• Andrew W Kirkpatrick, Naisan Garraway, David Ross Brown, David Nash, Alexander Ng, Bernard Lawless, Johan Cunningham, Rosaleen Chun, and Richard K Simons.
• Department of Critical Care Medicine and Surgery, Foothills Medical Centre, Calgary, Alberta, Canada. andrew.kirkpatrick@calgaryhealthregion.org
• J Trauma. 2003 Sep 1; 55 (3): 407-12.

BackgroundStandard rewarming methods for posttraumatic hypothermia are ineffective or require systemic heparinization. Centrifugal vortex blood pumps (CVBPs), heparin-bonded circuits, and, potentially, percutaneous access techniques, facilitate the institution of an extracorporeal circulation by noncardiac surgeons.MethodsSeven severely hypothermic patients requiring emergent operative intervention were rewarmed intraoperatively using the CVBP with heparin-bonded circuitry.ResultsPatients were critically ill (average Injury Severity Score of 43.5 [SD, 13.6] for the traumatized patients). The mean temperature before rewarming was 31.5 degrees C (SD, 1.6 degrees C). The CVBP outflow site was the common femoral vein in all patients, with the inflow into the superficial femoral artery (n = 2), contralateral common femoral vein (n = 2), and internal jugular vein (n = 3). The mean time to rewarm to 37 degrees C was 73.3 (SD, 30.5) minutes. All patients survived the initial operation, although the ultimate survival was 43%.ConclusionNoncardiac surgeons can effectively use an extracorporeal rewarming strategy incorporating a heparin-bonded CVBP to rapidly rewarm hypothermic coagulopathic patients undergoing surgery.

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