de la réanimation de patients polytraumatisés [13].…”

Section: Discussionunclassified

Réchauffement d’une hypothermie sévère grâce à un dispositif intravasculaire habituellement utilisé dans le refroidissement post-arrêt cardiaque

Pauchard

Gauche

2014

Réanimation

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Le réchauffement des patients souffrant d'hypothermie circonstancielle profonde peut être obtenu par plusieurs méthodes, dont aucune n'a de rapport efficacité/invasivité/disponibilité optimal. Nous rapportons le cas clinique d'une patiente de 94 ans admise en réanimation pour hypothermie sévère à 26°C dont l'évolution sera favorable en quelques heures grâce à une technique de réchauffement invasive, continue et automatisée, utilisant un dispositif intravasculaire nommé CoolGard 3000 ® , utilisée habituellement dans le refroidissement post-arrêt cardiaque.Mots clés Hypothermie accidentelle · Technique de réchauffement · Dispositif intravasculaire CoolGard 3000 ® Abstract Rewarming severely hypothermic patients is a major challenge. No optimal technique providing efficiency and availability, using minimally invasive methods exists. We report one 94 year-old woman admitted to the intensive care unit for severe hypothermia at 26°C/78.8°F. Outcome was favorable within a few hours using an invasive, intravascular, continuous and automated rewarming technique commonly used for cooling cardiac arrest patients.

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Active Intravascular Rewarming for Hypothermia Associated with Traumatic Injury: Early Experience with a New Technique

Cited by 11 publications

References 19 publications

Accidental Hypothermia

Accidental Hypothermia

Use of an Intravascular Heat Exchange Catheter and Intravenous Lipid Emulsion for Hypothermic Cardiac Arrest After Cyclobenzaprine Overdose

Réchauffement d’une hypothermie sévère grâce à un dispositif intravasculaire habituellement utilisé dans le refroidissement post-arrêt cardiaque

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