• Pablo Cruces, Camila Cores, Daniel Casanova, Federico Pizarro, and Franco Díaz.
• Unidad de Paciente Crítico Pediátrico, Hospital El Carmen de Maipú, Chile; Centro de Investigación de Medicina Veterinaria, Escuela de Medicina Veterinaria, Facultad de Ciencias de la Vida, Universidad Andres Bello, Chile; Red Colaborativa Pediátrica de Latinoamérica (LARed Network), Chile.. Electronic address: pcrucesr@gmail.com.
• J Crit Care. 2021 Jun 1; 63: 260263260-263.

BackgroundCOVID-19 is a disease associated with an intense systemic inflammation that could induce severe acute respiratory distress syndrome (ARDS), with life-threatening hypoxia and hypercapnia. We present a case where mild therapeutic hypothermia was associated with improved gas exchange, facing other therapies' unavailability due to the pandemic.Case ReportA healthy 38-year-old male admitted for COVID-19 pneumonia developed extreme hypoxia (PaO2/FiO2 ratio 42 mmHg), respiratory acidosis, and hyperthermia, refractory to usual treatment (mechanical ventilation, neuromuscular blockade, and prone position), and advanced therapies were not available. Mild therapeutic hypothermia management (target 33-34 °C) was maintained for five days, with progressive gas exchange improvement, which allowed his recovery over the following weeks. He was discharged home after 68 days without significant ICU associated morbidity.ConclusionsMild hypothermia is a widely available therapy, that given some specific characteristics of COVID-19, may be explored as adjunctive therapy for life-threatening ARDS, especially during a shortage of other rescue therapies.Copyright © 2021 Elsevier Inc. All rights reserved.

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