• Anna Jarosz, Sylweriusz Kosiński, Tomasz Darocha, Peter Paal, Robert Gałązkowski, Hubert Hymczak, and Rafał Drwiła.
• Department of Anaesthesiology and Intensive Care, John Paul II Hospital, Collegium Medicum, Jagiellonian University, Krakow, Poland. Electronic address: Anna-jarosz@hotmail.com.
• J. Cardiothorac. Vasc. Anesth. 2016 Dec 1; 30 (6): 1693-1697.

ObjectivesWhen 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.DesignRetrospective analysis of medical records of all patients examined by the hypothermia coordinator.SettingPatients consulted and treated by the Severe Hypothermia Treatment Centre.ParticipantsPatients who underwent accidental hypothermia.InterventionsFrom 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 ResultsDifficulties 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.ConclusionsThe 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 © 2016 Elsevier Inc. All rights reserved.

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