Advanced Cardiac Life Support in Hypothermi

Abstract

Hypothermic arrest cases often occur as a result of long-term cold exposure or accident. Although it is observed primarily in centers where the weather is cold, these cases can be found all over the world. Unexpectedly, hypothermic arrest cases may also be encountered in summer months and in hospitalized patients under observation. With the use of advanced assisted resuscitation methods such as extracorporeal life support and cardiopulmonary bypass, neurological survival in this population has reached 47-63%. Hypothermia is defined as a core body temperature below 35°C (95°F) and can be life-threatening if not addressed promptly. This condition can arise from prolonged exposure to cold environments, immersion in cold water, inadequate clothing, or underlying medical conditions that affect body temperature regulation. The primary goal of hypothermic resuscitation is to safely and effectively return the patient’s body temperature to normal levels. The treatment approach varies based on the severity of hypothermia, categorized into mild, moderate, and severe stages. In cases of mild hypothermia, passive rewarming methods are typically sufficient. Passive rewarming relies on the patient’s own metabolic heat production to gradually raise the body temperature. For moderate to severe hypothermia, active rewarming techniques are necessary. Active rewarming methods include administering warmed intravenous fluids to increase core body temperature from the inside, using external heating devices such as heating blankets or forced-air warming systems, and in extreme cases, employing extracorporeal rewarming techniques. Extracorporeal membrane oxygenation (ECMO) and cardiopulmonary bypass are advanced medical procedures that circulate the patient’s blood through an external warming device before returning it to the body, providing rapid and controlled rewarming. In summary, hypothermic resuscitation is a life-saving procedure that requires a methodical and patient-specific approach. The success of this intervention depends on the timely and appropriate application of rewarming techniques and the vigilant management of potential complications. Healthcare professionals’ expertise and prompt action are pivotal in ensuring the best outcomes for patients suffering from hypothermia.