Anna Jarosz1, Sylweriusz Kosiński2, Tomasz Darocha3, Peter Paal4, Robert Gałązkowski5, Hubert Hymczak6, Rafał Drwiła6. 1. Department of Anaesthesiology and Intensive Care, John Paul II Hospital, Collegium Medicum, Jagiellonian University, Krakow, Poland. Electronic address: Anna-jarosz@hotmail.com. 2. Department of Anaesthesiology and Intensive Care, Pulmonary Hospital and; Tatra Mountains Rescue Service, Zakopane, Poland. 3. Department of Anaesthesiology and Intensive Care, John Paul II Hospital, Collegium Medicum, Jagiellonian University, Krakow, Poland; Polish Medical Air Rescue and. 4. Department of Anaesthesiology and Critical Care Medicine, University Hospital Innsbruck, Innsbruck, Austria; Barts Heart Centre, St. Bartholomew's Hospital, Barts Health NHS Trust, Queen Mary University of London, London, United Kingdom; International Commission for Mountain Emergency Medicine (ICAR MEDCOM). 5. Polish Medical Air Rescue and; Department of Emergency Medicine, Medical University of Warsaw, Warsaw, Poland. 6. Department of Anaesthesiology and Intensive Care, John Paul II Hospital, Collegium Medicum, Jagiellonian University, Krakow, Poland.
Abstract
OBJECTIVES: When establishing the Severe Hypothermia Treatment Centre, certain problems and pitfalls regarding the qualification for extracorporeal rewarming were encountered. The authors shared their experience and opened a discussion with other centers that deal with severe, accidental hypothermia. DESIGN: Retrospective analysis of medical records of all patients examined by the hypothermia coordinator. SETTING: Patients consulted and treated by the Severe Hypothermia Treatment Centre. PARTICIPANTS: Patients who underwent accidental hypothermia. INTERVENTIONS: From July 2013 until January 2016, hypothermia coordinators at the Severe Hypothermia Treatment Centre examined the cases of 152 hypothermic patients. Of those cases, 127 patients were subjected to noninvasive rewarming in referral hospitals and 25 were accepted to the center for extracorporeal rewarming. MEASUREMENTS AND MAIN RESULTS: Difficulties that deferred or delayed the implementation of extracorporeal membrane oxygen rewarming were identified and addressed, including low platelet/red blood count, intraperitoneal fluid of unknown origin, abnormal results of head computed tomography, extremes of age, bleeding from the external auditory meatus, inaccuracy of infrared-based thermometers, iatrogenic trauma to the femoral vessels, chronic/terminal comorbidities, poisonings, pregnancy, hypoglycemia, hemodynamic stability despite severe hypothermia, and decontamination protocol. CONCLUSIONS: The problems discussed may delay the use of extracorporeal membrane oxygen rewarming in hypothermic patients but should not discourage medical teams from the implementation of extracorporeal rewarming. The prognosis for severe hypothermia is favorable, even with a long resuscitation time and low core temperatures. Copyright Â
OBJECTIVES: When establishing the Severe Hypothermia Treatment Centre, certain problems and pitfalls regarding the qualification for extracorporeal rewarming were encountered. The authors shared their experience and opened a discussion with other centers that deal with severe, accidental hypothermia. DESIGN: Retrospective analysis of medical records of all patients examined by the hypothermia coordinator. SETTING:Patients consulted and treated by the Severe Hypothermia Treatment Centre. PARTICIPANTS: Patients who underwent accidental hypothermia. INTERVENTIONS: From July 2013 until January 2016, hypothermia coordinators at the Severe Hypothermia Treatment Centre examined the cases of 152 hypothermicpatients. Of those cases, 127 patients were subjected to noninvasive rewarming in referral hospitals and 25 were accepted to the center for extracorporeal rewarming. MEASUREMENTS AND MAIN RESULTS: Difficulties that deferred or delayed the implementation of extracorporeal membrane oxygen rewarming were identified and addressed, including low platelet/red blood count, intraperitoneal fluid of unknown origin, abnormal results of head computed tomography, extremes of age, bleeding from the external auditory meatus, inaccuracy of infrared-based thermometers, iatrogenic trauma to the femoral vessels, chronic/terminal comorbidities, poisonings, pregnancy, hypoglycemia, hemodynamic stability despite severe hypothermia, and decontamination protocol. CONCLUSIONS: The problems discussed may delay the use of extracorporeal membrane oxygen rewarming in hypothermicpatients but should not discourage medical teams from the implementation of extracorporeal rewarming. The prognosis for severe hypothermia is favorable, even with a long resuscitation time and low core temperatures. Copyright Â
Authors: M Pasquier; M Blancher; S Buse; B Boussat; G Debaty; M Kirsch; M de Riedmatten; P Schoettker; T Annecke; P Bouzat Journal: Scand J Trauma Resusc Emerg Med Date: 2019-12-16 Impact factor: 2.953
Authors: Peter Paal; Mathieu Pasquier; Tomasz Darocha; Raimund Lechner; Sylweriusz Kosinski; Bernd Wallner; Ken Zafren; Hermann Brugger Journal: Int J Environ Res Public Health Date: 2022-01-03 Impact factor: 3.390
Authors: Anna Jarosz; Tomasz Darocha; Sylweriusz Kosiński; Robert Gałązkowski; Piotr Mazur; Jacek Piątek; Janusz Konstanty-Kalandyk; Hubert Hymczak; Rafał Drwiła Journal: ASAIO J Date: 2017 May/Jun Impact factor: 2.872