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Tidsskr. Nor. Laegeforen. · Jun 2000
Comparative Study[Rewarming of patients with accidental hypothermia with the help of heart-lung machine].
- K Farbrot, P Husby, K S Andersen, K Grong, M Farstad, and M E Koller.
- Kirurgisk institutt/Universitetet i Bergen.
- Tidsskr. Nor. Laegeforen. 2000 Jun 20;120(16):1854-7.
BackgroundDifferent techniques have been used for treatment of victims with accidental hypothermia. We have used cardiopulmonary bypass (CPB) for rewarming hypothermic patients with circulatory failure or cardiac arrest. This report summarises our experiences with this patient group.Material And Methods23 patients, submersions (n = 15), avalanche (n = 1) and primary hypothermia (immersion/air cooling) (n = 7), were rewarmed using extracorporeal circulation with standard equipment for open-heart surgery.ResultsOn a clinical basis, two patient populations could be identified; one group for whom asphyxia was probably present prior to and during cooling, and another group for whom asphyxia was unlikely. In the first group, one of 13 patients survived compared to the latter group where six out of ten survived. A search for laboratory and other variables that with certainty could contribute to the prediction of prognosis was unsuccessful.InterpretationDue to lack of safe prognostic predictors, all accidental hypothermic victims with circulatory failure should be rewarmed by cardiopulmonary bypass before further therapeutic decisions are made.
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